10 to 15 percent of couples face infertility issues. At least one-third of those couples dealing with male infertility rather than the assumed female infertility. These couples might wonder what are the causes of male infertility and how do you treat those issues.
What is Male Infertility?
Male infertility is a condition that lessens the possibility of starting a family with his partner. Infertility could stem from a variety of things, from injuries to issues creating sperm. People know that the process of conception for females is complicated and delicate, but it is the same for males. Let’s take a look at the process.
The Delicate Process of Conception
Just like females, infertility can stem at any point in the conception process. That is why your doctor has to look at every part and consider things like flaws, hormonal imbalances, and even past trauma to discern the issue hindering your fertility. Remember, any issues at any of these steps could be the root of the infertility issues.
- Production of Healthy Sperm: The first step starts with producing healthy sperm through a process called spermatogenesis. Your reproductive organs create the healthy sperm cells, and it requires at least one functioning testicle. Production of sperm cells also requires properly balanced hormones. For example, testosterone plays a crucial part of sperm production.
- The Sperm Has to Travel: You could have healthy sperm, but it won’t matter if it never leaves your body and enters your partner’s body. The sperm has to leave your body through semen. Sperm begins its journey in the testicles and moves down the tube, where it mixes with semen. Then, semen ejaculates out of the penis during sexual intercourse.
- Healthy Amount of Sperm in the Semen: So, your body created the sperm, and it travels with the semen. The next issue could be the amount of sperm inside of the semen. There has to be a high enough level to ensure that conception does occur. Anything below 15 million sperm per milliliter is considered a low sperm count. If your sperm count is low, you have a reduced chance of your partner conceiving. Remember, low sperm count doesn’t mean it is impossible; it just makes it harder!
- The Sperm Has to Move: Everything else is working great, but your sperm is unable to move towards its final destination. The ability for your sperm to move forward is called motility. Motility is vital. It allows the sperm to reach the egg all the way at the end of the fallopian tubes. Without motility, fertilization and conception will never take place.
What Causes Male Infertility?
A variety of issues causes male infertility. Healthy fertility starts with spermatogenesis, which is the production of semen in the male testicles. Sperm cells develop over the course of several months through a complex process. The issue could be at any step we listed above. Let’s take a look at some of the common issues.
- Sperm Issues: The first step to conception is the creation of healthy sperm, and that is where many males have issues. The sperm might not develop correctly or fully, or it might reproduce in odd numbers or not at all! Oligospermia and Azoospermia are two issues that hinder sperm development and prevent drainage of blood. Luckily, both of these are treatment causes of male infertility.
- Immunologic Infertility: Sometimes, male infertility is caused by the immunologic feedback to the sperm. Antibodies attach the sperm, causing them to avoid regular motion and performing their normal function. However, there needs to be more research on this reason for infertility to fully understanding how antibodies prevent the sperm from swimming correctly into the uterus.
- Blockage: You might have great sperm that can swim, but that means nothing if they are unable to leave your body because of blocked tubes. A variety of reasons can cause blockages. Any part of the male reproductive system can be blocked, preventing the transportation of sperm from the testicles to the urethra, then out of the body. Here are some of the possible causes.
- Infections: For example, any sexually transmitted disease increases the risk of infertility. Any infection can interfere with sperm production, and it can cause blockages along the passageways. Gonorrhea is a common STD that can lead to male infertility. If not treated quickly, males can experience permanent testicular damage. Another possibility is retrograde ejaculation, which is when the semen is unable to leave the body during sexual intercourse. Instead of coming out the tip of the penis as it should, the semen enters the bladder.
- Prior surgical treatment: There are plenty of surgeries that can cause blockages, such as vasectomy and reversals of vasectomy. Surgeries on the bladder, prostate, and urethra can also lead to ejaculation issues or blockages.
- Swelling: One of the most common causes of male infertility is called varicocele, which is the swelling of varicose veins inside of the scrotum. These are the veins that drain the testicles. The great thing about varicocele is that it is one of the easiest issues to treat, which can increase sperm count and motility.
- Developmental issues: If the passageways did not develop correctly, sperm might not be able to leave the body correctly. One example is called undescended testicles, which is one or both testicles don’t descend from the abdomen into the scrotum. Undescended testicles can lead to male infertility.
- Hormonal Issues: The hormones that are necessary for reproduction come from the pituitary glandular. If the pituitary gland is unable to generate enough hormones, it can lead to bad sperm development. If your doctor suspects that the issue is due to hormonal issues, you will need to have a few rounds of blood work to confirm. One hormone that your doctor will look at is called the FSH – follicle stimulating hormone. It is a pituitary hormone that encourages the testicles to make sperm. Levels that are too high indicate your body is struggling to make sperm.
- Medications: There are certain medications that can damage to sperm function, count, motility, manufacturing, and climax. The most common are medications that deal with depression, arthritis, digestive issues, infections, high blood pressure and cancer treatments. Cancer and chemotherapy can cause infertility issues.
Diagnosing Male Infertility
If you suspect that you have male infertility, you and your doctor will develop a plan to diagnose and treat the issue. The first step is to take a total history and physical examination. After that step, your doctor will write orders for blood work and a sperm analysis.
Most men find a sperm analysis difficult and awkward. You typically have to give the sample while in the office or close by because they need to be analyzed within an hour. The doctor looks at the volume, count, concentration, motility, and structure of the spermatozoa.
Your doctor might be able to determine the issue right from that sperm analysis. For example, you might have a very low sperm count or low motility.
If your sperm analysis doesn’t indicate the issue at hand, another choice is a transrectal ultrasound. Your doctor uses a probe that is inserted into the anus. The probe sends a beam of high-frequency noise waves towards the ejaculatory ducts. That test can determine if there are blocks along the passageways or other obstructions.
Another test that your doctor can run is a testicular biopsy that is beneficial to determine why your sperm count is so low. A biopsy can determine the reason for infertility and how to help recover sperm from using for fertility treatments.
Treating Male Infertility
The treatment you receive will depend on the issue diagnosed through testing. Luckily, there are plenty of treatment options that should be able to fix the problem. For example, you may need to switch medications or undergo a procedure to unblock passageways. You may need to take medication to help stimulate sperm production.
If not, your doctor will suggest you try a fertility treatment. IUI, or intrauterine insemination, is a procedure that places the sperm right up by the eggs. It is a great choice for males who struggle with motility. The sperm has to do very little work to find and fertilize the egg.
Another choice is called IVF, or in vitro insemination. IVF is a more invasive procedure. It does require the woman to take a few rounds of medication, as well as starting birth control for three months prior. The woman’s eggs are removed from the body and inseminated in a test tube. Then, the fertilized eggs are implanted back into her body. The hope is that they implant successfully.
Through science, couples who face serious infertility issues are still able to conceive a child. Years ago, that was not possible. While facing IUI and IVF can feel daunting and overwhelming, your doctor will walk you through the process and make everything feel comfortable.
The causes of male infertility vary, but with the help of your doctor, you can face and conquer this issue placed in front of you.