What is this Condition?

Male infertility - inability of a man to reproduce - is suspected whenever a couple fails to achieve pregnancy after about 1 year of regular unprotected intercourse. Male infertility accounts, in whole or in part, for 40% to 50% of infertility problems in North America.

What Causes it?

Numerous factors, including anatomic and hormonal abnormalities, can cause male infertility.

What are its Symptoms?

The obvious sign of male infertility is failure to impregnate a fertile woman. An infertile man may also have shrunken testicles, or an empty or swollen scrotum; inflamed seminal vesicles (pouches that secrete seminal fluid, which keeps sperm cells viable after ejaculation); abnormal masses on the spermatic cord and vas deferens (a tube that forms part of the spermatic cord); abnormal growths on the penis; hypospadias (a congenital defect in which the urinary opening is on the underside, rather than the tip, of the penis); or prostate enlargement.

How is it Diagnosed?

The doctor obtains a detailed history, which may reveal abnormal sexual development, delayed puberty, infertility in previous relationships, and a medical history of prolonged fever, mumps, impaired nutritional status, previous surgery, or injury to the genitalia. After a thorough history and physical exam, the most conclusive test for male infertility is semen analysis.

The doctor also may order other lab tests, such as studies of the organs that control hormone secretion and sperm formation, and measurement of testosterone levels in the blood. He or she may also perform a biopsy (removal and analysis of testicular tissue) and may order X-rays of the reproductive system.

How is it Treated?

If male infertility stems from an anatomic problem or infection, it’s treated by correcting the underlying problem. For instance, enlarged varicose veins in the scrotum must be surgically repaired or removed.

If infertility results from sexual dysfunction, treatment includes education, counseling or therapy (on sexual techniques, frequency of intercourse, and reproductive physiology), and proper nutrition with vitamin supplements. Men with decreased levels of follicle-stimulating hormone (which stimulates sperm formation) may respond to vitamin B therapy; those with decreased levels of luteinizing hormone (also active in sperm formation) may respond to therapy with chorionic gonadotropin (a hormonal substance that stimulates testicular function). Men with normal or elevated levels of luteinizing hormone require low doses of testosterone. Those with decreased testosterone levels, reduced semen motility, and a low sperm count may respond to chorionic gonadotropin.

Men with a low sperm count who have a normal history and physical exam, normal hormone study results, and no signs of disease need emotional support and counseling, adequate nutrition, vitamin. supplements, and hormone therapy with chorionic gonadotropin. and testosterone.

What can an Infertile Man do?

If you have a low sperm count, avoid activities that may impair nor­mal sperm development by raising scrotal temperature, such as wearing tight underwear and athletic supporters, taking hot tub baths, or habitually riding a bicycle. Be aware that a cool scrotal temperature is essential for adequate sperm development.

If possible, consider participating in support groups where you can share your feelings and concerns with other couples with the same problem.