Investigating Fertility in Men

When it comes to fertility issues not a lot of attention is given to the male side of the equation; even though in 30 percent of fertility cases the actual issue is with the male partner.

The focus on the female side of the fertility equation has to do in part with all the events that need to occur to ensure successful pregnancy, including:

  • The sperm needs to fertilize the egg
  • The egg needs to make it to the uterus
  • The egg needs to implant in the uterus wall
  • The fertilized egg needs to successfully develop into a viable fetus
  • The fetus needs to be able to develop and grow for nine months

Because all of these events occur inside the woman’s body, people tend to think of fertility as a woman's issue. In fact, there are certain issues with male fertility that can contribute to difficulty with conception.

Male Fertility Issues

With men who are struggling with fertility, the problem lies in two major areas: sperm quantities and sperm motility.

Sperm Quantities

There could be an issue with the amount of sperm the man produces, the quality of the sperm, or even if he produces any sperm at all. When sperm enter the uterus they have to travel all the way up to the fallopian tubes to the egg. Although fallopian tubes are only eight to twelve centimeters long (or 3.5 to 5 inches), that represents quite a distance to the tiny sperm. Also, the sperm don’t all make a beeline to the egg, some meander around a bit, end up getting lost, and die before they can reach the egg. The more sperm there are, and the healthier they are, the greater the chances that one of them will make it to the egg.

Sperm Motility

Motility involves how fast or how strongly the sperm swim. If the sperm aren’t good swimmers, then you run into the same issue that you have with not having enough – they can’t make the long trip to the egg before they die.

There are several things that can cause problems with sperm quantity, quality and motility.

Causes of Male Fertility Issues

  • Sperm production is controlled by a hormone called testosterone--if a man stops producing enough testosterone it can reduce the quantity of sperm he produces.

  • If the urethra or the sperm ducts are blocked by scar tissue or physical anomalies, the sperm may have difficulty traveling through the tubes.

  • Certain lifestyle factors, such as smoking, diet, alcohol and drug use, and exposure to environmental toxins can cause a low sperm count.

  • Sperm production only works when the testicles are cooler than your core body temperature, that’s why they are outside your body. Certain situations can raise testicular temperature and reduce sperm production including wearing tight pants and underwear, or varicose veins in the testicles, which can raise the temperature of the surrounding tissue.

  • Illnesses and infections can affect the tubes where sperm are made and stored, reducing a man's sperm count and damaging the sperm that is produced.

Diagnosing Male Infertility

  • Your doctor may start with a simple sperm test by having you ejaculate into a receptacle so he can view the sperm under a microscope.

  • If he feels he needs more information, the doctor could order a blood test to check your testosterone levels, or look for white blood cells that could signal an infection.

  • If the blood test does not reveal the nature of the problem, the doctor may inspect your genitalia for signs of damage that could cause the problem. This may involve a visual inspection, or an imaging scan, like an MRI or ultrasound, to check the tubes inside your penis and testicles for abnormalities.

Treatment for Male Infertility

The treatment you receive for infertility depends on the source of the problem.

If hormones are the cause, your doctor could prescribe testosterone replacement.The doctor might also try fertility drugs containing follicle stimulating hormone, which can boost sperm production in some men

If you have a blockage in one of the tubes, your doctor could perform surgery to remove it. This would also apply if the man has had a vasectomy

If the cause is unknown, your doctor may prescribe a combination of hormone therapy and lifestyle changes including:

  • Wearing boxers and roomier pants
  • Eating food rich in zinc, which is crucial to sperm production
  • Quitting smoking
  • Limiting alcohol consumption

If none of these solutions works, your doctor could recommend artificial insemination or other methods to help with conception.

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