Male Infertility

Male infertility is most commonly caused by low sperm count, low sperm motility, malformed sperm or blocked sperm ducts. Temporary causes include prolonged exposure to heat or to chemicals or medications. Several diseases also are linked to male infertility, including colitis, diabetes, multiple sclerosis/spinal cord injury, mumps and cancer.

If a couple is unable to conceive after one year of regular, unprotected intercourse, both partners should see physicians.

Because evaluations of men tend to be noninvasive and easier than those of women, the male partner should undergo one first. This evaluation includes a complete history and physical examination, as well as other tests:

• Urinalysis: To read protein and sugar levels. Abnormal measurements of these substances can indicate diabetes or kidney disease.
• Semen analysis: To evaluate sperm count and sperm movement. If it reveals a declining sperm movement, the physician may test for anti-sperm antibodies.
• Blood tests: To gauge hormone levels if the results of a semen analysis are abnormal.
• Biopsy: To determine if sperm is being trapped in the testicle.

Treatment depends on the cause of infertility:

• Medication: If the cause of infertility is hormone imbalance, replacement therapy can normalize that balance. Also, antibiotics can treat infections in the reproductive tract.
• Surgery, for various conditions:
  • Varicocele: These are dilated varicose veins, located above one or both of the testicles, that can impede semen production. The physician can treat this condition through small incisions above the scrotum.
  • Obstructed vas deferens (the sperm-carrying tubes): This 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 sutures.
  • Obstructed ejaculatory duct: The physician reopens the passage for sperm.
  • Cryptorchidism: When 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.