Male infertility

Fertility problems in men

What is Male infertility?

Male infertility is generally recognized as the failure to impregnate after one year of unprotected sexual activity. Infertility affects one in five couples in the US and is due to male infertility in 40% of all cases. Abnormal sperm or sperm count is the most common reason. Other factors causing infertility in the male are environmental or workplace toxins, stress, fatigue, alcohol, tobacco or drug use, increased heat inside the scrotum, exposure to diethylstilbestrol or anabolic steroids or prescription drugs that impair potency.

How is it diagnosed?

History: The couple will report failure to conceive over a period of time. Pertinent history may include prolonged fever or illness in the past three months, past surgery for varicocele, mumps orchitis, cryptorchidism or testicular injury.

Physical exam including a thorough genitalia exam will be performed.

Tests: Sperm analysis is done. Lab tests include a complete blood count (CBC), urinalysis, blood testing for syphilis, rubella antibody, Tay-Sachs (if Jewish), sickle cell (if black), thyroid function tests, and hormone levels. A testicular biopsy may be done.

How is Male infertility treated?

Any underlying cause will be treated. Fertility drugs may be prescribed. Counseling may be given concerning sexual technique to enhance fertility.

Medications

Information Brand Generic Label Rating
http://medtips.org/c/clomiphene.html Clomid Clomiphene Off-Label

Femara (Letrozole), Arimidex (Anastrozole)

Activity

Work and exercise moderately. Overexercising can be a factor in infertility. Rest when you tire.

Diet

Eat a normal, well-balanced diet

What might complicate it?

The presence of infertility in both partners may complicate treatment. Various ethical and moral decisions may need to be made. Infertility that is severe or prolonged over three years is more difficult to treat. Advancing age may introduce a sense of urgency about treatment.

Predicted outcome

The chances of conceiving are good if the reason for the infertility can be found and treated. When the cause is unexplained, pregnancy occurs 34% of the time within six months and 76% of the time within two years. In vitro fertilization is successful fourteen percent of the time. Failure to impregnate can cause frustration, resentment, feelings of inadequacy, anger, guilt and marital strife. The time and financial costs of fertility treatment may be a burden. Adoption may be the only option.

Alternatives

Other possible diagnoses include prostatitis, hypospadius, hypogonadism, endocrine disorders, varicocele, premature ejaculation, congenital genital abnormalities, retrograde ejaculation, and neurologic dysfunction.

Appropriate specialists

Fertility specialist, andrologist, and urologist.

Last updated 20 December 2015

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