The Male Factor
Although many people consider fertility a "woman's problem," up to half of all cases of infertility involve the male, specifically sperm problems. Infertility may limited to the male factor or it may be in combination with a female factor. Couples will quickly discover that both partners will be tested so as to quickly narrow down the list of potential problems and provide the physician an ability to treatment plan.
Getting Tested
After a physical examination, your doctor will probably order a semen analysis, to check the quality and quantity of sperm in the semen. Because the testing will require a fresh sample, you will probably provide the sample at the doctor's office.
Usually when the first analysis is normal, your doctor will order a second test to rule out a false negative results. Two normal tests usually rules out significant male infertility problems. However, when something looks irregular, your doctor will order further tests to isolate the problem.
Semen analysis can detect a number of potential problems including:
· Azoospermia. Where no sperm are produced, or are in the semen.
· Oligiospermia. Where few sperm are produced.
· Sperm motility. When sperm do not move normally, they are less likely to fertilizing an egg.
· Sperm morphology. Where problems with sperm form and structure cause infertility.
While these problems may be the reason you can't conceive, they may demonstrate an underlying medical condition which will have to be investigated.
Reasons for Male Infertility
There are a wide number of reasons for male infertility. Some are internal to the sperm, some external. Possible problems include:
· Sexually transmitted diseases or other infections such as chlamydia and gonorrhea can cause infertility but which can be resolved by treating the infection.
· Blockages in the testicles, prostate or urethra from birth defects or physical damage can cause fertility issues. Surgical intervention may resolve these problems.
· Retrograde ejaculation. In this condition, semen is directed into the bladder, and does not exit the penis through the urethra. It can be caused by diabetes and surgery to the bladder, prostate, or urethra.
· Genetic diseases. Although rare, genetic illnesses such as cystic fibrosis or chromosomal disorders can cause infertility.
· Autoimmune problems. Here the immune system will attack sperm cells as if they were a foreign body.
· Hormonal problems. Hormonal imbalances in the pituitary and thyroid glands can cause infertility by interfering with the production of sperm.
· Sexual problems. Erectile dysfunction (impotence) and premature ejaculation will obviously have an effect on fertility. Erectile dysfunction may be caused by psychological problems such as anxiety, or physical problems such as diabetes, high blood pressure, high cholesterol, and heart disease. In addition, impotence may be a known effect of cardiac or anti-anxiety medications.
· Varicoceles. Varicoceles are enlarged varicose veins prevent blood from flowing properly in the scrotum. Varicoceles are found in up to 40% of men being evaluated for infertility. Unfortunately, recent studies question whether correcting varicoceles will reverse male infertility.
Environmental Factors That May Cause Male Infertility:
· Excessive exercise. Exercise can release too many steroid hormones leading to fertility problems.
· Stress.
· Obesity.
· Use of drugs. Drugs such as tobacco, marijuana, cocaine and steroids can reduce sperm counts.
· Exposure to toxins and environmental hazards. Pesticides, lead, radiation, mercury and heavy metals may affect fertility.
· Heat. Although temporary, higher temperatures in the testicles could reduce sperm production. This may arise from wearing tight clothing, frequent bike riding or by hot baths or saunas.
Getting Pregnant When Male Factor Infertility Is Involved
The physician will first investigate the environmental factors of your lifestyle so as to suggest behavioral changes you can make to increase your fertility.
With a low sperm count, your doctor may recommend decreasing sexual activity to build up a better concentration of sperm. He or she may also suggest vitamins as recent studies have found that low sperm counts can be increased by taking a combination of a folic acid and zinc.
If you have abnormal hormone levels, your doctor may recommend hormone treatment. Retrograde ejaculation is occasionally treated with over-the-counter cold medicines.
In some cases of mild infertility, artificial insemination or other assisted reproduction techniques, such as GIFT and ZIFT, may be helpful. With more severe infertility micromanipulation of the zygotes through intracytoplasmic sperm injection (ICSI) may provide relief. This laboratory procedure has a single sperm is injected into the egg which is implanted into the uterus after fertilization.
