Male Infertility: Everything You Need to Know
Infertility can be an extremely isolating experience. And while it may be considered primarily a women’s issue, the fact is that male factor infertility accounts for over a third – potentially as high as 50 percent – of all infertility cases. The numbers are growing quickly; so much that some experts believe we are close to having a true fertility crisis on our hands. But because men’s fertility is so rarely discussed, many don’t speak up – or even realize they’re part of the male infertility statistics.
What is male infertility?
Any male reproductive issue that lowers the chances of a female partner getting pregnant is known as male factor infertility. Though there are different types of male infertility, it is usually related to sperm production or delivery.
The male reproductive system makes, stores and transports sperm. Sperm and the male sex hormone, testosterone, are made in two testicles, which are located in the scrotum. When sperm leave the testicles, they go into a tube called the epididymis. They move from the epididymis to the vas deferens just before ejaculation. There, they mix with fluid from the prostate and seminal vesicles to form semen, which then travels through the urethra and out of the penis. If any part of this process doesn’t happen normally, there is a high risk of male factor infertility.
Some of the most common causes of infertility in males include:
- Undescended testicles
- Retrograde ejaculation, or backward ejaculation of sperm
- Blockage of sperm-carrying ducts
- Hormonal imbalance
- Abnormalities with sperm size, shape, number and motility
A report from July 2017 shows that sperm concentration has fallen by 52 percent among men in Western countries between 1973 and 2011. 40 years ago, the average Western male had a sperm concentration of 99 million per milliliter. By 2011, the average concentration was just 47.1 million. Anything under 40 million per milliliter is considered below normal and may cause male infertility.
What are the symptoms of male infertility?
While the most obvious sign is the inability to conceive a child after more than a year of trying, the symptoms of male infertility may otherwise go unnoticed. However, some men realize something is wrong even without trying to conceive due to other health problems; symptoms of a more serious issue may include:
- Problems with sexual function, such as erectile dysfunction or difficulty ejaculating
- Pain or swelling in the testicles
- Signs of a chromosomal or hormonal abnormality such as breast growth or decrease in facial or body hair
What can cause a man to be infertile?
Past illness or infection, medical conditions and hormonal imbalances are most commonly linked to male factor infertility. However, experts believe that a combination of lifestyle and environmental factors play a major role too, especially when it comes to the health, quality and quantity of sperm.
Causes of low sperm count in men can include stress, alcohol, drug use, smoking, obesity, inactivity, and even watching more than 20 hours of television per week – in general, poor lifestyle choices.
Exposure to some environmental toxins is also a concern, specifically endocrine disrupting chemicals. These are found in common compounds like phthalates and bisphenol A (BPA) in everyday items. They mimic the effect of estrogen, a feminizing hormone, and can interfere with a masculinizing hormone like testosterone. Any exposure to endocrine disrupting chemicals can, in fact, impact the health of sperm.
Even heat can be attributed to low sperm count; studies show that birth rates decline nine months after a heat wave, which means that climate change could ultimately play a role in male infertility. And while age-related infertility is more often attributed to women, a man’s fertility also decreases starting in his mid-30s. After 40, men are at a greater risk of having children with genetic abnormalities and conditions like autism and schizophrenia.
Can male infertility be treated?
Male infertility is often a sign of overall health issues – the canary in the coal mine – and should be taken seriously. Depending on the diagnosis and severity, male factor infertility is treatable. The first challenge is awareness. Many men simply don’t know that their fertility could be in jeopardy. A recent Canadian study found that men knew just 50 percent of the potential risks to sperm production – aside from taking general care of their health, avoiding things such as exposure to high heat, tight clothing, and even excessive bike riding are major means of prevention. That said, men who exercised more than 15 hours a week also had a 73 percent higher sperm count than those who exercised less than 5 hours a week.
Aside from lifestyle choices, infertility treatments and alternatives are an option for many couples trying to achieve pregnancy.
Intrauterine Insemination (IUI) utilizes a catheter to transfer sperm directly into a woman’s uterus. It is less expensive than other fertility treatments, but also has a lower success rate.
In Vitro Fertilization (IVF) involves eggs and sperm being combined in a lab to create an embryo, which is then transferred back to the woman’s uterus.
Intracytoplasmic Sperm Injection (ICSI) is a supplementary procedure to IVF treatment done specifically to increase the chances of male fertilization. A single sperm is drawn from the testicle and then injected into a single egg to create an embryo.