Male factor infertility is a common cause or contributing factor of infertility. It requires careful evaluation by a reproductive endocrinologist to determine an exact cause.
Cause of Male Factor Infertility
Male factor infertility is often attributed to the following conditions:
- Low sperm count
- Abnormal sperm morphology – the size and shape of sperm
- Sperm motility (movement) problems
Diagnosing Male Factor Infertility
Your fertility specialist will perform a complete medical history and physical to diagnose male factor infertility. Testing may include:
- Semen analysis – a sample of semen, the fluid that nourishes and protects sperm, is analyzed to determine sperm count and quality. Measurements are taken for the total volume of semen, the concentration of sperm in the semen, the percentage of sperm that show forward movement, the shape and size of sperm and to look for infection or inflammation
- Hormonal testing – blood tests to determine the levels of hormones that control sperm production including follicle-stimulating hormone (FSH) and testosterone. Luteinizing hormone, estradiol, prolactin and thyroid hormone levels may also be evaluated. This additional testing is often done to look for an underlying cause of a severely low sperm count.
- Urology evaluation – your fertility doctor may refer you to a fertility urologist for an examination and further evaluation depending on the sperm parameters and hormone testing
- Testicular biopsy – in men with severely low sperm counts or azoospermia (no sperm in the ejaculate), a small tissue sample may be removed from each testicle for microscopic exam
- Additional tests – ultrasound or other imaging tests may be done to evaluate the condition of the testicles, blood vessels and possible obstructions inside the scrotum
Treatment of male factor infertility
Treatment of male factor infertility depends on the cause. Your urologist in conjunction with your fertility specialist may even recommended a combination of treatment modalities that could include:
Surgery – done to repair obstructions and varicoceles (swollen or twisted veins in the scrotum)
Medication – used to correct hormonal imbalances that negatively impact sperm
Fertility treatments – many treatment options allow a man’s own sperm to be used for his partner’s pregnancy. In cases of mild male factor infertility, artificial insemination (intrauterine insemination or IUI) may be successful. In cases of more severe sperm abnormalities, your fertility specialist may recommend in-vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI)
Lifestyle tips for improving male fertility
- Healthful diet – a diet rich in fruits and vegetables that contain natural antioxidants may slightly boost sperm count and movement
- Weight control – obesity has been shown to reduce sperm production. Maintaining a normal weight and staying active is recommended
- Avoid testosterone supplements – more and more men are being started on testosterone therapy for ‘low T’. Unfortunately testosterone therapy can significantly lower sperm counts. This effect is often reversible with stopping the testosterone and potentially starting another medication. However, in some cases the sperm count does not recover.
