Male infertility, sometimes called male-factor infertility, is diagnosed when a man is unable to impregnate a fertile woman after a year of regular, unprotected sexual intercourse. In couples experiencing difficulty conceiving, the issue can arise from either partner or both. At the Reproductive Center of New Jersey (RSCNJ), we can help identify the cause of infertility, whether due to the male or female partner, and create a customized fertility treatment plan to best address it.
How common is male infertility?
Many people commonly believe that infertility in couples is primarily caused by female issues, but this is not the case. The American Society for Reproductive Medicine states that around half of all infertility cases involve a male infertility factor. Male infertility is solely responsible for 20-30% of infertility cases and contributes to another 20-30% of cases alongside female factors.
Normal male reproduction
Men produce sperm in their testicles, and it is stored and transported in a system controlled by hormones. During ejaculation, the sperm mixes with seminal fluids to form semen, which leaves the body through the penis. If the semen contains enough sperm of adequate quality, one of those sperm can then fertilize a female egg that may be present in the woman’s fallopian tubes, resulting in pregnancy.
Conditions must be just right, including hormone levels, genes, and environmental conditions, for a man to impregnate a woman. When something goes wrong with any of the male reproductive system functions, male infertility may occur.
Causes of male infertility
There are various causes of male infertility, including problems with sperm production, as well as age and other lifestyle factors. In some cases, doctors may be unable to determine the cause of infertility.
Sperm production
Male infertility, sometimes called male-factor infertility, most often occurs due to problems with sperm production. A normal ejaculation contains roughly 20 million – 300 million sperm. For a sperm to be viable, it must have the right structure and shape (morphology) as well as good movement (motility).
Sperm Basics and Male Infertility
Age and lifestyle factors
Men can develop infertility issues due to excessive drug and alcohol use. A man’s age may also result in infertility, or at least a decline in fertility. Time and lifestyle have an impact on the reproductive parts that manufacture new sperm cells. As a result, more sperm become impaired from a DNA perspective, putting a pregnancy at greater risk for miscarriage and increased health risks for any resulting children.
Testosterone therapy, which some men undertake to improve their sex drive, can also result in male infertility. Men who wish to be fathers and are considering testosterone therapy should discuss it with their physician first.
Healthy habits to boost fertility
If you’re experiencing male factor infertility, there are steps you can tack to increase your chances of pregnancy success, such as:
Maintaining a healthy diet
The cells in a man’s body can’t properly function if it lacks nutrients. Therefore, it is important for men to maintain well-balanced diets to ensure their bodies have the nutrients necessary to function properly, which assists in the production of healthy sperm.
Avoiding alcohol and drug abuse
Aside from contributing to overall poor health, drugs, steroids, and alcohol can lower the number and quality of a man’s sperm. Steroids specifically can cause testicles to shrink, decreasing sperm production.
Controlling weight
Men who are overweight may struggle to produce sperm. Obesity can also lead to a decreased sex drive. It is important for men to maintain a healthy weight in comparison to their height (BMI).
Not using tobacco
Tobacco is proven to decrease sperm production, in addition to causing a number of other overall health concerns.
Avoiding stress
Prolonged stress can interfere with the hormones needed to produce sperm. Sometimes, infertility itself can lead to stress, so it is important for men to find a healthy release during the time in which they are trying to conceive. Yoga, meditation, and exercise are great ways to relieve day-to-day anxiety.
Reducing environmental exposure
Certain chemicals can create female hormone-like effects in the male body, which can lead to reduced sperm production. Pesticides, herbicides, insecticides, and other chemicals may also affect the sperm’s ability to bind to an egg during fertilization.
Avoiding activities that cause increased scrotal temperature
In order for sperm to mature, they must be a couple of degrees below normal body temperature. That’s why the testicles are in the scrotum located outside the main body. Spending excessive time in hot tubs, wearing tight underwear, holding a laptop directly on the lap, and other activities that increase scrotal temperature can decrease sperm production.
Genetic disorders & male infertility
For the most part, genetic factors relate to abnormalities in sperm quality and production. Sometimes, structural problems that cause infertility are due to genetic issues. This can include being born without a vas deferens, the tube that carries sperm to the ejaculatory duct. This congenital problem can result in azoospermia, or no sperm production.
Male chromosomal anomalies cause about 15% of cases of extreme sperm abnormalities that cause infertility. These include Klinefelter’s syndrome and chromosome translocations that break up chromosome pair functioning. Y chromosome microdeletions, in which tiny areas of a chromosome are missing, cause male sperm problems. Single-gene genetic disorders, including Kalmann syndrome and cystic fibrosis, also cause fertility issues.
More on genetic causes of infertility
Medical issues
Medical issues and lifestyle factors may not cause male infertility, but their presence can increase a man’s risk of being infertile. Medical problems resulting in male infertility include:
- Ejaculation issues, such as retrograde ejaculation (when semen goes to the bladder rather than out the penis)
- Vasectomy
- Erectile dysfunction (cannot sustain an erection through ejaculation)
- Varicocele (swollen vein that drains the testicle)
- Infection
- Tumors
- Undescended testicles
- Structural defects in some part of the system
- Previous surgeries
- Radiation treatment
- Medications
- Hormone problems
- Exposure to toxins
Correcting male infertility
Once the doctor diagnoses the cause of infertility, treatment can begin. Medications may be used to correct a hormonal imbalance or address some ejaculation problems. Surgery can correct certain structural issues, such as varicocele, and can also reverse a vasectomy. Other treatment options involve assisting sperm to get to the egg for fertilization. This can be done with artificial insemination, most likely intrauterine insemination (IUI). In vitro fertilization (IVF) may also be used, including intracytoplasmic sperm injection (ICSI). Using a sperm donor is another option to overcome male infertility.
Diagnosis and treatment of male infertility
