- Infertility is the failure
of a couple to become pregnant after 1 year of having regular, unprotected sexual
intercourse. Problems in the male reproductive system can prevent a woman from getting
pregnant.
Infertility is a problem for one of every six
couples. Problems in the male partner are responsible for about 50% of infertility cases.
Many couples seek help from a specialist.
 |
- How does it occur?
|
- Male infertility most commonly occurs because the man
produces too few sperm or no sperm at all. Reasons for this include:
| exposure to toxic
chemicals or radiation |
a genetic disorder, such
as Klinefelter's syndrome |
taking frequent, long,
hot tub baths |
| alcohol, tobacco, or
drug abuse |
a severe mumps infection
as an adolescent or adult. |
|
-
Sometimes the sperm are abnormal. That is, they are
malformed and cannot swim properly or they have a short lifespan. A normal sperm has a
lifespan of about 4 days. Defective sperm can result from:
| inflammation of the
testicles (a possible complication of having the mumps as an adult) |
hormone-related problems
(such as certain tumors of the pituitary gland) |
| abnormally twisted or
swollen veins in the scrotum (the sac that holds the testicles) |
abnormally developed
testicles (most often of unknown cause, but in rare cases caused by a hormone-related
problem). |
| damage to the spermatic
tubes (resulting from a previous vasectomy or a bacterial infection such as gonorrhea or
chlamydia) |
|
Sometimes the problem is in delivering the sperm to
the woman's vagina (ejaculation). Problems with ejaculation may include:
| early ejaculation |
retrograde ejaculation
(semen is forced back into the bladder) |
| a complication of
radiation therapy or surgery. |
inability to maintain an
erection (possibly due to side effects of some blood pressure medications or diseases such
as diabetes or Peyronie's disease) |
|
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Sometimes the problem is a natural decline in
fertility that comes with aging. The decline occurs more rapidly after age 40.
|
- How is it diagnosed?
|
- A couple's failure to become pregnant can be due to
male or female problems, or both. At first, the couple usually sees a primary care
physician together.
Specialists are often consulted to investigate and
treat infertility. Men usually see a urologist. The doctor will give you a physical exam.
You may have to give the doctor more information to
help determine why pregnancy doesn't occur. The doctor will ask both you and your partner
questions during joint and separate interviews. Knowing if the man or woman has had
children with another partner will help the doctor make a diagnosis.
Some of the questions usually asked are about
previous medical conditions such as illnesses and infections, use of drugs and alcohol,
sexual intercourse practices, detailed sexual history, genital surgery, circumcision, and
normal genital development.
The doctor may order the following tests:
| a semen analysis to check for the
number and quality of sperm |
blood tests to check for infections
from sexually transmitted diseases and for a hormone imbalance |
cultures of fluid from the penis to
check for infections. |
-
| How is it treated?
|
If the doctor discovers an underlying disorder that
is causing the infertility, he or she will recommend treating this problem to try to
restore fertility. Treatment may include medication (usually hormones or antibiotics) or
surgery. Sometimes a combination of treatments for both partners is necessary.
To restore your fertility the doctor may suggest
that you do the following:
| Take hormones to treat a
hormone imbalance. |
Take drugs to stimulate
sperm production. |
Take an antibiotic to
clear up an infection. |
| Have therapy to treat
ejaculation problems. |
Avoid long, hot showers
and frequent use of hot tubs and saunas. High temperatures can reduce your sperm count.
Also, wear boxer shorts rather than jockey shorts. |
Have surgery to correct
a disorder in the testicles. |
If you cannot produce any sperm, you must consider
other choices, such as a using sperm donated by someone else or adoption.
If your sperm count is low, artificial insemination
may be an option. The sperm is collected at several different times, stored until there is
a sufficient amount, and then placed in the woman's body during the most fertile time in
her menstrual cycle. This procedure has varying success. If your sperm count is still too
low or the sperm are not able to function properly, the woman could become pregnant using
sperm donated by another man.
In vitro fertilization is yet another option. In
this procedure, the egg is fertilized with sperm in the laboratory and implanted into the
woman's body. This procedure is an option if the man's sperm count is low or the woman's
fallopian tubes are blocked or damaged and cannot be corrected with surgery. In vitro
fertilization is expensive and success rates are often low.
The period of investigation and treatment for
infertility can be stressful for a couple and put unusual strain on their relationship.
Counseling may help the couple get through any difficult times.
| What can be done to
help prevent infertility?
|
You may not be able to prevent infertility resulting
from genetic abnormalities or an illness.
Some of the things you can do to reduce your risk of
developing disorders that might cause infertility include: |
 - Ask the Expert about
- Sexual Health
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|
| Prevent sexually
transmitted diseases by using condoms and making sure that both you and your partner only
have sex with each other. |
Limit the amount of
alcohol you drink. |
Avoid use of
recreational drugs (such as marijuana) and overuse of prescription and over-the-counter
drugs. |
| Avoid exposure to toxic
substances such as industrial chemicals, herbicides, and pesticides. |
Maintain good personal
hygiene and health practices. |
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