Infertility is defined as a couple's inability to become pregnant after one year of regular, unprotected sex. Male infertility means the male is unable to impregnate the female because of male factors.
The inability to get pregnant may be caused by conditions in either partner. Although in some couples no cause is ever found, it is estimated that 30% of infertility is caused by male factors. An additional 30% is caused by female factors, while the remaining 40% is caused by a combination of female and male factors.
Male infertility may be caused by many diseases, conditions, and other factors. Situations that raise the temperature in the testicles can interfere with normal sperm production.
Male infertility occurs when the man's partner does not conceive after one year of attempting to become pregnant. Other signs and symptoms depend on the underlying cause of the man's infertility.
There are many male factors that can make a couple unable to become pregnant. These may include conditions such as the following: diabetic neuropathy, in which nerve damage causes problems with erection or ejaculationextreme obesityhormone imbalances, such as hypothyroidismhypogonadism, a condition in which the testes fail to develop normallyinherited conditions that impair the ability to produce sperm, such as Down syndrometesticular torsion, a condition in which the blood supply to the testicle is cut offundescended testicles, a condition in which the testes fail to drop into the scrotumvaricocele, a group of enlarged veins inside the scrotum
Diseases also can be a factor in infertility, for example: autoimmune disorders, which can cause the body to produce antibodies that attack spermliver diseasesickle cell anemiakidney diseasegenital infections such as gonorrhea and genital herpesinfections of the reproductive organs, such as prostatitis and epididymitisother infectious diseases, including mumps
Additional factors in infertility include the following: certain medications, such as cimetidine and phenytoincertain supplements, such as anabolic steroidschemotherapy used for cancerdiet low in folic acid or low in lycopene, which is found in plants such as tomatoesexcessive exercise, which lowers testosterone levels and decreases sperm productionexposure to diethylstilbestrol, also known as DES, as an infant in uteroexposure to toxins such as lead, mercury, or pesticidesfrequent hot baths or use of hot tubsinjury to the testicleslow sperm count, poor sperm quality, and poor movement of spermradiation therapyuse of recreational drugs, such as alcohol, methadone, and marijuanasexual problems, such as erectile dysfunction and premature ejaculationside effects of treatments for testicular cancer or prostate cancersurgery of the reproductive system, such as transurethral resection of the prostatevasectomy, a surgical procedure to tie off the sperm-carrying tubeswearing tight-fitting pants and underwearwork that requires prolonged sitting, which increases the temperature in the scrotum
A recent study has found that baby boys who wear diapers lined with plastic have significantly higher temperatures inside the testicles. The researchers suggest that disposable diapers may have contributed to the increase in male infertility over the past 25 years.
Some cases of male infertility may be avoided by doing the following: Avoiding drugs and medications known to cause fertility problems.Avoiding excessive exercise.Avoiding exposure to environmental hazards such as pesticides.Avoiding frequent hot baths or use of hot tubs.Avoiding tight underwear or pants.Eating a diet with adequate folic acid.Getting prompt treatment for sexually transmitted infections. Having regular physical examinations to detect early signs of infections or abnormalities.Keeping diseases, such as diabetes and hypothyroidism, under control.Practicing safest sex or safer sex to reduce one's risk for sexually transmitted infections.Taking a lycopene supplement.Wearing protection over the scrotum during athletic activities.
Although more research needs to be done, parents may want to consider alternatives to disposable diapers for male infants.
The diagnosis of infertility begins with a medical history and physical exam. The provider may order blood tests to look for hormone imbalances or disease. A semen sample is usually needed in order to assess the volume of semen, the number of sperm in the sample, and how well they move..
Male infertility can create tension in a couple's relationship. Sexual relations may become less pleasurable. Fertility evaluations can be expensive. Eventually, 85% of couples find a cause for their inability to conceive. However, some couples never become pregnant, even with the newest treatments. Adoption may be the best choice in some cases.
Male infertility is not contagious. However, male infertility can be caused by a sexually-transmitted infection, which may be transmitted to sexual partners.
Treatment of male infertility focuses on the underlying cause. Without treatment, 15% to 20% of infertile couples will eventually get pregnant. Treatment for a male with infertility may include: avoiding extended periods of time in hot baths and hot tubseating a healthy diet and exercising in moderationhaving a varicocele surgically repairedhaving vasectomy reversal surgery, which reconnects the tubes carrying sperm from the testeslearning about the best times to conceivemaking lifestyle changes, such as smoking cessation and limiting intake of alcoholtaking antibiotics for any diagnosed infectiontaking hormone therapytreating erectile dysfunction with counseling, medication, or surgerywearing loose-fitting underwear, such as boxer shorts
If these treatments don't work, other means of fertilization may be considered, such as: artificial insemination. This involves placing sperm directly in the cervix or uterus as a medical procedure.in vitro fertilization (IVF). This involves fertilizing the egg with sperm in a laboratory, then returning the resulting embryo to the woman's uterus as a medical procedure. intracytoplasmic sperm injection. This version of IVF involves placing the individual sperm cells directly inside the woman's eggs in the laboratory, rather than just together in the same dish.
Surgery can be complicated by bleeding, infection, or a reactions to the anesthetic. In vitro fertilization increases the chance of having a multiple pregnancy, such as twins. Antibiotics and other medications may cause stomach upset, diarrhea, or an allergic reaction.
Within a year after infertility is diagnosed, 80% to 85% of couples who have treatment get pregnant. It may take several attempts before a couple gets pregnant. Partners must decide how many and what kind of procedures they are willing to undertake.
The man can monitor his own ability to impregnate a woman. Any new or worsening symptoms should be reported to the healthcare professional.
The Merck Manual of Medical Information, Home edition, 1997
Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998.
Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000