What Causes Infertility in Men?

Male infertility refers to a male’s inability to result in a pregnancy with a fertile female after a year of regular unprotected intercourse. The leading causes of infertility in men are low sperm concentration, poor motility (how the sperm move), and impaired delivery of the sperm to the egg.

According to the American Society for Reproductive Medicine (ASRM), approximately 20 percent of a couples’ fertility issues are due solely to male infertility, and it is a contributing factor in another 30-40 percent of cases.

Men in LGBTQ+ relationships have an identical risk of facing infertility as men in heterosexual relationships.

What is Male Infertility?

Infertility attributed to the male partner can be caused by:

• Hormonal issues
• Obstruction (inability of sperm to exit the testicle/epididymis)
• Genetic conditions affecting sperm production or obstruction
• General health and lifestyle issues
• Exposure to steroids like testosterone
• Disease or cancer
• Overexposure to environmental toxins

Causes of Male Fertility

Sperm Disorders

Sperm may be immature, abnormally shaped, unable to swim — or in some cases, not an adequate amount of sperm. Additionally, you may not make any sperm. This problem may be caused by many different conditions, including:

• Infections or inflammatory diseases
• Hormone or pituitary gland problems
• Immune problems
• Environmental and lifestyle factors
• Genetic diseases

Structural Problems

Anything that blocks the genital tract can stop the flow of semen. This could be a genetic or congenital disability. Infection or inflammation from a sexually transmitted disease can also block semen. Other causes include scar tissue from surgery or twisted, swollen veins in the scrotum.

Other Factors

Other factors may include erectile dysfunction or premature ejaculation. Liver or kidney disease or treatment for seizure disorders are examples of problems that can cause infertility.

Male Fertility Testing

The male partner should be tested for fertility issues anytime a couple is diagnosed with infertility, which is defined as no pregnancy after one year of timed intercourse when the woman is under 35, and six months when the woman is over the age of 35.

Common male fertility tests include: (please note some male fertility testing is performed by a Urologist)

• Physical examination and review of medical and sexual history
• Semen analysis to determine semen volume, sperm concentration (number per milliliter), motility (movement) and morphology (shape)
• Blood hormone analysis to detect variance in hormone levels
• An ultrasound of internal organs
• Biopsy to check for infection and other abnormalities

Treatments for Male Infertility

A reproductive endocrinologist can develop a treatment plan to help couples who cannot conceive due to male infertility following a thorough evaluation and infertility diagnosis.

Sometimes, a urology consult will be requested to investigate further and treat the cause of male infertility.

Common Fertility Treatments for Male Infertility Include:

• Lifestyle changes, such as losing weight and quitting smoking
• IUI involves the collection and washing of sperm, and then injecting the sperm directly into the uterus; often used to treat mild male infertility.
• IVF with intracytoplasmic sperm injection (ICSI) is a procedure that involves a single sperm cell being injected into a single egg to create an embryo.
• Sperm aspiration is a surgical procedure that involves a fertility doctor inserting a needle directly into the testicle or epididymis to extract the sperm, which can then be used for IVF.
• Hormone therapy in the setting of deficiency to stimulate the production of sperm in the testicle
• Vasectomy reversal to allow sperm to be released in a man’s semen during ejaculation
• Donor sperm may be needed for advanced cases of male infertility in which a man’s sperm is not viable or available; it can be used in IUI or IVF.

Don’t give up on your dreams of pursuing parenthood! While the entire process can be daunting and you never thought you’d have to visit a fertility clinic, you need not lose hope. The team at Fertility Specialists Medical Group (FSMG) is here for you.  Schedule a consult today.