Common causes of fertility problems in men

05.01.2015

About 10 percent of reproductive-age couples in the United States will have difficulty getting pregnant. About 30 percent of cases are due to fertility problems in the man, 30 percent to fertility problems in the woman, and the rest to unexplained causes or multiple factors involving both partners.

If you've had regular, unprotected sex for more than a year (or six months if you're over 35) without conceiving, see your doctor. The National Infertility Association says at least half of those who have an infertility evaluation and treatment will be able to have a successful pregnancy.

A reproductive urologist can identify male fertility issues, recommend treatment options, and help couples decide which options to pursue.

You also may want to see a genetic counselor. Sometimes, there's a genetic reason for male infertility that could be passed down to children. A genetic counselor can help couples understand their options for conceiving.

Read on to learn about the common causes of infertility and available treatments. Keep in mind that success rates may vary because one couple can have multiple fertility problems.

- lifestyle factors;

Making healthy choices can improve your fertility. You may be at greater risk of having trouble conceiving if you:

smoke,
drink alcohol heavily,
use drugs,
take anabolic steroids,
take certain medications, including testosterone replacement therapy,
have been treated for cancer,
have poor nutrition,
are significantly over- or underweight,
are exposed to toxins, such as pesticides or lead.

If you have any of these risk factors, be sure to talk to your doctor. Learn more about steps men can take to try to ensure a healthy pregnancy.

- blockages;

A small percentage of men have a blockage in their ejaculatory duct that prevents sperm from getting into ejaculate fluid. If your vas deferens or epididymis tubes are blocked or damaged, they can prevent your sperm from getting to your partner's egg. Infection, injury, congenital defects, or a vasectomy could cause this blockage.

Possible symptoms: none.

Possible solutions: Surgery to repair an obstruction or reverse the vasectomy, or surgery to remove sperm for in vitro fertilization (IVF).

- varicocele;

Varicoceles (enlarged veins, similar to varicose veins, in the scrotum) raise the temperature in the testes, which may affect sperm production.

Possible symptoms: Some men have scrotal pain, and others have no symptoms. (The problem can be detected through a physical exam or ultrasound.)

Possible solutions: Surgery to repair the varicocele, artificial insemination, or IVF.

- irregular sperm;

If you have little to no sperm, poor sperm motility (ability to move), or abnormally shaped sperm, your sperm may not be able to fertilize your partner's eggs.

Possible symptoms: None.

Possible solutions: fertility drugs; artificial insemination with donor sperm (or with your own if your count, shape, and motility are not too abnormal), or intracytoplasmic sperm injection (ICSI).

- anti-sperm antibodies;

Your body can develop antibodies that kill your own sperm, most commonly after a vasectomy, testicular torsion (where the testicle twists inside the scrotum), infection, or trauma.

Possible symptoms: none.

Possible solutions: Artificial insemination, assisted reproductive technologies (ART), or intracytoplasmic sperm injection (ICSI). Steroid drugs, such as prednisone, are sometimes used to suppress sperm antibodies, but many doctors don't recommend them because of side effects from prolonged steroid use.

- unexplained fertility problems.

Your doctor may diagnose you with an "unexplained fertility problem" if she can't pinpoint the cause of your trouble conceiving. Some experts think environmental toxins may be contributing factors, but no direct links between fertility and these possible problems have been confirmed.

Possible symptoms: None.

Possible solutions: Fertility drugs combined with artificial insemination, or ART procedures such as IVF.

Source: babycenter.com