Infertility in Man

Infertility in Man

What is infertility?

Infertility is when a couple is having unprotected sex (without using birth control) for 1 year and no pregnancy has happened. Approximately 15% of couples attempting to conceive a baby have difficulty in achieving pregnancy. Infertility is a complex problem with many possible causes.

The male partner has a factor in the cause of infertility in half of couples with infertility. For this reason, it is important for men (as well as the women) to be evaluated when there is difficulty getting pregnant.

In order to achieve pregnancy a sperm and egg need to come together for fertilization. The cause of infertility in men is often related to the number of sperm produced, the ability of the sperm to swim the right way, or for the sperm to reach your partner’s egg.

Some medical diseases, genetic conditions, medications, or lubricants used during sex may cause fertility problems. Exposure of the testicles to enlarged veins in the scrotum, heat from hot-tubs, or other exposures (radiation, chemotherapy, drugs) can also change the number and function of sperm.

How male fertility be evaluated?

First you and your partner will be asked questions about your general health, sexual health, and any previous pregnancies, followed by a thorough physical exam.

For the evaluation of the man’s fertility, you will most likely be asked to produce a semen analysis to check how many sperm you have and how healthy they are. You may also have blood tests to check for infections, hormone levels, and other diseases. Ultrasound of the testis are often performed to look at the area of the body where sperm are produced and its surrounding structures. Based on these results, further testing may be ordered.

How is it treated?

There are multiple options for each couple and treatment should be designed on a case-by-case basis.

General recommendations for those trying to achieve pregnancy may include the need to change the lubricants you use during sex, the frequency that you have sex, or the timing of sex. You will be asked to stop smoking, use of illicit drugs, or abuse of alcohol.

Options to achieve pregnancy in couples with male factor infertility include medical or surgical intervention to improve sperm count and function with use of hormones, vitamins, or other drugs, or the use of Assisted Reproductive Techniques (ART). The use of ART is normally coordinated by your partner’s doctor (reproductive endocrinology).

Overall, new medical, surgical, and assisted reproductive techniques have increased the potential for couples to have successful pregnancy.

We offer a wide variety of surgical interventions at the Center for Urologic surgeries, including:

  • Microsurgical Varicocele ligation: correction of enlarged veins in the scrotum that warm testis
  • Microsurgical Vasectomy Reversal
  • Microdissection Testicular Exploration and Sperm Extraction (micro-TESE)
  • Microsurgical Epididymal Sperm Aspiration (MESA)