Male infertility, more specifically referred to as male factor infertility, is an umbrella term for a number of conditions that may affect men and prevent them from successfully conceiving a child with their partner. There are a number of conditions and contributing factors that can lead to male infertility. Some can be easily treated with simple procedures, and others may require more advanced intervention.
Infertility is not an exclusively female problem, nor is it an exclusively male problem. In 35% of couples who have difficulties, both a male and female factor are the cause. In 8% of infertility cases, male factor is the only identifiable issue.
Types of Male Infertility
There are many things that can contribute to male factor infertility, but these factors fall under four major categories: structural abnormalities, ejaculatory disorders, sperm production disorders, and immunologic disorders.
- Structural Abnormalities: There may be issues with the reproductive tract that can limit or completely block the flow of seminal fluid, which contains the sperm necessary for conception. These structural problems can be congenital (meaning they were present from birth), or the result of infection, trauma, or prior surgery.
- Ejaculatory Disorders: There may be issues with the process of ejaculation, making it difficult or even impossible for the sperm to reach the female during intercourse.
- Sperm Production Disorders: This type of male factor infertility is present when there is something inhibiting the production of sperm. These problems can include a condition called varicocele, having a vasectomy, or another medical condition that limits the body’s ability to produce sperm.
- Immunologic Disorders: An immunological disorder is a condition that may prevent the sperm from meeting and penetrating the egg in the female. These disorders can include the presence of anti-sperm antibodies or endocrine disorders.
Causes of Male Factor Infertility
There are a variety of causes for each type of male factor infertility. In some cases, a cause is unable to be determined, but the following factors may contribute to male infertility:
- Damaged reproductive organs
- lifestyle factors (drug uses, smoking, weight, stress and mental health)
- chromosome defects
- prior surgeries
- hormone imbalances
- environmental and exposure factors (overheating the testicles, radiation, heavy metal exposure, chemicals)
Diagnosing Male Infertility
Because infertility often has both male and female contributing factors, when diagnosing infertility, both partners are often examined and tested. To diagnose male infertility, your doctor will likely start off a couple of standard tests. Then, if needed, more testing can be done.
- Physical Exam with Detailed History: A general physical examination, including the genitals, and collecting information on your health history will be one of the first things done when forming a diagnosis. The history should include any chronic conditions you currently have, past illnesses, injuries, surgeries, and any inherited conditions you could potentially have.
- Semen Analysis: A semen sample is collected either by masturbation or using a special condom during intercourse, and then sent to the lab for testing. The semen will be tested to determine the number of sperm present and any abnormalities in the way the sperm move (motility) or in their physical structure (morphology).
- Additional Testing: If the physical exam and semen analysis are not conclusive or provide results that require further testing, your doctor may recommend one or more of the following tests:
- Scrotal ultrasound
- Hormone testing
- Genetic testing
- Testicular biopsy
- Post-ejaculation urinalysis
- Transrectal ultrasound
- More specialized sperm function testing
Treatments for Male Infertility
Depending on what causes the male factor infertility, there are a variety of treatments that can be helpful and increase the probability of conception.
- Assisted reproductive technology (ART) may include obtaining sperm through normal ejaculation, surgical extraction, depending on the cause of infertility. The sperm is then used in a procedure like intrauterine insemination (IUI) or in vitro fertilization (IVF).
- Surgery to correct structural abnormalities or ejaculatory disorders.
- Hormone treatments to correct imbalances.
- Treatments for sexual issues like premature ejaculation or erectile dysfunction.
- Treating any infections present in the reproductive tract.
For More Information
The diagnosis and treatment of male infertility often involves a multi-subspeciality team of providers that may include your primary care physician, urologist and reproductive endocrinologist.