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Male Factor Infertility

Approximately 50 percent of couples that have trouble conceiving experience male factor infertility. With male factor infertility, the sperm function is compromised, so the sperm has difficulty fertilizing an egg. A thorough evaluation by your physician begins will include a detailed medical history that reviews past and present medical conditions.

Certain risk factors are associated with male infertility, such as testicular trauma, history of genital infections, cigarette and marijuana smoke, environmental exposure to chemicals and toxins, excessive alcohol consumption, exposing the genital area to hot temperatures like sitting in a hot tub or sauna, undescended testicles, contacting mumps after puberty, and exposure to DES.

One of the most common causes of male infertility is problems with the production of sperm. The sperm may be abnormal in shape, immature, or have decreased mobility.  Sometimes, a man may have normal sperm, but the sperm are produced in small amounts or not at all.

Genetic diseases can also affect male fertility.  Cystic fibrosis, which affects the lung and digestive system, can also be a cause of infertility. Most men who have cystic fibrosis are born without a vas deferens, which results in male infertility.  Noonan syndrome is an inherited condition which causes abnormal testicular function. Hemochromatosis and Sickle Cell Disease can also contribute to male factor infertility. Klinefelter syndrome occurs when a man has an extra X sex chromosome, which can produce very low quantities of sperm, or no sperm at all.

Chromosome rearrangements, where a piece of a chromosome has exchanged places with another, can also produce male factor infertility. Men with low sperm counts, or no sperm, have a higher occurrence of chromosome rearrangements. Not only can chromosome rearrangements cause male factor infertility, but also deletions in the Y chromosome when 46 chromosomes present, or missing sections of the Y chromosome can affect a male’s fertility potential.

Obstructions can also contribute to infertility by blocking the flow of semen. These obstructions may be present at birth or may have occurred from an infection in the reproductive tract.

The primary way to look for male factor infertility is by performing a semen analysis.   The results of the semen analysis will determine the quality and quantity of sperm by using several different criteria.  These criteria consist of sperm volume, sperm count, sperm shape, sperm movement, ph level, and white blood cell count. If significant abnormalities are found, your physician may recommend that you have further testing, such as blood work, to check your hormone levels. 

Treatment options may include IUI, or artificial insemination, where high quality sperm are placed into the uterus bypassing the cervix, which increases the odds of pregnancy.  Another option, in-vitro fertilization coupled with intracytoplasmic sperm injection (ICSI), is fertilization assisted by micromanipulation in the embryology laboratory.  Sperm can be surgically extracted if necessary. Occasionally, your doctor may prescribe medications for male infertility that is the result of a hormonal disorder such as a low testosterone. Your physician may also refer you to a urologist, a doctor who specializes in the male reproductive system for a more extensive evaluation including a physical exam.
For your best odds of success, both partners should have an evaluation at the initial infertility consultation.  Male factor is a common cause of infertility that can be treated once the source of the problem is identified.

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