Male Infertility

Male infertility is any condition in which the man adversely affects the chances of initiating a pregnancy with his female partner. Most commonly, these problems arise when the man is unable to produce or deliver fully-functioning sperm.

Male infertility is a significant factor in about 40% of couples who have infertility problems.

 

Causes

Common factors in male infertility are:

  • Sperm disorders. Sperm may be underdeveloped, abnormally shaped or unable to move properly. They may also be produced in abnormally low numbers or seemingly not at all. (Sperm disorders are the most common problems of male infertility.)
  • Varicoceles. Dilated scrotal veins that impair sperm development by preventing proper drainage of blood.
  • Retrograde ejaculation. Occurs when semen pushes backwards into the bladder instead of out of the penis due to a failure of nerves and muscles in the bladder neck.
  • Immunologic infertility. Antibodies attack sperm and prevent their normal movement and functioning. The causes for this may include testicular trauma, testicular infection, large varicoceles or testicular surgery.
  • Obstruction. Repeated infections, prior surgery, inflammation or development problems can cause obstructions that block sperm from its normal passage.
  • Hormones. Low levels of hormones produced by the pituitary glands can cause poor sperm development.
  • Genetics.
  • Certain medications.

 

Diagnosis

A complete history and physical exam is typically followed by:

  • Blood work
  • Semen analysis. Used to assess factors such as volume, count, concentration, movement, and structure of spermatozoa, that help or hinder conception.

Other tests may include:

  • Transrectal ultrasound. Used to determine if your ejaculatory ducts are either poorly developed or obstructed with cysts, calcifications or other blockages.
  • Testicular biopsy. Used when semen analysis shows low or no sperm to determine the cause of infertility.
  • Hormonal profiles. Used to discover the sperm-producing ability of your testicles and to rule out serious conditions.
  • Genetic testing. Used to identify specific obstacles to fertility and problems with sperm.