Why does infertility happen in men, and what treatments are available?
Male infertility contributes to up to 50% of all couples struggling with infertility. However, infertility discussions often focus on women and female infertility. So what causes male infertility? Here’s a guide to the most common reasons for men to be infertile.
What Does Normal Male Fertility Look Like?
The male side of reproduction needs two things:
- Healthy sperm that are capable of fertilizing an egg
- The ability to ejaculate so the sperm can reach the egg for fertilization.
Healthy sperm falls within certain ranges for shape, quantity, and movement. If any of these factors are abnormal, or if ejaculation is blocked for any reason, this can cause male infertility.
Sperm Disorders: a Common Cause of Male Infertility
The most common cause of male infertility comes from abnormalities in the sperm. For instance, sometimes sperm is shaped unusually or cannot move well enough to fertilize an egg, or there isn’t enough sperm produced.
Sperm disorders can come from certain infections or illnesses, including genetic diseases. Certain lifestyle behaviors, like tobacco use and heavy drinking, can also negatively affect sperm production.
Structural Challenges Can Affect Sperm Production and Movement
Sometimes anatomy or physical blockages can cause male infertility, by affecting sperm production or preventing the sperm from being released.
For example, varicoceles, or swollen veins in the scrotum, can cause lower sperm quality and quantity. On the other hand, sometimes previous infections, surgery, or injury can create a blockage, so the sperm cannot move freely. Surgery can treat some physical blockages, depending on the specific challenge.
Hormonal Issues Can Affect Fertility
Hormonal imbalances can affect both sperm and ejaculation. Hormones play a key role in sperm production. If the hormones are out of balance, for instance if there is a problem with the pituitary gland, that can lead to infertility. Hormone imbalances may be treatable through medication.
The Unexplained Causes of Infertility
Sometimes, there is no one easily identifiable cause of infertility, male or female. About 20% of all cases of infertility have no specific diagnosis. For men, some genetic disorders affect the DNA of a sperm, making it harder to fertilize an egg or develop into an embryo. This might not show up in a standard sperm analysis or medical evaluation. Your fertility doctor may still recommend different treatment options, including hormonal medications. If these types of treatments don’t work, assisted reproductive technology may still be an option.
Assisted Reproductive Technology Options for Male Infertility
There are many assisted reproductive technology (ART) treatments available for cases where hormonal or surgical treatments didn’t work. The three most common ART treatments are:
Intrauterine insemination (IUI)
IUI involves taking your sperm sample and placing it directly into your partner’s uterus. This way, the sperm doesn’t have to pass through the cervix, and it has a much higher chance of making it to an egg in the fallopian tubes. IUI may be a good option for people with low sperm count or low motility (movement).
In vitro fertilization (IVF)
In IVF, both sperm and eggs are retrieved from the intended parents (or a donor) and combined in a lab to develop embryos. The embryo is then transferred to a uterus to hopefully develop into a pregnancy.
IVF with intracytoplasmic sperm injection (ICSI)
ICSI involves injecting a single sperm directly into an egg, increasing the chances of successful fertilization. Because it is so precise and direct, ICSI may be able to help even in cases of extremely low sperm quantity or quality.
What Are the Next Steps for Male Infertility?
If you’re concerned about infertility, the first step is to set up an initial consultation and fertility assessment. Typically this includes a physical examination, interview with a specialist, blood test, and semen analysis. Then, you and your fertility doctor will discuss your test results and possible treatment options.
Infertility can be challenging, but you’re not alone. We’re here to help support you on your journey. Make an appointment today.
