If you were to take a look at Infertility statistics, you may be surprised.
Infertility is a complex issue affecting about 15% of couples attempting to conceive. That’s one in eight adult couples with fertility issues with one in six couples infertile. Infertility is defined as the inability to conceive after six to twelve months.
Oftentimes, the focus of infertility tends to be on female issues in fertility, but upwards of 40% of couples have both male and female fertility issues. And in up to 50 percent of couples having difficulty getting pregnant, the problem is at least in part related to male reproductive issues.
The American Society of Reproductive Medicine estimates that roughly one-third of infertility cases can be attributed to male factors, with another one-third due to women. In the remaining one-third of infertile couples, infertility is caused by either a combination of factors or in 20% of cases, is unexplained. Therefore both partners should be evaluated.
Male Infertility Symptoms
In men, the most common issue is few or no sperm. In women, the most common problems are ovulation disorders and blocked tubes. Infertility treatment options will depend entirely on the factors causing infertility. The good news is that reproductive medicine has changed dramatically and new technology in treating infertility for both men and women are available.
The reassuring news for men is that infertility specialists like our very own Dr. Shaw, have a variety of tools and infertility treatments to correct many problems including hormone manipulation to raise testicular testosterone levels, artificial insemination, infertility medications to counter retrograde ejaculation, microsurgical techniques to undo the damage caused by blockages, and several other infertility prevention methods.
The Science Version of “The Talk”
In normal conditions, male fertility depends on the production of normal sperm and the delivery of it to a female partner’s vagina. The process begins with the development of sperm in the testicles. Sperm cells are produced by a complicated process of cell division that occurs over a period of several months.
Once formed, sperm leaves the testicles and are stored in the epididymis where they fully develop. They are then pushed through the vas deferens and urethra during ejaculation. The production and maturation of sperm require the presence of an intact genetic blueprint in addition to a favorable environment including the presence of adequate levels of the male hormone testosterone and a slightly decreased scrotal temperature of 96 degrees Fahrenheit are necessary.
What Causes Male Infertility?
Male infertility is any condition in which the man is unable to produce or deliver fully-functioning sperm normally. This can be caused by a number of issues:
– Sperm disorders: Problems with the production and development of sperm are the most common symptoms of male infertility. Sperm may be underdeveloped, abnormally shaped or unable to move properly. Or, normal sperm may be produced in abnormally low numbers or not at all. This can be detected on a simple semen analysis.
– Varicoceles: A varicocele is present in 16% of men. A varicocele is a dilated scrotal vein and commonly found in 40% of infertile men. Varicoceles impair sperm development by preventing proper drainage of blood. Varicoceles are easily discovered on physical examination and scrotal ultrasounds. This is the most common surgically correctable cause of male infertility.
– Retrograde ejaculation: Retrograde ejaculation occurs when semen pushes backwards into the bladder instead of out the penis. This is caused by the failure of nerves and muscles in the bladder neck to close during orgasm. It can be caused by previous surgery, medications or diseases affecting the nervous system.
– Immunologic Infertility: In this case, a man’s body attacks its own sperm (antibodies) preventing the normal movement and function of sperm. This may be caused by injury, surgery or infection.
– Obstruction: Obstructions such as repeated infections, prior surgery, vasectomy, inflammation or congenital developmental problems at a portion of the male reproductive tract can prevent the normal transport of sperm.
– Hormones: Hormones produced by the pituitary gland (including testosterone) are responsible for stimulating the testicles to make sperm. When levels are severely low, poor sperm development can result.
– Genetics: Genetics play a central role in fertility. Abnormalities in chromosomal numbers and structure, as well as deletions on the important Y chromosome present in normal males, can impact fertility.
– Medications: Certain medications can affect sperm production, function and ejaculation. Such medications are usually prescribed to treat conditions like low testosterone, arthritis, depression, digestive problems, infections, hypertension, and cancer.
Infertility is diagnosed by taking a careful history, performing an exam, using a semen analysis, checking lab work for certain hormones, ordering imaging which may include an ultrasound of the scrotum or prostate or an MRI of the pituitary gland and possibly a testicular biopsy.
Treatment options for men are variable and based on clinical findings. They can include everything from surgery to medications to correct hormone imbalances to more complex options like Intrauterine insemination (IUI), In vitro fertilization (IVF) or Intracytoplasmic sperm injection (ICSI).
Causes of Infertility in Males and Females
– Stop smoking cigarettes or marijuana: Smoking has been linked to low sperm counts, sluggish sperm and abnormally developed sperm.
-Stop the hard-partying: Alcohol can reduce the production of normally formed sperm.
– Watch your weight: Being overweight (obese) and underweight can have fertility issues due to hormonal imbalances and/or decreased sperm count and functionality.
– Get some exercise (in moderation): Exercise is good for you for a number of reasons. Excessive exercise could lower the amount of testosterone by increasing the amount of cortisol in your body which would lower your sperm count.
– Stay away from anabolic steroids: Illegal steroid use and testosterone replacement therapy can cause testicular shrinkage and stop the production of sperm.
– Take your vitamins and supplements: Vitamin C, E, and Zinc have been found to affect sperm quality. Make sure your vitamin includes all three for healthy sperm and to counteract free radicals.
– Reduce stress: Life stressors are abundant. Not only does stress affect hormone levels, but also may interfere with libido and erections.
– Avoid toxins: Jobs that require regular exposure to environmental toxins or poisons (pesticides, insecticides, lead, radiation or heavy metals) can all affect sperm production.
– Get checked out by your doctor annually: From diabetes to kidney disease, testicular cancer to cystic fibrosis, STDs and other infections all can inhibit fertility.
– Stay out of the heat: Human testes cannot function properly unless they are able to stay cooler than the rest of the body. The male anatomy is designed to create distance between the testes and the core body temperature. The ideal temperature for healthy sperm is 96 degrees Fahrenheit. Anything above that ideal temperature can cause fertility issues. So stay away from briefs, hot tubs, infections creating a high fever, laptop use in certain positions and cell phones in your pocket… all of which expose the testicles to a warmer than normal environment.
Getting a complete evaluation by both partners together should help understand infertility issues and help make better decisions about treatment. It may involve a variety of specialists including primary care doctors, urologists, OBGYNs, endocrinologists and fertility specialists.
As always, Dr. Shaw and the Austin Urology Institute are a readily available resource for you to learn how to prevent infertility and keep it that way. Got any questions? Send us a message, we’re happy to help.