Male Fertility Tests
Male Infertility Treatments
|What Causes Male Infertility?
In order for a man to impregnate a woman, he needs to produce sperm in sufficient quantity and quality which are capable of finding their way to the woman's egg and fertilizing it. If his production is compromised in any way, infertility may result. The most common cause of male infertility is failure to produce enough sperm. Today, men are seeking advice in increasing numbers about their fertility. The average sperm count is declining rapidly. 50 years ago the average sperm count was 113 million per ml and today it is about 70 million. Scientists are not sure what is causing the decline; a number of factors are probably at play including the epidemic increase in sexually transmitted diseases and stressful lifestyles. Generally the physical causes of male infertility can be categorized in 4 ways: (1) something is wrong with the sperm (2) hormone imbalances (3) damage to the testes or (4) ejaculation problems.
• About 30 percent of male infertility cases are thought to be caused by varicoceles.
• In 30 percent of cases the cause is never determined.
• Up to 20 percent are caused by infections, primarily sexually transmitted diseases (STDS) like chlamydia, herpes, syphilis and gonorrhea.
• About 7 percent are due to blockages in the reproductive organs.
• 5-7 percent are caused by genetic disorders.
• 2-5 percent are caused by a hormone imbalance.
Sperm Count And Quality
Male fertility tests (specifically a semen sample) will help doctors determine the quality of a man's sperm. The results can indicate either:
1. Low sperm count - This is the main cause for most men. The average sperm count should be 20 million sperm per milliliter of ejaculate. A number less than this is called oligospermia. There are many causes of a low sperm count, ranging from:
- Lifestyle choices such as smoking, obesity, taking certain prescription medications and anabolic steroids.
- Varicoceles, an abnormal dilation of veins in the testes, similar to varicose veins. They are more commonly found in the left testicle and cause poor blood flow, damaging sperm production.
- Hormone imbalance, but this can be quickly checked with a blood test.
- Having conditions like diabetes, kidney disease, liver disease or sickle cell disease.
- Previous cancer treatments like chemotherapy or radiation therapy.
2. Sperm that can't swim straight - There may be plenty of sperm but the sperm have abnormal tails so they cannot swim straight or they can't swim at all. This is technically called immotile sperm or Kartagener's syndrome. When discussing the ‘fitness level’ of your sperm, the doctor will refer to your sperm motility.
3. Abnormally shaped sperm (called morphology) - If the sperm has a strange head it is called teratozoospermia. If at least 15 percent of your sperm is normally shaped you are considered fertile. Below this is infertile, and below 5 percent is particularly severe. Age, lifestyle choices and genetic factors influence morphology.
4. No sperm at all on ejaculation - No sperm in the semen is called azoospermia. It is not possible for a couple to become pregnant naturally if there is no sperm on ejaculation. It will require treatment in a fertility clinic. The cause could be a mechanical problem, fixable by surgery or a hormone problem which might be fixed with hormone injections.
While hormones are more commonly associated with female infertility, men's own hormones also play a huge role in their fertility. A lack of testosterone can impair sperm production. Or a general hormone imbalance may be caused by other medical conditions like diabetes, kidney failure and thyroid disease. While these conditions are not directly related to fertility they can indirectly affect it. Also men go through their own version of menopause called andropause where hormone levels change.
Physical Trauma and Mechanical Problems
If the testes are damaged, so too is their ability to produce hormones. Sperm production may be low or completely absent in severe cases. Common causes of testes damage are:
1. Receiving a kick in the groin.
2. Twisted testis which blocks blood supply. This needs to be treated within 6 hours or the damage to fertility can be permanent.
3. Inflammation or swelling of the testes, also called orchitis. Orchitis is caused by STDs but also mumps (but only after puberty), typhoid and tuberculosis. Also, severe influenza can damage sperm production for 6 months.
4. Genetic disorders such as klinefelter's syndrome can cause testicular failure. It means the man has an extra female X-chromosome.
5. Birth defects where the man is born with undescended testes (testicles fail to drop into the scrotum before birth). This is medically called cryptorchidism. In rare instances some men have no vas deferens, these are the tubes linking the penis and testes. CBAVD (congenital bilateral absence of the vas deferens) is more common in people with cystic fibrosis.
1. Erectile dysfunction is the inability to sustain an erection (impotence). 10 percent of men between the ages of 40 and 70 suffer complete erectile failure. In most cases the cause is psychological. However certain medications and medical conditions increase it's prevalence including depression medications, blood pressure medications, diabetes and heart attacks.
2. Retrograde ejaculation is where the muscles that push the semen through the penis do not work properly. Instead the semen is pushed into the bladder and is harmlessly urinated out of the body. It is more common in diabetics and men who have had their prostate removed.
3. Blockages in the reproductive system can cause infertility. The most common cause is inflammation due to an STD but it could also be caused by a hernia.
Testing Your Body: How does a doctor test for infertility in men?
Where To Get Help: Infertility resources
Certain lifestyle factors can seriously impact sperm production. These are:
Heavy Alcohol Consumption: Even one night's drinking binge can seriously damage your sperm to the point where it takes months to be restored.
Cycling: Studies show that cyclists are more prone to infertility, particularly if they use a bike with a hard seat.
Excess Heat: Holding a laptop on your knees can overheat the testes and interfere with sperm production. Wearing tight underwear also increases the temperature 'down there'.
Obesity: Obesity, also one of the causes of infertility in women, can cause decreased fertility in men.
Smoking: Seriously impacts both sperm count and sperm cell motility.
Diet: Not enough vitamin C and Zinc in the diet causes problems.
Environmental Hazards: Exposure to toxins like pesticides, paint, lead, mercury, boron, benzene, radiation and heavy metals.
Medications: Certain prescription drugs should be avoided if you want to improve your sperm count. Talk to your doctor before taking any of the following:
- Depression medications, especially Prozac.
- Anti-ulcer drugs.
- Blood pressure drugs, in particular beta blockers which may cause impotence.
- Cholesterol medications.
- High doses of body building steroids.
- Antibiotics may affect sperm production.
Age: Although age is not as pressing in men as it is in women, recent studies show that after the age of 40, fertility is also impacted in men.