Male Infertility

Though erectile dysfunction seems to get tons of airtime, you don't often hear mention of male infertility. Male infertility, also referred to as “subfertility”, is an issue that one in six men will experience in their lifetime (based on 2002 reports from the Center for Disease Control). That being said, most of these men will not be aware of their infertility until they are trying to conceive, or if they experience dry orgasms.

Who is infertile?
Any man can experience male infertility, and just because you are infertile today does not mean that you will be so two years later. The National Women's Health Information Center (a branch of the U.S. Department of Health and Human Services) defines infertility as the failure to conceive after one year of trying through unprotected intercourse.

Although it can, male infertility does not have to involve a block or obstruction. It can also be hormonal or related to the production of the sperm. These issues can result from habits that you never dreamed could have a negative effect on sperm production, such as testosterone creams or tight pants. As many as 25% of men that experience male infertility, have cases that are deemed idiopathic; which simply means nobody understand why.

How do you find out?
If you suspect that your attempts at conception are being undermined by infertility, typically the first place you should look is at the male; though your fertility clinic may want to start testing you as a couple. This is not to say that the male is any more likely to be infertile, or the only one that is experiencing infertility, but male infertility is much easier to determine and has a much higher success rate than female infertility.

Semen analysis is one of the most important tests that is done when determining male infertility. This will measure the quantity and quality of the sperm that is being produced, as well as the semen that drives the sperm. There will also be blood tests, a physical examination, and a review of your medical history. After these tests you may require additional testing, such as the hamster egg test, CASA, in vitro mucous penetration test, hemizona assay test and electron microscopy. Each test has its own specific purpose and will help guide you and your specialist toward the proper treatment options for your individual case.

Though the male may be identified as being infertile, it’s important that he should not be viewed as an infertile partner; rather, you should consider yourselves an infertile couple. He has not chosen infertility and should not be blamed for it. The path that you take to try to overcome it will involve both of your efforts.

What causes male infertility?
There can be several reasons that a male is deemed infertile, and there can be several causes attributed to each. Some causes for infertility in a male are:

Low sperm count. The laboratory-defined range for normal sperm count per milliliter is 20-150 million. It’s possible for you to conceive with a lower count than 20 million and be infertile with a count over 20 million, but these guidelines are simply the numbers that the specialist prefers to see. In reality the quality can be much more important than the count, but the count can be a good indicator.
Low motility. Motility refers to sperm that move. If more than half of your sperm are not moving, the motility can be a contributing factor. Sperm need to be able to progress, or swim forward, in order to fertilize the egg in the female's fallopian tube. Most won't survive as it's a very long trip, so the more motile, the better.

Poor morphology. Morphology relates to the shape of the sperm. Sperm is segmented into three sections; the tail that swims, the midsection that operates as the fuel tank for the trip, and the head. Sperm that are misshapen will be rejected by the egg. The normal range starts at approximately 14%.

“Weak” sperm. Some sperm are simply not able to penetrate the egg. Tests, such as the hamster egg test, are designed specifically to detect this very issue.

Most reasons that sperm are not effective can be detected, but the causes are sometimes a bit more elusive. A man’s sperm may be suffering because of an infection that he is not aware of, blockage or restriction of passages that the sperm travel (such as the vas deferens or the urethra), toxins that he is either accidentally or unknowingly exposed to, hormonal imbalances, undescended testicles, varicoceles, poor physical health, or even diabetes.

What can I do?
There are many small adjustments that you can make to coax your productivity and viability, but it’s important to know when to say it's time to see a specialist. Your fertility specialist will assist you in determining the source of your infertility, as well as guide you through treatments that will help make conception more achievable. Over 90% of all male infertility cases are correctable. Even if you are unable to make your sperm more viable through treatment, often you can make the egg more available via IVF or IUI.

Infertility is not a life sentence; help is out there. Seek counsel from your physician regarding your situation if you feel that infertility may be jinxing your efforts to conceive. Male infertility does not mean that you are less of a man, but not investigating the possibility of male infertility can be all that’s keeping you from conceiving.