Infertility is defined as the inability to conceive a child after one year of regular, unprotected intercourse. It affects about 20 percent of couples, with male-related problems the cause of 30 percent to 50 percent of infertility. A diagnosis of infertility is not necessarily a verdict of sterility; only 1 percent to 2 percent of infertile couples are actually sterile, and half of those who seek help can eventually bear a child.
Male infertility is most commonly caused by sperm disorders such as low sperm count, low sperm motility, malformed sperm or blocked sperm ducts. Further, a temporary drop in sperm production can result from prolonged exposure to heat or to chemicals or medications that affect sperm production. Several diseases also can affect sperm production, including colitis, diabetes, multiple sclerosis/spinal cord injury, mumps and cancer.
If you are unable to conceive after one year of regular, unprotected intercourse, both partners should see physicians.
Because evaluation of men tends to be noninvasive and easier than that of women, the male partner of an infertile couple should undergo evaluation first. This evaluation includes a complete history and physical examination, as well as other tests:
- Urinalysis: An analysis of your urine will provide a reading of protein, sugar and testosterone levels. Abnormal measurements of these substances can indicate diabetes, kidney disease or a testosterone deficiency.
- Semen analysis: This test evaluates sperm count and sperm movement. If the test reveals a declining sperm movement, the physician may test for antisperm antibodies.
- Blood tests: If the results of a semen analysis are abnormal, the physician may perform a blood test to gauge your hormone levels.
Treatment of male infertility is typically multifaceted.
- Medication: If the cause of fertility is hormone imbalance, replacement therapy has proven effective in normalizing that balance. Also, antibiotics can treat infections in the reproductive tract.
Surgery: Various conditions may require surgery.
- Varicocele: These dilated varicose veins, located above one or both of the testicles, impeded semen production. The physician can treat this condition through small incisions above the scrotum.
- Obstructed vas deferens: This condition is often the result of a vasectomy, trauma or surgery. The physician removes the scarred segment and reattaches the two ends of the vas deferens with suture.
- Obstructed ejaculatory duct: The physician will treat this condition by reopening the passage for sperm.
- Cryptorchidism: With this condition, one or both of the testicles has not descended. The physician can surgically lower the testicle into the scrotum. Results are best when performed early in life.
- Biopsy: When there is no sperm in the ejaculate, the physician will perform a biopsy to determine whether sperm is being produced at all or if it is being produced but is trapped in the testicle. Your physician can recommend several procedures based on the outcome.
For more information on male infertility visit WebMD's Infertility & Reproduction Health Center.