Male Fertility

Is Male Infertility Fertile Ground for Concern? Symptoms, Diagnosis and Treatment of Male Infertility

By Juan P. Alvarez, M.D., FACOG

Infertility was once considered to be just a female problem.

Then John Legend shared his infertility story.  So did Gordon Ramsey, Jimmy Fallon, Mark Zuckerberg, and countless other celebrities and non-celebrities alike.

The celebrity connection is not an essential part of the infertility conversation but it is a perfect way to eradicate any negative connotations and dispel myths about male infertility.

The Statistics

The latest statistics suggest 20-30 percent of infertility issues are caused solely by the male and male infertility can contribute to up to 50% of overall cases of infertility.

The Signs and Symptoms of Male Infertility

Unfortunately, there may not be any obvious signs or symptoms of male infertility.

Sometimes the only sign of male infertility is the inability to conceive.

However, there are certain conditions that can signal the possibility of male factor infertility:

  • Problems with sexual function, such as difficulty with ejaculation or low volume of fluid ejaculated or erectile dysfunction
  • Pain, swelling or a lump in a testicle or an undescended testicle
  • A feeling of “worms” in the scrotum could suggest dilated veins

The presence of these symptoms may mean nothing but they are an indication that a physical exam and a medical workup should be performed by either a primary care doctor or a urologist.

The Diagnosis

If a male partner has no symptoms, then the best fertility test would be trying to conceive.

At Conceptions Florida, we generally recommend a fertility evaluation if a couple has been trying to get pregnant for more than 12 months when the female partner is under the age of 35 years of age or for more than six months when the female partner is over the age of 35.

Semen analysis is the best way to evaluate the fertility potential of a man. There are four important components of the semen analysis: volume, concentration, motility, and morphology. The normal reference values for the semen analysis have been set forth by the World Health Organization (WHO) based on studies of close to 2000 men.

Based on these studies, we know there is a certain total motile sperm count that is considered to be fertile and that a lower count is generally an indication of low fertility.

Semen parameters can change from day to day. So, when a man has a low sperm count, it is reasonable to repeat the analysis as one single analysis is not enough to diagnose a problem. It’s only repeated low results which are a cause for evaluation and treatment.

Factors Which May Affect Sperm Count

There are many factors that can affect sperm counts, including genetics, environmental, and health/lifestyle causes. Heavy metal exposure, industrial chemical exposure, radiation, overheating of the scrotum such as frequent hot tubs or sauna use can decrease sperm count. Heavy alcohol consumption, cigarette smoking, anabolic steroids, and recreational drugs can also impact sperm count.

The Treatment

If your semen analysis indicates a low sperm count, a zero sperm, sperm motility or swimming issues, or misshapen sperm, the next step would be an appointment with a urologist who specializes in male infertility.  Depending on the cause, there are currently medical and surgical options to either increase sperm counts, unblock an obstruction or to extract sperm directly from the testis to help men conceive.

And don’t worry, most men report the exam is painless.

In the meantime, it cannot hurt to take better care of your body since your sperm is directly affected by your lifestyle. Stop smoking, limit your alcohol intake or recreational drug use, practice stress-reduction techniques such as yoga and meditation, and exercise regularly. By taking care of yourself, you can improve your chances of fertility and promote the energy level you will need when you become a dad.

And remember, you are not alone. We will be with you on your journey to create or expand your family. With treatments like intrauterine inseminationsurgery, IVF, and the use of fertility medications, and gestational carriers, parenthood may be just around the corner.