Deciding to start a family is an exciting choice for any couple. Still, many couples find that getting pregnant isn’t as simple as they hoped. Infertility affects one in seven couples. Figuring out what causes infertility is a challenge both partners face.
Female infertility is not the only reason that couples can’t conceive a baby. Male infertility is also a significant factor in infertility for couples. There are treatments for some types of male infertility and lifestyle changes that may improve your chances of conceiving.
What is male infertility?
Infertility is the term doctors use when a heterosexual couple can’t conceive a baby through intercourse. If you have been having regular, unprotected sexual intercourse for 6-12 months and can’t conceive, your doctor will diagnose infertility. The root cause of infertility isn’t always immediately apparent. Both partners will need testing to understand why they can’t conceive.
About 30% of infertility situations are due to male infertility. Male infertility means that the man’s reproductive tract isn’t working correctly. There is a problem preventing sperm from connecting with your partner’s egg.
Causes of male infertility
To get your partner pregnant, you need to be able to get an erection and ejaculate sperm into her womb. In addition, the sperm needs to be healthy enough to move through her body to reach the egg awaiting fertilization. Infertility means you have difficulty with one of those functions.
Typically, testicles produce millions of sperm every day. These single cells contain half of the genetic code for making a baby. The sperm have an oval-shaped head and a long tail which can propel them toward the egg inside your partner’s body.
In some cases, people don’t produce enough sperm to fertilize an egg successfully. The sperm could also be unable to move, abnormally shaped, or not mature enough to travel from testicles to the uterus. There are several reasons that you might have sperm disorders, such as:
- Infections or illnesses that damaged your ability to make sperm
- Hormone or pituitary gland problems
- Immune disorders that cause your body to attack your sperm
- Lifestyle factors such as tobacco use, heavy alcohol consumption, drug use, or exposure to certain toxins
- Underlying health conditions
Some conditions physically restrict the movement of sperm. Swelling or scarring inside the testicles can block the vessels sperm travel through to leave the body. Sexually transmitted infections can lead to this type of problem. Swollen veins inside the testicle can prevent normal semen flow. This condition is called varicocele.
Scarring or other physical damage from past injuries or surgery can be a factor in infertility as well. Overheating testicles limits sperm production in some people. Repeated impact to the testicles can damage them and reduce sperm production.
Erectile and ejaculation issues
Both erectile and ejaculation dysfunction can lead to fertility problems. A penis needs to be able to become and stay erect to ejaculate sperm. Inability to maintain an erection limits fertility.
Some people don't ejaculate outward. Instead, the semen circles back into the bladder and never leaves the body. This is called retrograde ejaculation. It can be caused by conditions such as diabetes, some physical disabilities, and certain medications.
Infertility may be linked to other health conditions you have. People with a history of liver or kidney disease may have fertility issues as well. Treatment for seizure disorders can affect fertility.
Treatment for male infertility
Treatment for male infertility depends on the cause of infertility. Your doctor will do tests to figure out why you are infertile. You may have to produce a sperm sample so your doctor can see how many there are and how well they move. You may also need blood tests to check your hormone levels. Imaging tests can give your doctor a look inside your testicles to identify any blockages.
You can decrease your risk of infertility by making lifestyle changes. Maintaining a healthy weight, wearing cool, loose-fitting clothing around your testicles, and avoiding tobacco and recreational drugs can improve overall sexual function.
Some medications can address erectile dysfunction. If you have problems ejaculating, there are medications that can help. Hormone treatment can address some types of infertility. If you have infertility caused by inflammation, anti-inflammatory medications may bring the swelling down and allow sperm to move more freely.
A doctor can repair some physical issues with surgery. If you have a varicocele blockage of the vessels in your testicles, your doctor may be able to clear it with a simple procedure performed in their office. A medical procedure might help with retrograde ejaculation that doesn't improve with medication. Your doctor will have you come to the office and bring yourself to orgasm. After that, they can use a catheter to collect sperm from your bladder.
If you are not producing many or good-quality sperm, your doctor may suggest using assisted reproductive technology (ART). You can collect sperm in a sterile cup, and your doctor can select healthy ones and do either intrauterine insemination (IUI) or in vitro fertilization (IVF).
If you don’t have a treatable form of infertility, you and your partner can consider other options for starting a family. You can look into using donor sperm to initiate a pregnancy. You may also want to consider adoption or becoming foster parents to children in need.
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Eunice Kennedy Shriver National Institute of Child Health and Human Development: "What treatment options are available for male infertility?"
Johns Hopkins Medicine: "Male Infertility."
Urology Care Foundation: "Male Infertility."
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