FERTILITY PROBLEMS IN MEN

 Basic information

description

Infertility is the inability to achieve pregnancy after 1 year of sexual activity without contraception. Infertility affects 10% to 15% of reproductive-age couples. Causes of infertility are about equal in men and women (35% in each). In 20% of couples, both have problems, and in 10%, the cause is unknown.

FREQUENT SIGNS & SYMPTOMS

Failure to impregnate a fertile woman.

causes

In males, it is due to low sperm counts, poor sperm quality, or both. There are known risk factors (e.g., chronic illness), but in many cases, no cause is found.

risk increases with

• Certain physical problems of the penis or testicles (e.g., blockage in certain tubes or undescended testes).
• Antisperm antibodies (immune system targets sperm in error).
• Retrograde ejaculation (sperm go backward instead of forward).
• Urinary-tract infection or injury to the genitals.
• Hormone, metabolic, or endocrine disorders.
• Some types of surgery (e.g., bladder or prostate).
• Mumps.
• Some genetic disorders (e.g., Klinefelter's syndrome).
• Excess alcohol use or substance abuse.
• Use of some drugs, such as antihypertensives, cytotoxic drugs, male hormones, and MAO inhibitors.
• Sexually transmitted disease, such as syphilis and nonspecific urethritis that causes scarring.
• Varicose veins in the testicles (varicocele).
• Overheating of the testicles.
• Intercourse problems (e.g., premature withdrawal, poor timing with menses, too infrequent).
• Exposure to insecticides or industrial chemicals.
• Aging, poor nutrition, or poor general health.
• Smoking.
• Cancer and its treatments.
• Obesity.
• Excess stress (both mental and physical).

PREVENTIVE MEASURES

• Specific preventive measures depend on the cause.
• To increase chances of conception, have intercourse every other day starting a few days before ovulation. (Sperm live for up to 72 hours.) Don't use lubricants.
• Try some lifestyle changes:
  • Stop smoking. It can reduce sperm counts and impair sperm motility.
  • Avoid alcohol or any substances of abuse.
  • Avoid hot baths or showers or hot tubs.

expected outcomes

Some fertility problems are minor and reversible. Often, no clear cause for infertility is found. Each patient should approach treatment with optimism.

possible complications

Emotional stress caused by feelings of guilt, inadequacy, and loss of self-esteem.

 diagnosis & treatment

general measures

• Diagnosis begins with a detailed medical history and general physical exam. Medical tests may include blood and urine studies and semen analysis (to check on quality, quantity, form, and motility). More testing may be done depending on these results.
• A fertility treatment plan will be developed that is based on each couple's needs. It may include lifestyle changes, medical therapy (e.g., drugs or surgery), or assisted reproductive techniques (ART). ART can help many couples who are unable to conceive. The different ART options will be explained to you.
• A medical fertility specialist may be recommended for help and guidance.
• Counseling may be helpful for stress, sexual therapy techniques, marriage problems, or alcoholism.
• To learn more: Resolve, 1760 Old Meadows Rd., Ste 500, McLean, VA 22102; (703) 556-7172 (not toll-free); website: www.resolve.org or American Fertility Assn., 305 Madison Ave., Suite 449, New York, NY 10165; (888) 917-3777; website: www.theafa.org.

medications

• Drugs may be prescribed to treat a cause of infertility.
• Dietary supplements may be recommended.

activity

Exercise regularly, but not too strenuously. Get enough sleep.

diet

Eat a well-balanced diet. Begin a weight loss diet if overweight is a problem.

 notify our office if

You or a family member is concerned about fertility.

Special Notes: