Male Infertility

Primary infertility describes couples who have never been able to become pregnant after at least 1 year of unprotected sex (intercourse).

Secondary infertility describes couples who have been pregnant at least once, but have not been able to become pregnant again.

Male infertility may be due to:

  • A decrease in the number of sperm
  • Sperm being blocked from being released
  • Sperm that do not work properly

Male infertility can be caused by:

  • Environmental pollutants
  • Exposure to high heat for prolonged periods
  • Genetic abnormalities
  • Heavy use of alcohol, marijuana, or cocaine
  • Hormone deficiency or taking too much of a hormone
  • Impotence
  • Infections of the testes or epididymis
  • Older age
  • Previous chemotherapy
  • Previous scarring due to infection (including sexually transmitted diseases), trauma, or surgery
  • Radiation exposure
  • Retrograde ejaculation
  • Smoking
  • Surgery or trauma
  • Use of prescription drugs, such as cimetidine, spironolactone, and nitrofurantoin

In healthy couples both under age 30, having sex regularly, the chance of getting pregnant is only 25 - 30% per month. A woman's peak fertility occurs in her early 20s. As a woman ages beyond 35 (and especially after age 40), the likelihood of getting pregnant drops to less than 10% per month.

When to seek help for infertility depends on your age. For women under age 30, it is generally recommended to try to conceive for at least a year before seeking testing.


Symptoms

Experiencing infertility can bring on a range of painful emotions in one or both members of the couple. In general, having at least one child already tends to soften these painful emotions.


Exams and Tests

A complete medical history and physical examination of both partners is essential.

For men:

  • Semen analysis
  • Testicular biopsy (rarely done)

Treatment

By having sexual intercourse at least every 3 days in the weeks leading up to and through the expected time of ovulation in your partner. Ovulation occurs about 2 weeks before the next period starts. So, if you get your period every 28 days, you should have sexual intercourse at least every 3 days between the 7th and 18th day after you get your period.

Treatment depends on the cause of infertility. It may involve:

  • Education and counseling
  • Medical procedures such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
  • Medicines to treat infections and clotting disorders, or promote ovulation

It is important to recognize and discuss the emotional impact that infertility has on you and your partner, and to seek medical advice from your health care provider.


Outlook

A cause can be determined for about 80 - 85% of infertile couples.

Getting the right therapy (not including advanced techniques such as in vitro fertilization) allows pregnancy to occur in 50 - 60% of couples who were infertile.

Without any treatment, 15 - 20% of couples diagnosed as infertile will eventually become pregnant.


Prevention

Because sexually transmitted diseases (STDs) often cause infertility, practicing safer sex behaviors may minimize the risk. Gonorrhea and chlamydia are the two most common causes of STD-related infertility.

STDs often don't have symptoms at first, until PID or salpingitis develops. These conditions scar the fallopian tubes and lead to decreased fertility, infertility, or an increased risk of ectopic pregnancy.

Getting a mumps vaccine in men has been shown to prevent mumps and its complication, orchitis. The vaccine prevents mumps-related sterility.

Some forms of birth control, such as the intrauterine device (IUD), carry a risk for pelvic infection, especially in women with more than one sex partner and when sexually transmitted diseases occur.

Maintain a healthy diet, weight, and lifestyle to optimize your chances for getting pregnant and having a healthy pregnancy.

Remember to take either prenatal or multivitamins containing folate while you are trying to become pregnant to decrease your risk for miscarriage and fetal abnormalities.

 

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