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Men’s Health Month: The Truth About Male Infertility

When a couple can’t conceive, the problem could be his

When a couple has trouble getting pregnant, it’s easy to assume the problem is the woman’s. You might be surprised to learn that only about one-third of infertility is attributed to the female partner, and one-third to the male partner. The other third is usually caused by a combination of both.Male and Female couple with possible fertility or infertility problems

To find out the root cause of infertility, we recommend that both partners be evaluated at the same time after one year of trying to get pregnant (six months if the woman is over age 35).

So, what if it’s him? In observance of Men’s Health Month, we’d like to share some facts about male infertility.

 

First, the basics
About 100 million sperm are produced daily, but it takes 90 days for them to become mature enough to fertilize an egg.

Optimum body temperature is extremely important for healthy sperm production. Small muscles in the male reproductive system help move testicles further away from the body when it is warm, and bring them closer to the body when it’s cold. That’s why tight underwear is not good for sperm production, as it prevents the testicles from moving away from the body when they become too hot.

Most problems with the male reproductive system can be grouped into three main categories:

  • Pretesticular. This includes hormonal abnormalities, such as those in the thyroid gland, or general health issues such as diabetes, kidney or liver problems.
  • Testicular. These issues can include abnormal sperm production caused by low testosterone, chromosomal abnormalities, trauma or a dilation of the veins around the testicles that increases their temperature.
  • Posttesticular. This could include a blockage of the duct that transports sperm outside the body. It can be acquired, such as after a vasectomy, or congenital, such as in cystic fibrosis.

 

Testing and treatment
The easiest way to test for possible factors of male infertility is a semen analysis. This can be done through “collection” in a cup, either in a private room at your doctor’s office or at home if you bring the sample to the office within one hour. You’ll need to be abstinent for two to five days prior to collection for the best results.

Your sperm will be assessed for volume, concentration, percentage of motility (movement) and morphology (shape). The sample will also be assessed for infection, pH and viscosity. Abnormalities in one of more of these areas could be a contributing reason why you and your partner have not been able to conceive.

If your first semen analysis is abnormal, we recommend testing a second time to make sure the cause was not simply anxiety (which is very common). If your results are still abnormal after the second test, we recommend that you schedule a physical exam and history with a urologist who is experienced in male fertility.

Treatment for male infertility depends on the cause, but most problems can be corrected. Treatments may include medications, surgery, intrauterine insemination or sperm extraction for the purpose of in vitro fertilization (IVF). Some commonly used medications, such as those prescribed for peptic ulcer disease, can interfere with sperm production, so check with your doctor for any possible drug interactions.

 

Prevention, testosterone and other factors
There are things you can do to optimize sperm production and improve your chances of conception, and one of those is simply living a healthy lifestyle.

Take vitamins and antioxidants, eat clean (no processed foods), maintain a healthy weigh, don’t smoke, limit your alcohol intake and engage in light exercise to reduce stress. Take steps to make sure testicles don’t overheat — stay out of hot tubs or saunas, wear boxers instead of briefs, and don’t work with a laptop on your lap.

One thing to note about testosterone. If a male is diagnosed with low testosterone, he is usually started on testosterone injections. While these injections will help him feel better, this “extra” testosterone will stop all sperm production. In order to produce sperm, the body has to produce testosterone on its own.

So, if you have been diagnosed with low testosterone and want to have children, don’t take supplemental testosterone. Ask your doctor to recommend other medications that will increase your body’s own testosterone production, such as Clomid or hCG injections.

And speaking of supplements, be careful with ones that are recommended for fitness and bodybuilding. Although not always displayed on the label, they may contain testosterone and other synthetic androgens/anabolic steroids, which will also stop sperm production. Once you stop taking testosterone or workout supplements, sperm production usually returns within six months.

If you’re struggling to start your family or have additional questions about male infertility, we’re here to help. Call us to schedule a consultation at 502-897-2144.

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