Male infertility not uncommon

Sperm testing can provide clues to cause, best treatment path.

A challenge inherent in male infertility is that its root cause is often unknown until the time comes when a man and his partner are ready to conceive a child.

Infertility in both men and women is diagnosed after the couple has tried to conceive for at least a year with no success. In most cases, couples will begin their investigation of its cause by looking at the reproductive health of the woman, but will quickly turn their focus to the man.

Studies have shown that up to 15% of couples are unable to conceive after one year of having unprotected intercourse. About a third of the time, infertility is because of a problem with the man. Another third of the time it is a problem with the woman. In the remaining third of cases, the problem lies with both the man and woman, according to the National Institutes of Health (NIH).

“Infertility is much more common than most people realize,” said Aaron Block, MD, a family physician with Franklin Family Practice. Block specializes in male infertility, providing the testing and counseling necessary to get a man to the place where he and his partner have the best chance to conceive.

An initial step Dr. Block takes with couples who are referred to him is to test the quantity and quality of a man’s sperm. Abnormal semen production is said to account for half of infertility problems in men, the NIH said. Therefore, testing a man’s semen often helps determine if the man might be a cause for the couple’s infertility, and if so, the testing helps determine a path forward in treating it.

There are many different reasons why a man may be infertile, and those reasons are often broken down into two different groups: those that are reversible and those that cannot be reversed, said Block, who practices with Premier Physician Network. As suggested by the name, reversible causes often can be resolved once treated or addressed:

Medications – Many medications used for other health conditions such as anti-depressants and hypertension can affect a man’s fertility. Likewise, anabolic steroids and testosterone replacements can have a negative impact on sperm production.

Untreated diseases – Diseases such as diabetes and hypertension can greatly affect fertility when they are left untreated.

Hormonal imbalances – Men who have hormonal abnormalities such as an imbalance of testosterone versus estrogen or just have low testosterone to begin with may struggle with infertility. Pituitary dysfunction can also play a role.

Lifestyle and habits – Many times, lifestyle choices have a significant effect on a man’s fertility. Anything that can create excessive heat in a man’s groin area such as wearing tight underwear

or sitting on a bike for a long period of time can be contributors. Smoking, excessive alcohol consumption, stress and a poor diet also play a role in sperm production.

Non-reversible factors are harder to address and often provide a lower probability for improving infertility. These may include genetic abnormalities, previous trauma to the testicles, and a history of radiation or chemotherapy that may have destroyed spermproducing cells.

The causes for infertility are numerous; however, many cases can be resolved once discovered. For this reason, it’s important for men to be evaluated despite the emotional strain it may place on the individual or on his relationship with his partner.

“A lot of men feel embarrassed or de-masculinized by infertility, but it’s no different than any other health issue that I talk about with patients. In all cases, I tell them that we are not machines built in a lab to perfection. No one’s body works 100% in all areas,” Block said. “In the end, men who are willing to show up at an appointment are going to be pretty engaged in the process.”