Male Infertility
What is male infertility?
Infertility means not being able to conceive after 12 months of unprotected intercourse.
If the cause of the fertility problem is found in the man, this is male infertility. Male infertility is found in approximately half of all childless couples.
What causes male infertility?
Male infertility has several causes:
Hormonal problems
Genetic disorder or chromosome defects
Problems with the testicles and sperm production
Difficulties with erection or ejaculation
Infections including sexually transmitted infections and mumps / testicular infections
Some medications and drugs
Trauma and previous urological surgery
Cancer and its treatments
How is male infertility diagnosed?
Your doctor will conduct a thorough medical history and physical examination, and conduct tests to evaluate the possible cause of male infertility. In most cases of male infertility, either the semen is unable to reach the egg (obstructive) or the semen quality is poor (non-obstructive).
Tests performed to distinguish between these two causes may include:
Hormone profile including testosterone
Semen analysis x 2
After ejaculating into a sterile container you should deliver the sample to the laboratory. You should not ejaculate for 2-5 days prior and you should not do this test if you are unwell with a febrile illness.
Urine tests
Ultrasound / MRI
Testicular biopsy
This may be done for diagnostic reasons as well as for treatment reasons to obtain sperm for IVF.
How is male infertility treated?
It is important both the male and female partners are assessed simultaneously. Treatment is aimed at reversing any treatable cause or obtaining sperm samples for future IVF treatments.
One of these reversible causes of male infertility is a varicocele. A varicocele is enlargement of the veins that drain blood from the testicles. The condition affects about 15-20% men in general population and 25% of men with abnormal semen analysis. It is not fully understood how a varicocele affects fertility. Treatment of a clinically significant varicocele in infertile patients with abnormal semen analysis can increase chance of fertility.
Patients who have had a previous vasectomy may also be able to naturally conceive after having a vasectomy reversal. The success rate of vasectomy reversal depends on many factors, but the most important is the time since vasectomy.