Infertility is defined as the inability to conceive after one year
of unprotected sexual intercourse. It affects approximately 15-20%
of all couples. Most couples generally are able to conceive during a
twelve-month period without contraception. Male infertility factors
account for about 50% of all cases (male cause only 30%, and
male/female cause 20%). For the most part, male infertility is due
to a problem with the sperm itself such as a low sperm count, poor
motility (non-active or slow moving sperm), or abnormally shaped
sperm. Environmental factors include overheating testicles with
excessive exercise or tight underwear (holds testicles close to warm
body) and toxic exposure to chemicals or radiation. Systemic
diseases such as diabetes, bacterial infections, mumps, cancer and
sexually transmitted diseases; side effects from certain
medications; drug and alcohol abuse; smoking; trauma (surgery or
injuries); psychological disorders (depression, anxiety); impotence;
and intercourse problems (premature ejaculation, infrequent sexual
activity) may contribute to male infertility. Finally, hormonal
disorders; chromosomal (gene) abnormalities; cryptorchidism (undescended
testes); immunological disorders (produce antibodies against sperm);
and a varicocele (inflammation of spermatic cord veins) have also
been known to cause male infertility.
Symptoms may include:
• Inability to produce a pregnancy after one year of
unprotected sexual intercourse.
WHAT YOUR DOCTOR CAN DO:
• Diagnose the disease by asking about your symptoms, doing a
physical exam, and ordering a semen analysis and urinalysis.
• Order laboratory tests to evaluate hormone levels and function,
gene studies, sperm antibody production (body mistakenly produces
immunity against sperm), or infectious conditions
• Order a post-coital test to evaluate the compatibility of sperm
and cervical mucus.
• Order non-invasive tests such as a Doppler study (venous blood
circulation) or ultrasound to examine testes and spermatic cord.
• Rule out other diseases or conditions such as psychological
disorders or female infertility.
• Review and adjustment of current medications and/or dosages
• Antibiotics for bacterial infections, steroids to correct hormonal
imbalances, or hormone replacement therapy
• Surgery to remove cancer or repair abnormalities such as
varicoceles, structural abnormalities or obstructions
• Artificial insemination or in vitro insemination with husband or
• Sperm washing to limit auto-immune factors (removal of antibodies
followed by some form of insemination)
• Intracytoplasmic Sperm Injection (ICSI) - Injecting a single sperm
into an egg with a small pipette
• Testicular Sperm Aspiration - Biopsy (removal) of a small amount
of testicular tissue with sperm cells followed by ICSI.
• Counseling or psychological assistance with sexual dysfunction,
relationships, and abuse problems.
WHAT YOU CAN DO:
• See your doctor or a urologist who specializes in fertility.
• Wear loose fitting boxer shorts instead of tight, restrictive
• Avoid hot tubs, prolonged hot showers and extended bicycle rides.
• Familiarize yourself with your partner's ovulatory cycle; have
sexual relations during her most fertile period. Do not ejaculate
for 3 days before these relations.
• Avoid or limit alcohol use.
• Stop smoking. Ask your doctor if you need help.
• Do not use lubricants because they tend to slow down sperm
motility and some may contain spermicidal agents.
• Take all medications as directed by your doctor.
• Exercise with moderation.
WHAT YOU CAN EXPECT:
• A large percentage of male infertility cases are not serious, and
for the most part treatable.
• Some complications may include psychological distress (low
self-esteem, anxiety and guilt), worsening of conditions that led to
infertility, and permanent infertility.
CALL 1061 OR SEEK IMMEDIATE MEDICAL
ASSISTANCE If you and your partner are unable to conceive
after 1 year of unprotected sexual intercourse, if you started
treatment and are unable to conceive after 6 months of treatment, or
if you experience side effects from the medications or treatments
and if after surgery, you develop signs of infection (pus,
inflammation, fever, and increased pain), or uncontrolled bleeding.