Education & Diagnosis
Male infertility means that the man is not able to conceive a child through frequent, unprotected sexual intercourse. Infertility affects 15% of couples attempting pregnancy in the United States. Approximately half of those cases involve "male factor" fertility problems. Male infertility can be caused by hormonal, chromosomal, structural or unknown abnormalities. While the only primary symptom is not being able to produce a child, there are some other symptoms that might suggest infertility as well including a swelling of the testicles, delayed ejaculation, erectile dysfunction and signs of a chromosomal or hormonal abnormality. It becomes important to get a full physical by your urologist to rule out any underlying problems, as well as discover if and what is causing your infertility.
Testing & Treatment
Some types of male infertility can be treated, while others cannot. Treatment for male infertility will ultimately depend on the cause. A basic male fertility evaluation should be done before more invasive testing is done on either partner so that any underlying problems can be addressed first. An initial male fertility evaluation usually includes a complete physical exam, hormone testing and a thorough review of a man's medical history. This evaluation should also include semen analysis, in which a sample is taken and reviewed to determine the volume, count, concentration, movement and structure of sperm. Depending on the results of the initial male fertility evaluation, a urologist may order additional tests such as an ultrasound of the ejaculatory ducts or a testicular biopsy. Once the underlying cause has been identified, a course of treatment can be established.
- Varicocele: The most common cause of infertility in men is a varicocele or varicose veins scrotum. Varicoceles are abnormally dilated spermatic cord veins that allow retrograde blood flow to the testes. A varicocele is thought to raise the temperature of the testicles, impairing sperm.
- Blockages: Obstructions along the male reproductive tract that preventing normal transport of sperm from the testicles to outside the penis.
- Hormonal imbalances
- Genetic diseases, most of which are either directly or indirectly associated with sperm abnormalities.
- Environmental and lifestyle factors
Surgical treatment options are available for those who are experiencing Varicocele or blockages. If an infection is causing the infertility, a blood test will reveal this and medication can be administered. Treatment for male infertility for sexual intercourse problems such as with impotence is available and may include erectile dysfunction medication and/or a penile implant or penile prosthesis.
Varicoelectomy – surgical removal or ligation of the abnormal testicular veins. This procedure is most commonly performed operation for the treatment of male infertility. Studies show that approximately 90% of patients see sperm improvement in the semen following this procedure.