Not all causes of a couple’s infertility are related to the female. Male infertility accounts for around 30% of all cases. Male factor infertility is an issue for many couples struggling to conceive. Luckily, there are many assisted reproductive technologies (ART) available for couples who wish to conceive.
The root cause of male infertility is not always easy to establish. For approximately 50% of men diagnosed with infertility, the exact cause remains unknown. Usually, male factor fertility problems have to do with quality or quantity of sperm, though there is an issue with ejaculation that can contribute to these problems. While lifestyle choices are often involved, many men have several conditions combined that lead to infertility.
Azoospermia is defined as the complete absence of sperm in the ejaculate/semen. This problem affects around 5% of men who have infertility issues. It may be that the body does not produce any sperm, or it could result from blockage/obstruction in the ejaculatory ducts or vas deferens. This may prevent the sperm from leaving the testicles.
A low sperm count is an oligospermia. This means there are few sperm cells in the semen. This could also be caused by a partial blocked ejaculatory duct or vas deferens obstruction.
Some men develop enlarged varicose veins in their scrotum. This affects reproductive function, impacting sperm production, transport, and quality. A varicocele is often easily treated with the right reproductive technology.
Congenital Absence of the Vas Deferens
For some men, the tubes that transport sperm to the penis from the tests do not develop before birth. A man with this condition often produces viable sperm in the testes, but the sperm has no way to travel to the urethra. Therefore, pregnancy becomes impossible.
Poor Sperm Motility and/or Morphology
Sometimes, a man produces an adequate quantity of sperm, but there are problems with the shape of the cells (morphology) or how they move (motility). These issues mean the sperm cannot travel through the reproductive tract to reach or penetrate the egg cell.
Premature Ejaculation and Erectile Dysfunction
If a man ejaculates before vaginal penetration, the chances of pregnancy are affected. In addition, consistent trouble achieving and/or maintaining an erection can make conception difficult.
Treatment Options for Male Factor Infertility
A number of treatment options exist for treatment of male infertility. Depending on the source of the problem, male infertility can be treated by a reproductive specialist. The options include:
- Vasectomy reversal – For men who have a vasectomy, the procedure may be reversed with the surgeon reconnects the two vas deferens components. This reversal surgery is done outpatient, performed using general anesthesia. For men who have the surgery within 10 years of the original vasectomy, pregnancy rates are 50% higher.
- Varicocele repair – Repairing varicoceles in the scrotum results in a better environment for sperm. This improves sperm count, mobility, and motility. The surgical repair is a minor outpatient procedure, and it can lead to increase chances of conception for the couple.
- Ejaculatory duct resection – This procedure is used to correct blocked ducts, and is a minor surgery performed using a local anesthetic.
- In vitro fertilization – When problems involve altered sperm shape or motility, in vitro fertilization is an option. This involves combining the cells together in a laboratory petri dish and placing the resulting embryo inside the woman’s uterus.
Intracytoplasmic sperm injection – This involves assisting the sperm to fertilize the egg by placing it inside the egg using tiny instruments.