Definition & Overview
Infertility is often associated with women. However, statistics show that more than 50% of couples from around the world who are seeking help for infertility issues discover that the problem resides solely with the male party. Male infertility is a more common problem than most men realize or would often admit. However, if men seek assistance for infertility problems early on in a relationship, the problem may be reversed. If not, they will at least know about the issue and can plan accordingly.
Male infertility problems generally revolve around the quantity, quality, and the ability to deliver semen into a fertile female. To gain a better understanding of what makes a man infertile, the basics of male fertility must be understood.
The male reproductive system consists of the penis, scrotum, and testicles. The penis is the main organ used in sexual intercourse. Its function is to deliver sperm into the female reproductive system. The penis is made up two main parts: the shaft or body, and the glans or head.
Inside the penis is the urethra, which is a tube that originates from the bladder and runs all the way to the tip of the head. There is also another tube from the testicles going to the urethra. This tube transports semen made in the testicles. In short, the urethra transports both semen and urine, which is why it is part of both the urinary and reproductive systems.
When a man becomes sexually aroused, blood fills the shaft and glans of the penis making it rigid and erect. Semen, which is produced in the testicles, begins to flow through the urethra, and at the right moment, around 150 million sperm cells in the semen are ejaculated from the penis into the female cervix. Despite the large number of sperm cells ejaculated from the penis, only one of those cells will reach a fertile egg.
From the description of the male reproductive system, you’ll be able to see that the possible problems may be from the quantity and quality of sperm cells and in the transportation method.
Cause of Condition
Male infertility problems fall into one or more of the following categories:
Azoospermia: Azoospermia is a condition described by the absence of sperm in the semen. It could mean that the body isn’t producing sperm.
Oligospermia: Oligospermia is a condition wherein only a minimal amount of sperm is being produced.
Sperm Motility: Sperm motility refers to the movement of sperm. If sperm isn’t moving the correct way, the chances of one reaching an egg and fertilizing it is slim to nil.
Sperm Morphology: Sperm morphology refers to the structure of sperm. Sperm with incorrect structure results in male infertility. The above conditions are caused by a wide variety of factors, such as blockages, sexually transmitted diseases, birth defects, retrograde ejaculation, genetic and hormonal diseases, erectile dysfunction, diabetes, hypertension, varicoceles, heart disease, and high cholesterol levels.
Treatment for male infertility will rely heavily on treating the exact cause of the condition.
The primary symptom of male infertility is the inability of a couple to conceive a child, even when they are not utilizing any method of family control. Other symptoms may include:
- Erectile dysfunction - reduced sexual desire or inability to ejaculate
- Pain in the testicles
- Chromosomal or hormonal abnormalities
- Lower than normal sperm count
- Frequent respiratory infections
It’s important to realize that male infertility is a sensitive issue. The failure to conceive a child can cause emotional and psychological stress to both parties. Understanding the cause of the condition will help alleviate the stress. However, it is best if the couple seeks medical assistance together to prevent emotionally alienating a single party.
Who to See & Types of Treatment Available
When facing infertility problems, couples should not assume that the problem lies with the male or female party. Only a complete medical analysis of the male and female reproductive systems will determine where the problem resides and what type of treatment would be able to increase the chances of them conceiving a child normally. Both male and female parties will need to undergo a physical examination and a detailed study of their medical histories. In addition to a physical exam and medical history study, the male party will also undergo semen analysis. If the results of the semen analysis are normal, the doctor will have the female party undergo fertility exams. If the results are not normal, additional exams will be needed to pinpoint the problem. These exams include:
- Transrectal ultrasound
- Hormone testing
- Testicular biopsy
- Scrotal ultrasound
- Genetic tests
- Post-ejaculation urinalysis
- Sperm function tests
- Blood tests
Once the exact cause of the condition has been identified, the doctor will recommend a treatment plan. This plan will involve treating the underlying cause. However, in some cases, the underlying cause cannot be determined (unexplained infertility). If this is so, the doctor will recommend treatment options that have worked for other patients. These include:
- Treatment for infections
- Hormone treatment
- Assisted Reproduction Therapy (ART)
In most male infertility cases, medical treatment is often supplemented with home treatments, such as increasing the frequency of sex or improving the timing, living a healthy lifestyle, and avoiding the use of lubricants.
The majority of male infertility problems can be treated, but there are cases wherein treatment ends in a failure. In such cases, the couple would need to consider obtaining healthy sperm from a donor. Sperm banks are widely available and they are ready to provide an infertile couple with enough sperm so that the woman can be impregnated through artificial insemination.
Although there have been insufficient studies to prove its effectiveness, it is believed that herbal supplements and a variety of vitamins are able to increase sperm count. However, before attempting the use of any supplement, it’s best that you consult your doctor. Always remember that there is a risk of using supplements, especially when taken in high doses.
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Swerdloff RS, Wang C. The testis and male sexual function. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 242.