Male Infertility: Are You Informed?
Background
Infertility affects 15% of couples attempting to achieve pregnancy. In 30% of cases, the male is the primary cause of the couple’s infertility, and in an additional 20% of cases, he is a contributing factor. Initial screening of the male should be done when no pregnancy has occurred within 1 year of unprotected intercourse, a known male infertility risk exists, a known female factor exists, or a man questions his fertility potential. Studies have shown that the best chance for a couple to achieve pregnancy is when both members of the partnership are evaluated simultaneously. For the male, that means a thorough history and physical and at least one screening semen analysis. Depending on the results of theses exams, other tests may be indicated.
Who to See
Men are often reluctant to come in for evaluation. Initial screening of the male can be done quickly and in a cost effective manner by a physician trained in male infertility, usually a Urologist or Andrologist. Specialized treatment, including microsurgery, should be done by a Urologist with advanced training in microsurgical techniques and treatment of the infertile male.
Causes of Male Infertility
Male infertility may be caused by a number of conditions. Some are reversible and some are not reversible but may still be treated using assisted reproductive technologies (ART) utilizing the available sperm from the male. Common conditions that may cause male infertility include varicoceles (varicose veins of the testes), endocrine abnormalities, semen volume problems, infections, testicular damage, and genetic abnormalities.
Recent Advances
Much progress has been made in the past 10 years in the identification and treatment of male factor infertility. Genetic testing can often identify potential causes of male factor infertility and allow assessment of risk of transmission to offspring. Microsurgical techniques are used to repair varicoceles, extract sperm from the testes, and repair obstructed tubes in the van deferens or epididymis (a system of ductules emerging posteriorly from the testis that holds sperm during maturation). In addition, assisted reproductive technologies allow the fertilization of a single ovum with a single sperm.
Lifestyle Suggestions
Not all male factor infertility requires medication, surgery, or ART. Lifestyle may adversely affect a man’s fertility. Hot tubs, tobacco, recreational drugs, excessive alcohol, and high stress have all been implicated in decreasing male fertility potential and should be reduced or eliminated. A working knowledge of the female ovulation cycle and timing of intercourse are also of great benefit. A careful review of all prescription and over-the-counter drugs, including herbal therapies, must be performed since many of these treatments may additionally be harmful to sperm.
A Division of:
