Male Infertility

What is male infertility?

Infertility is a disease of the reproductive system that impairs one of the body’s most basic functions: the conception of children. It is defined in practical terms as a couple’s inability to achieve pregnancy after a year of unprotected intercourse.

Infertility is a common problem, with more than 5 million couples in the United States dealing with these problems. Infertility affects one in every six couples who are trying to conceive. In at least half of all cases of infertility, a male factor is a major or contributing cause. This means that about 10% of all men in the United States who are attempting to conceive suffer from infertility.

What causes male infertility?

Conception is a complicated process that depends upon many factors: the production of healthy sperm by the man and healthy eggs by the woman; unblocked fallopian tubes that allow the sperm to reach the egg; the sperm’s ability to fertilize the egg when they meet; the ability of the fertilized egg (embryo) to become implanted in the woman’s uterus; and good embryo quality.

Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman’s hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result.

Male infertility can be related to a man’s inability to produce sperm cells, known in medical terms as azoospermia. Or it can be related to the production of low or poor quality sperm, oligospermia. Other problems that can occur include malformed sperm that cannot live long enough to fertilize the egg and genetic diseases that impair fertility.

The good news is that many cases of male infertility are treatable, allowing couples to achieve their goal of having a family.

What are the symptoms of male infertility?

Besides the inability to conceive children, there are many other issues that accompany male infertility.

Psychological & Emotional Issues

The statistics tell only part of the story about male infertility. It is much more difficult to describe the psychological and emotional impact infertility has on a couple who want to have children. Many times, conceiving a child becomes the total focus of their lives. Feelings of depression, loss, grief, inadequacy and failure are common in men as well as women seeking pregnancy.

Individuals or couples experiencing any of these feelings are encouraged to seek professional help from a counselor or psychologist experienced in dealing with infertility issues. A professional can help you deal realistically with the situation and provide support even while you are going through treatment.

How is male infertility diagnosed?

Diagnosis begins with a complete physical examination of the man to determine his general state of health and identify any physical problems that may impact his fertility. The doctor also interviews the couple about their sexual habits. If the physical examination and history do not indicate any reason for the couple’s inability to conceive, the next step is to conduct testing to identify the cause of infertility.

How is male infertility treated?

With modern technology and methods, the number of treatment options for male infertility has expanded. Depending on the cause of infertility, treatment may include:

Medical Therapy for Male Infertility

When sperm production is too low to achieve pregnancy, medication to increase the number of sperm produced is an option. We offer the newest, most effective medications for this problem. For men with low hormone levels, hormone therapy may be required to correct the balance.

We also counsel our patients as needed regarding lifestyle practices that may improve their fertility.

Surgical Treatment of Male Infertility

Depending on the cause of infertility, a surgical procedure may be necessary to correct a defect or remove an obstruction. Our physicians are among the most experienced in the country in surgical procedures to restore fertility. The most common procedures performed here include vasectomy reversal and varicocele repair.

Vasectomy Reversal & Microsurgical Reconstructive Surgery

Vasectomy reversal – a vasovasostomy or vasoepididymostomy – are common procedures that we perform in an outpatient setting. In either procedure, the surgeon reconnects the vas deferens, the tube in the scrotum through which the sperm passes. Viewing the vas deferens through a high-power surgical microscope, the surgeon carefully sews the ends back together.

Blockages in the vas deferens are repaired with a similar technique. The vas deferens is surgically split, the blockage is removed, and the ends of the tube are reconnected. When the original vasectomy was performed many years previously, an additional blockage may have formed in the epididymis, the coiled tube that lies against the testicle where sperm cells mature. Blockage at the epididymis also can occur due to infection or injury. Whatever the cause, the surgeon will fix the problem by bypassing the blockage in the epididymis in a procedure called a vasoepididymostomy.