Overview
Male infertility is a condition in which problems like reduced sperm production, abnormal sperm function, or blockages to sperm delivery result in the inability to conceive. Many couples struggle to conceive, and infertility is generally defined as having been unable to conceive after a year or more of regular unprotected sexual intercourse. While it can be sometimes difficult to determine, it appears that male infertility is a factor in around half of these cases.
There are numerous potential causes for male infertility. Inadequate sperm production can be the result of testicular dysfunction or low testosterone. There can also be problems with the tubes that transport sperm from the testicles. The sperm themselves can have issues with motility that prevent them from penetrating the egg.
These mechanisms can be affected by infection, tumors, antibodies, hormone imbalance, medications, prior surgeries, and more. Every case of male infertility is unique, and treatments are varied.
Symptoms
Being unable to conceive a child is the primary symptom of male infertility. There can be other symptoms that may indicate infertility or conditions that cause it, including:
- Difficulty ejaculating or small ejaculate volume
- Erectile dysfunction
- Abnormal swelling or lumps on the testicles
- Reduced sperm count
- Difficulty getting pregnant for one year or longer
Diagnosis
In many cases, couples unable to conceive can have more than one underlying cause. As such, both partners will likely have to consult a physician. Many tests can identify the underlying cause, but it is not uncommon for no conclusive answer to be determined.
A physician may determine likely causes through family history and medical history, including past procedures and injuries. A semen analysis is a standard test that can determine the sperm count and check for any abnormalities in the shape and function of the sperm. Due to regular fluctuations, more than one test may be required.
Further tests can include a scrotal ultrasound to identify problems with the testicles or a transrectal ultrasound to check the prostate and the tubes that carry semen from the testicles. There are also a variety of hormone tests that can identify any abnormalities.
Treatment
The exact cause of male infertility isn’t always possible to determine. There are many measures that a physician can recommend to increase male fertility and the chance of conception.
Surgery
In some cases where blockages like varicoceles or obstructions cause male infertility to the vas deferens, minor surgery can correct the issue and allow for higher sperm counts.
Hormone Treatments
The complex interplay of hormones can affect male fertility. In some cases, hormone treatments to increase or reduce levels of specific hormones can increase fertility.
Treatments for Sexual Dysfunctions
Sometimes the cause of male infertility is a sexual dysfunction like premature ejaculation or erectile dysfunction. Psychological factors often cause these, and counseling could be an effective treatment.
Assisted Reproductive Technology
There are several methods for conceiving when treatment is unable to produce results during regular sexual intercourse. When viable, sperm can be retrieved surgically and inserted into the female genital tract or used for in vitro fertilization.
Procedure
Depending on the underlying cause of the infertility, a variety of procedures or fertility options may be recommended.