Understanding Infertility - Male Factor
When dealing with infertility it is important to remember that Infertility is not just a woman's problem; 40% of the time it is a male factor, 40% it is a female factor, and 20% of the time it is both. There are many reasons why a man may have fertility problems. Fortunately, once diagnosed, some of these causes may be treatable.
Sperm disorders and Male Infertility
A major cause of male infertility is a sperm disorder. Of the millions of sperm normally deposited into the vagina, only a few hundred will get close to the egg and have a chance to fertilize it. Many factors play a role in determining whether or not the sperm will succeed:
- Sperm count (total number of sperm in a sample)
- Sperm concentration (number of sperm per milliliter of semen)Volume of semen the man produces
- Sperm motility (number of sperm with the ability to move)
- Forward progression (quality of movement)
- Sperm shape
A deficiency in any of these factors may cause infertility in men. Although sperm count is important, sperm motility and forward progression appear to be even more crucial in determining the likelihood of whether or not the sperm will succeed in fertilizing the egg. Despite a low sperm count, many men with high-quality sperm may still be fertile.
As a result of these many male infertility factors, it is important to perform semen analysis early on in the attempt to determine the reasons for infertility. Two to three analyses should be performed over a period of two to six months since sperm quality can change over time. These tests will help give doctors a broader overview of any infertility issues related to the man's sperm.
What causes male infertility sperm disorders? A variety of issues including:
- Age. Generally, a man's fertility starts declining at around the age of 35 as the quality of a man's sperm diminishes. In addition, sperm motility can also decline with age.
- Immune disorders. Problems with the immune system can cause a man's body to treat sperm as if it were a foreign matter. As a result, the immune system may produce antibodies to fight and destroy the sperm.
- Cancer treatments. Depending upon the location of the treatment and the drug and dosage used, chemotherapy and radiation may contribute to male infertility.
- Sexually transmitted diseases (STDs). STDs may damage the parts of the body that transport sperm through the reproductive tract.
- Testosterone, Androgel, and other male hormone substitutes. Used in lieu of antidepressants or as performance-enhancing additives, they increase testosterone levels, but may also be responsible for halting sperm production.
- Other factors. Lifestyle and environmental factors may lead to issues with a man's sperm.
Anatomical issues and Male Infertility
A variety of possible anatomical problems can influence fertility:
- Scrotal varicocele. Varicocele is one of the most commonly identifiable causes of male infertility. Varicocele is a varicose vein around a testicle that may hinder sperm production, movement and shape by raising the testicle's temperature.Scrotal varicoceles are found in about 15% of males and in approximately 40% of infertile men, most often on the left side or simultaneously on both sides.
- Retrograde ejaculation. Retrograde ejaculation involves the ejaculate flowing backward into the bladder instead of leaving the penis.
- Undescended testis. An undescended testicle is one that has failed to complete its passage from within the abdomen to reach its normal position in the scrotum. This condition is present in about 3% of newborns, with fewer than 1% needing treatment. Testicles that don't descend into the scrotum are not likely to function -normally. Because they may not make sperm, they can cause fertility difficulties.
- Erectile dys-function. Erectile dysfunction is the inability to get or maintain an erection. An erection is essential for ejaculation.
Some of these diagnoses are reversible or treatable. For those that are not able to conceive on their own, patients may have success through intrauterine inseminations (IUI). If pregnancy is not achieved through IUI, the other option would be to conceive through IVF, possibly with ICSI. If you have more questions about Male Factor Infertility or would like a Semen Analysis, please call our fertility clinic 904-260-0352 to schedule an appointment. Our cost for Semen Analysis is $125.00 and it is often covered by insurance.