1. Home
2. Fertility 101
3. Male Infertility

Male Infertility

Male infertility is common, contributing to roughly one-third of all infertility cases. Fortunately, lifestyle changes, clinical therapies, and fertility treatments can effectively address male infertility for couples trying to conceive. At Kentucky Fertility Institute, we can help determine the cause of male infertility and develop a personalized treatment plan to manage it.

Causes of Male Infertility

Issues with semen health are the most common cause of male infertility. The concentration (amount), motility (movement), and morphology (shape) of sperm cells can impact their ability to reach and fertilize the egg successfully. Male infertility can be caused by various medical, genetic, environmental, and lifestyle factors, including:

• Chromosomal (genetic) issues

• Hormonal imbalances

• Anatomic problems of the reproductive system

• Vascular problems of the reproductive syste

• Use of certain medications

• Prior cancer treatment

• Obesity

• Exposure to certain toxins, such as industrial materials or heavy metals

• Smoking or e-cigarette use

• Excessive alcohol use

• Use of marijuana or other illicit drugs

Sperm Disorders

Several conditions can impact sperm function, including:

• Oligospermia: Having low sperm count

• Azoospermia: When there is no sperm present in the semen

• Cryptozoospermia: When there is an extremely low sperm count

• Polyzoospermia: When there’s an unusually high concentration of sperm

• Asthenozoospermia: Having diminished sperm motility

• Hypospermia: Having a low volume of semen

• Hyperspermia: Having an abnormally high volume of semen

• Teratozoospermia: Having a high number of abnormally shaped sperm

• Necrozoospermia: When dead sperm is present in a semen sample

Male Infertility Symptoms

The primary symptom of male factor infertility is the inability to conceive. This is defined as engaging in regular, unprotected sex for a year without achieving pregnancy if under the age of 35, or for six months if over the age of 35. Other symptoms that can accompany male infertility include:

• Abnormal breast tissue growth

• Reduced body hair

• Pain or swelling in the testicles

• Low sex drive

• Sexual dysfunction (issues with erection or ejaculation)

Diagnosing Male Infertility

The first test for evaluating male infertility is typically a semen analysis. During this test, the patient will provide a semen sample by masturbating into a sterile container. An experienced technician will then assess sperm parameters including count, motility, and morphology. In addition to a semen analysis, other common studies include hormone testing, sperm DNA fragmentation, and genetic testing.

Treating Male Infertility

There are various ways to treat male infertility, including:

Preventative Care

Lifestyle factors can play a significant role in male infertility. Some ways to prevent male fertility issues or improve them include:

• Achieving and maintaining a healthy BMI

• Eating a well-balanced diet

• Reducing alcohol consumption

• Quitting smoking and drug use

• Avoiding certain medications, like testosterone

• Avoiding testicular injury or prolonged heat exposure

While following these steps can’t guarantee successful conception, they can help to significantly improve sperm quality for some men.

Medications

In some cases of male infertility, medications can help to improve sperm count. Use of these medications is considered “off label”, and should only be considered under the advice of a board-certified reproductive specialist or urologist. Common medications used in management of male infertility include clomiphene citrate, anastrozole, letrozole, menotropins (hMG), human chorionic gonadotropin (hCG).

Surgical Treatment

A varicocele is an abnormal enlargement of veins within the scrotum. Varicoceles are chronic conditions and can compromise blood flow within the testicles. For many men, varicoceles do not cause any symptoms and may go unnoticed. For other men, they can be a source of scrotal pain or discomfort. Untreated varicoceles can lead to problems with testicular health and potentially cause issues with sperm production and quality. Men with varicoceles who are experiencing discomfort or infertility should be evaluated by an experienced urologist, and surgical management can be considered in some cases. With successful surgery, normal blood flow to the testicles can be restored and lead to improvements in sperm health and fertility.

Fertility Treatment

Fertility treatments can help couples experiencing male factor infertility conceive. These treatments include:

• Intrauterine insemination (IUI): A procedure where highly-concentrated sperm is inserted directly into the uterus

• In vitro fertilization (IVF): A process where sperm is combined with an egg in a laboratory for fertilization, producing an embryo that is then inserted into the uterus

• Intracytoplasmic sperm injection (ICSI): A procedure where a laboratory specialist uses a microscope to inject a single sperm cell directly into an egg as a part of IVF treatment.