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Future of Fertility

What Everyone Should Know About Male Infertility

It is thought that one out of every six couples deals with infertility. Male infertility refers to a health issue that lowers a male’s chance of getting a female partner pregnant. Up to 50 percent of infertility cases are believed to be linked to the male partner.

“Historically, if a couple had problems getting pregnant, the woman would get checked first and the man would get checked second,” said Ajay Nangia, MD, professor of urology at the University of Kansas Health System in a podcast for the Urology Care Foundation. “As time has gone by, however, more people are aware that the man and woman should get checked at the same time if they are having trouble getting pregnant.”

Male infertility can be the result of a low sperm count, abnormal sperm function, or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices, and other factors can also play a role in causing male infertility.

Most often, the cause is related to the process of making or moving the sperm. For example, some men have sperm that have a short life span. Other men can have a very low sperm count and some men cannot make sperm at all. Sometimes these problems can be reversed. Other times, they cannot. This is why is it is important to talk to your health care provider as they can help sort it out.

“It’s important for men to know there are treatable and reversible causes of male-factor infertility,” said Stanton Honig, MD, clinical professor of urology at Yale School of Medicine. “There are things we can adjust in terms of lifestyle, medical treatments, or even surgical treatments that can make a difference.”

Taking medication for conditions such as depression, cancer, or high blood pressure can also change sperm production, function, and delivery.

When to seek out help and what to expect

Dr. Honig noted that if a man is having trouble with infertility, it is worth it for him to see a urologist as soon as possible to find out the root cause. The urologist will take a medical history and do a routine physical exam. “It’s usually just talking to a doctor, having a painless physical exam, and gathering a semen analysis,” said Honig.

Treatment options

The good news is that many cases of male infertility are treatable, which allows couples to achieve their goal of having a family. Male infertility can be treated without surgery, with surgery, or with assisted reproductive technology treatments. Non-surgical options include lifestyle changes, medications, counseling, or hormone treatments. Other treatment options include surgery or the use of assisted reproductive technology.

There are also options for pregnancy without having sex. These methods are called assisted reproductive techniques. Examples of these techniques include in vitro fertilization (IVF), which is when an egg is retrieved from the ovaries and fertilized by sperm in a lab. Then, after three to five days of growth, the fertilized egg, called an embryo, is put back into the uterus. Another way involves intrauterine insemination (IUI), or placing sperm into the uterus through a tube. IUI is often used when there is low sperm count and movement problems, or when there is retrograde ejaculation (also known as dry orgasm).

Advances in reproduction techniques have moved to the point where a single sperm can be physically inserted into an egg. This procedure is called intracytoplasmic sperm injection (ICSI) and has changed the treatment option for even the most severe male-factor infertility. Because of ICSI, up to 80 percent of infertile men have the potential to conceive with their partner.

If you struggle with male infertility, there is hope. Dr. Honig reminds men to be tested sooner rather than later.

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