Male Infertility

If you and your partner are having trouble conceiving, the problem could be male infertility, also called the “male factor.” Thirty to 40 percent of all cases of infertility are related to problems with sperm production. In another third of cases, infertility is caused by a combination of male and female problems.

There are a variety of reasons for male infertility, but you can find comfort in knowing that many are treatable. Causes include:

• Problems with the sperm count, shape or movement
• Hormonal imbalances
• Difficulty ejaculating

These problems may stem from lifestyle choices, like smoking, heavy alcohol use, recreational drugs, lack of a healthy diet and being overweight. But certain medications and illnesses can also affect the amount and quality of the sperm.

If you and your partner are having trouble conceiving, your doctor may suggest several different ways to diagnose the problem, including a:

• Physical exam — Your doctor will most likely start with an exam to look for abnormalities, like a varicocele, which are enlarged veins inside the scrotum.
• Semen analysis — Your doctor may also ask for a semen analysis. For this test, a sample is collected and tested for sperm count, shape and movement.
• Hormonal test — Your doctor will likely make sure that your hormone levels are within the normal range.
• Biopsy — If you semen analysis comes back with low sperm count, your doctor may recommend taking a sample directly from your testicle. If sperm counts are higher in this sample, that may be a sign that there is a blockage.

If you have a varicocele or a blockage, your doctor may be able to repair the problem with surgery. Hormonal problems can often be corrected with medication.

If your doctor doesn’t find a problem that can be fixed with medication or surgery, there are still other avenues couples can pursue to conceive. Assisted Reproductive Technologies, or ART, offer new options for couples who previously thought they were unable to have a baby.

• Testicular Sperm Extraction (TESE), Microsurgical Epididymal Sperm Aspiration (MESA) — When a man's sperm cannot move through his genital tract because of a blockage, the sperm can be surgically removed using TESE or MESA procedures. The TESE procedure involves getting the sperm directly from the testes. The MESA procedure involves collecting the sperm from the tubules next to the testicles that collect the sperm. The sperm are usually then used for in-vitro fertilization, or IVF.
• Intracytoplasmic Sperm Injection (ICSI) — The ICSI technique attempts to achieve fertilization by the direct injection of a single sperm into the egg.