The male partner is either the sole or a contributing cause of infertility in approximately 40 percent of infertile couples, according to the American Society for Reproductive Medicine. For this reason, it’s important for couples struggling to conceive to understand that fertility is a team effort, and the male role is just as important as the female’s part.
Most male infertility issues are caused by a problem within the testes themselves. The first step in evaluating the male partner is the male must provide a semen sample, following the instructions of a physician. The semen is then analyzed for the amount of sperm, its movement ability, and its appearance and shape.
Generally, more than one semen sample will be analyzed over several months, and a doctor may order other tests as well. There are many causes for male infertility, but in some cases doctors cannot find obvious causes of poor sperm quality.
In those cases, intrauterine insemination (IUI), also called artificial insemination, or in vitro fertilization (IVF) may be recommended.
“Male factor” is the term used to describe the problems of the male partner in fertility. Most fertility specialists and urologists would agree on the following major causes for male infertility. The conditions below are discovered through physical exam, semen analysis, blood testing, sometimes by ultrasound or other imaging techniques.
For various hormonal or sometimes unknown reasons, some men do not produce adequate numbers of sperm. The potential causes and treatment approaches may be detected by physical exam and hormonal testing. Medication therapy may sometimes be helpful to increase the number of sperm. If there are any anatomical problems, these may be approached surgically.
About 10 percent of men who have infertility problems make sperm normally but have an obstruction in their genital tract so that none of the sperm can get from the testis into the ejaculate. Men who have had a vasectomy will sometimes seek surgical reversal.
In other cases, men may have been born with the absence of the vas deferens, the duct which conducts sperm from the testicle to the penis. This is usually associated with cystic fibrosis. Additionally, infections may have blocked the sperm ducts and a surgical approach may allow sperm to be ejaculated normally.
Men who have hormonal abnormalities may have inhibited sperm production. For sperm to be produced, the man’s hypothalamus, pituitary, and testis must have normal hormonal secretion.
Furthermore, the normal hormones must work on the testicular tissue that actually produces sperm. These can be investigated and sometimes treated with improvement of a man’s sperm production. About 10 percent of men with male infertility have problems with their hormones that lead to very low sperm counts.
Varicocele, a condition that can diminish sperm quality, shows up as dilated or varicose veins in the scrotum and may be corrected surgically.
The exposed position of the testicles makes them susceptible to injury. Sometimes injuries or surgery may interfere with the blood supply to the testicle and reduce the growth and maturation of sperm.
Boys may be born without their testicles fully descended into their scrotum. This needs to be corrected medically or surgically in early life. If this is not performed, sperm production after puberty may be deficient.
Major medical conditions such as kidney failure, liver disease, cancer, and other cardiovascular illnesses may impact sperm production.