What is Male Infertility?

Male infertility is when a male is unable to conceive a child after a year of unprotected sexual intercourse. Male infertility is associated with low sperm count, sperm malfunctions, and blocked sperm pathways. Treatments are available to help you manage your fertility.

Types of Infertility

Both men and women experience infertility. There is only one type of male infertility. However, there are two types of female infertility.

Types of female infertility:

• Primary infertility — When a female is unable to get pregnant.
• Secondary infertility — When a female has been pregnant at least once in the past but is unable to get pregnant again.

Symptoms

The inability to conceive is the most common symptom. Usually, there are no other clear symptoms or signs. However, sometimes there is another problem that causes the infertility, like a genetic disorder, obstructed sperm pathway, or hormone imbalance.

You may also see these male infertility symptoms:

• Difficulty ejaculating
• Low sex drive
• Minimal ejaculation
• Lump in testicles
• Pain in testicles
• Swollen testicles
• Breathing problems
• Inability to smell
• Stunted hair growth

If you experience any of these symptoms or have a female partner over the age of 35, please see a doctor. A fertility specialist at Baptist Health may be able to help.

Risk Factors

There are several male infertility risk factors.

Common infertility risk factors for males:

• Undescended testicles
• Damaged testicles
• Hernia surgery
• Early puberty
• Late puberty
• Some medications
• High temperatures

Causes

Male infertility can be caused by health issues, medical treatments, medications, environmental exposures, and lifestyle habits.

Male infertility causes:

• Medications — Some medicines can make a man's sperm less healthy. This can happen when men take certain drugs.
• Tumors — Cancers and nonmalignant tumors can impact male reproductive organs and the glands that make reproductive hormones.
• Hormone imbalances — Overproduction or underproduction of hormones can cause infertility in men.

• Undescended testicles — During development in the womb, one or both testicles did not move from a male baby’s belly into a part of their body called the scrotum.
• Varicocele — A varicocele is a swollen vein that empties the testicle of semen. This condition is both common and reversible.
• Infection — Infections can scar the delivery passage of sperm.
• Ejaculation complications — When ejaculation sends semen into your bladder instead of out of your penis, this is called retrograde ejaculation.  
• Antibodies — A common cause of male infertility is the presence of anti-sperm antibodies, which are immune cells that attack sperm.
• Sexual complications — Sexual complications can include erectile dysfunction, irregular reproductive organs, or psychological and emotional issues.
• Prior surgeries — Vasectomies, prostate surgeries, some abdominal surgeries, and other related procedures can remove sperm from your ejaculate.
• Defective sperm pathways — Blockages in the tubes that transport semen.
• Defective chromosomes — Certain genetic disorders can cause male infertility.
• Celiac disease — Celiac disease is sensitivity to gluten and may contribute to infertility in men.

Environmental causes:

• Radiation — When you expose your body to radiation, you can unintentionally lower your sperm count. High doses of radiation can permanently reduce sperm count.
• Exposure to Chemicals — Prolonged exposure to chemicals can lead to lower sperm production. Industrial chemicals include organic solvents, herbicides, and pesticides.
• High temperatures — Exposure to high temperatures may reduce sperm production.
• Exposure to heavy metals — Male infertility is associated with exposure to lead or other heavy metals.

Lifestyle causes:

• Obesity — Excess body fat can impair sperm function and lead to irregular hormone levels.
• Tobacco use — The use of tobacco products can lower sperm count.
• Alcohol abuse — Abusing alcoholic substances can negatively impact sperm production and the ability to get and maintain an erection.
• Drug use — Use of some legal and illegal substances can reduce sperm count and function.

Diagnosis

Male infertility diagnosis may require a combination of tests. These tests can be expensive. Let your doctor know about your medical insurance ahead of time to figure out what is covered by your plan.

During your visit, your doctor may conduct a review of your symptoms and medical history, followed by a routine physical examination. Based on this information, your doctor will recommend appropriate diagnostic tests.

Common male infertility tests:

• Semen analysis — A semen sample is examined for abnormalities.
• Ultrasound — This imaging test uses high-frequency waves to inspect your scrotum, testicles, and rectum. An ultrasound of your rectum involves a lubricated medical tool called a rectal wand that is inserted into your rectum.
• Sperm function tests — Specialized tests that evaluate various sperm functions such as post-ejaculate sperm survival rate and ability to fertilize an egg.
• Hormone tests — These tests gauge your hormone levels.
• Genetic tests — Genetic testing is performed to rule out inherited conditions that may impact fertility.
• Testicular biopsy — Your doctor will take testicle samples to exam for sperm production and function.
• Urinalysis — A urinalysis test performed post ejaculation.

Treatment

Doctors cannot always determine exactly why you are not able to conceive. If a specific cause is not identified, they might suggest potential male infertility treatments or procedures. Your female partner may also need to be checked and treated.

Common infertility treatments:

• Medication — Fertility medications help normalize healthy hormone balance and reduce erectile dysfunction.
• Counseling — Counseling may help mitigate any psychological or emotional reasons for infertility.
• Surgery — Your doctor may repair scarred or obstructed passageways preventing semen release during ejaculation.
• Lifestyle changes — Doctors often recommend frequent exercise, healthy eating, reducing caffeine, and avoiding alcohol and illegal drugs.
• Assisted conception — Assisted reproductive technology (ART) might be used to assist in conception. Assisted conception can involve surgical extraction of semen, in vitro fertilization, and direct insertion of semen into an egg.

Rarely, treatment is not able to help you conceive a child. If this happens, you might consider a sperm donor or adoption.