Informing Couples About Male Infertility

A dream of many couples is to start or grow a family, but getting pregnant is sometimes challenging. Infertility is a common diagnosis, impacting 15% of couples attempting pregnancy. Of those couples, 50% can be traced to male infertility. Couples struggling to conceive should consider screening to uncover any underlying causes. Understanding male infertility, in particular, helps couples navigate diagnosis and treatment, potentially preparing for in vitro fertilization (IVF) or other forms of support. For men, infertility typically involves issues with sperm production, function, or delivery that prevent successful fertilization. Testing and finding the possible factors involved can save couples time, and expense, and increase the chances of pregnancy later.

Sperm production challenges

Testing is the biggest factor couples must consider at the beginning of the fertility journey. With male factor infertility, sperm production, or a lack thereof, is the most common cause. Low sperm count, called oligospermia, reduces the chances of a natural conception. When a sperm sample is analyzed, a low sperm count is defined as less than 15 million sperm per milliliter (ml) of semen. Some men have a complete absence of sperm, a more severe case called azoospermia. Besides adequate sperm production, sperm quality is another key factor. Poor movement, called motility, limits the ability of sperm to reach the egg. Sperm shape or morphology reduces the chances of sperm penetrating the egg for fertilization. These infertility markers can be found via close analysis of sperm samples under a microscope.

Structural and delivery issues

Physical tests, ultrasounds, and scans play a significant role in diagnosis. Men can have structural issues that prevent the delivery of sperm, despite healthy production. These scans can reveal varicocele, obstructions in the epididymis, vas deferens, or ejaculatory ducts. These issues prevent sperm from entering the ejaculate. Some tests reveal ejaculatory dysfunction, including retrograde ejaculation, which diverts sperm into the bladder instead of outward. Some of these abnormalities are genetic and may need advanced imaging or even surgical evaluation beyond basic analysis.

Lifestyle plays a role

Couples should also understand that there are external factors that impact male fertility. Exposure to certain toxins and daily habits slowly damages sperm and impacts reproductive health. Some men are exposed to heavy metals, toxins, radiation, and pesticides in certain professions. Smoking, excess drug use, and even alcohol consumption also degrade sperm health. Even high body temperature from frequent hot tub use, laptop placement, or tight-fitting underwear may impact fertility. Studies show high stress increases inflammation, reduces testosterone, and can reduce male fertility. Taking a closer look at the many factors that may affect fertility can be instrumental in treatment.

Check all the boxes

A holistic approach is required to find the true underlying reasons and to create a custom treatment plan. The first steps involve semen and hormone analysis. Physical exams will identify possible abnormalities. The fertility team can also look deeper, doing genetic analysis and deoxyribonucleic acid (DNA) fragmentation analysis of sperm. While searching for answers internally, doctors and couples will find the external factors impacting fertility. Assessing lifestyle, daily habits, exposure to toxins, and stress can help provide a complete picture. This assessment helps with a more effective treatment plan. Male fertility can benefit from hormone therapy, lifestyle changes, or surgery as needed. Most cases, however, can benefit from IVF or intracytoplasmic sperm injection (ICSI), an advanced strategy.

Success is around the corner

For couples hoping to get pregnant with male infertility, there is hope. The objective is to find all the possible factors affecting fertility. There can be sperm production issues, hormonal challenges, genetic issues, and lifestyle habits that impact fertility. Sometimes, a combination of issues may be at play. Consider getting medical support as soon as possible. Younger patients are more likely to achieve successful fertility outcomes. The fertility team can keep patients informed, create a custom plan, and help with achieving pregnancy.