1. Home
2. Resources
3. PCRM Blog
4. Male Infertility: Shedding Light on a Silent Struggle

Male Infertility: Shedding Light on a Silent Struggle

Understanding Male Infertility

Infertility is often perceived as a women’s health issue, but in reality, male infertility is a factor in about 30-40% of infertility cases. Despite this, conversations around fertility struggles tend to focus on women, leaving many men feeling isolated or unaware of how their reproductive health plays a role in conception.

Male infertility is defined as the inability to conceive a child after one year of unprotected intercourse due to issues with sperm production, function, or delivery. It is a medical condition, not a reflection of masculinity or personal failure. By increasing awareness and understanding, we can help normalize conversations around male infertility and ensure that men receive the support and care they need.

Causes of Male Infertility

There are many potential causes of male infertility, including:

1. Sperm Disorders

Issues with sperm production, movement (motility), or count can impact fertility. A low sperm count (oligospermia) or the absence of sperm in semen (azoospermia) can significantly reduce the chances of conception.

2. Hormonal Imbalances

Testosterone and other hormones play a crucial role in sperm production. Testosterone production and sperm production go hand in hand. Conditions such as hypogonadism (low testosterone levels) can lead to decreased sperm production. Because of the relationship between sperm and testosterone production, taking testosterone (as testosterone replacement therapy or anabolic steroids) will also decrease sperm production.

3. Varicocele

A varicocele is an enlargement of veins within the scrotum that can increase testicular temperature and impair sperm production. This condition is one of the most common reversible causes of male infertility.

4. Vasectomy

A vasectomy, also sometimes referred to as male sterilization, is a form of permanent birth control that prevents pregnancy by surgically severing the vas deferens. The vas deferens are long thin tubes that transport sperm to the semen. Patients who have vasectomies and then change their minds later in life typically have to undergo some kind of fertility care to achieve their family-building goals.

6. Genetics

Severe male fertility abnormalities can be caused by changes in the sperm producing genes leading to severe oligospermia (ie. very low sperm concentration) or azoospermia (i.e., no sperm in the ejaculate). These conditions include Klinefelter syndrome (i.e., a chromosomal disorder in which men are born with an extra X chromosome), Y chromosome microdeletion (ie. the section of the Y chromosome that instructs sperm production is missing), and cystic fibrosis.

7. Infections

Infection or inflammation in the male reproductive system, such as sexually transmitted infections, mumps orchitis (testicular inflammation due to mumps), or prostatitis (inflammation of the prostate), can impact sperm production.

8. Lifestyle and Environmental Factors

Certain lifestyle choices and environmental exposures can negatively impact sperm health, including:

• Smoking, excessive alcohol use, and drug use
• Obesity and poor diet
• High levels of stress
• Exogenous testosterone (the use of steroids to build muscle)
• Exposure to heat (such as frequent use of hot tubs or saunas)
• Toxins and pollutants, such as pesticides or heavy metals

Diagnosis and Testing for Male Infertility

If a couple is struggling to conceive, both partners should undergo fertility testing to determine potential causes. For men, this typically includes:

• Semen Analysis: Evaluates sperm count, motility, and morphology.

If there are severe abnormalities on the semen analysis, the following testing is recommended:

• Hormone Testing: Measures testosterone and other hormone levels.
• Scrotal Ultrasound: Identifies physical abnormalities such as varicocele.
• Genetic Testing: Helps diagnose genetic conditions affecting fertility.

Treatment Options for Male Infertility

The good news is that many cases of male infertility are treatable. Treatment options depend on the underlying cause and may include:

• Lifestyle Changes: Improving diet, reducing stress, quitting smoking, and maintaining a healthy weight can enhance sperm health.
• Medication or Hormone Therapy: Used to correct hormonal imbalances or infections.
• Surgical Procedures: Correcting varicoceles or other structural issues can improve sperm production and quality.
• Assisted Reproductive Technologies (ART): Procedures like in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) can help overcome sperm abnormalities.

Conclusion

Male infertility is common, treatable, and nothing to be ashamed of. By normalizing discussions around male reproductive health, we can ensure that men receive the care, information, and support they need. Infertility is not just a women’s issue—it’s a shared experience, and addressing it openly can help more couples achieve their dreams of parenthood.

If you or someone you know is experiencing fertility challenges, know that you are not alone. If you wish to learn more about male infertility or have your fertility tested please ask your physician for a referral to PCRM. One of our fertility specialists will be happy to meet with you.

See all articles