Deciding to bring a child into this world is a very important decision for couples. However, many couples find that pregnancy is difficult to achieve even after a year of trying. This could be due to fertility issues with either or both partners. In almost half of such cases, the problem lies with the male partner. It becomes crucial, then, for the partner to undergo a male fertility evaluation to assess the issue and address it with possible solutions.
Male Fertility Evaluation: Why Do You Need One?
Infertility problems affect almost 15% of couples around the world with males contributing to approximately 50% of these cases. According to research, there are more than 30 million infertile men around the world. Typically in a majority of cases of a couple unable to achieve pregnancy, it is the female partner who has a fertility issue that gets assessed for fertility issues, long before the male partner is asked to undergo evaluation.
This often leads to anxiety and frustration among infertile couples which may have long-term complications in relationships, along with a negative impact on the mental and physical health of both partners. It is thus a good practice for both partners to seek medical evaluation when they are unable to achieve pregnancy.
What Are the Causes of Male Infertility?
To understand the causes of male infertility let us quickly understand how the male reproductive system works. The male system consists of a pair of testes, or testicles, that produces the sperms, the seminal vesicles that produce semen (a fluid that nourishes the sperms), the prostate gland that also produces part of the semen, the vas deferens (a tube that carries the sperm bathed in semen through the urethra) and the penis.
During sexual arousal, the sperm exits the testes to enter the vas deferens. It mixes with the semen. This semen now enters the urethra and exits through the urethral opening at the tip of the penis into the female genitalia.
The primary causes of male infertility could be either obstructive or non-obstructive. Obstructive problems are essentially anatomical or physical problems when there is a blockage, due to an abnormality, within the tract through which the sperms travel (from the testes to the urethra). Non-obstructive problems are indicative of a physiological problem with sperm production.
- Blockages – Blockages may be due to birth defects or may be a result of a surgery, injury, or infection. In such cases, the sperms are not able to reach the urethra and into the female reproductive organs during sexual intercourse.
- Retrograde ejaculation – This condition occurs when semen does not come out of the urethra during sexual intercourse and instead, enters the bladder. This may be caused due to certain underlying conditions like diabetes, some medications, or prior surgery to the bladder, prostate gland, or urethra.
- Undescended testes – This condition is characterized by the inability of the testes to descend from the main body into the scrotum during fetal development. This hampers normal sperm development.
- Varicoceles – This condition is characterized by dilation (enlargement) of veins within the scrotal sac that eventually hampers the quality and quantity of sperms.
- Autoimmune disorders – In these conditions, the man’s immune system mistakenly identifies sperm as foreign and starts producing antibodies against them. When the sperm come outside the testes, they are targeted by these anti-sperm antibodies and destroyed/neutralized.
- Genetic issues – Mutations and deletions in genes associated with male fertility may lead to a variety of problems. For example, gene deletions in the Y chromosome or mutations in genes required for the normal production of male hormones can lead to infertility. Some males do not have vas deferens, the main tube that carries sperm from the testes. This is also due to a genetic defect.
- Lifestyle habits – Alcohol and drug abuse, morbid obesity as well as psychological stress, can lead to infertility issues.
Problems with Sexual Intercourse
The ability to physically and emotionally complete and enjoy sexual intercourse is one of the prerequisites to achieving pregnancy. If the sexual intercourse is painful, if the male suffers from problems like premature ejaculation or erectile dysfunction or there are underlying psychological issues, these may cause infertility.
Many times, the exact cause of infertility can not be identified. This is called idiopathic infertility.
What Can You Expect During a Male Fertility Evaluation?
Male infertility evaluation is not as scary as it sounds. It is usually a painless process that includes information gathering and some tests. A medical practitioner called a urologist (one who specializes in the urinary system) who also has specialty training in male fertility will likely assess you.
The physician will start with your medical history. This includes –
- understanding whether you’ve had any surgeries before and see if they might have a role to play in your fertility issues
- your current medication, both prescription and non-prescription.
- any allergies you might be suffering from.
- lifestyle habits and exposure review. This includes alcohol, tobacco, recreational drug use, and exposure to environmental toxins.
- family history of genetic diseases and reproductive health.
- a review of all infections (including sexually transmitted ones) you’ve had in the past.
- a history of testicular trauma, or undescended testicles.
A physical examination will be conducted after the review of the medical history. During the examination, the physician will thoroughly examine your genitals to see if any problems – varicocele, the position of the urethral opening, and presence or absence of vas deferens – can be observed.
The next important assessment is the semen analysis. This is done to evaluate the quality and quantity as well the motility of sperm in the semen. A laboratory technician will look at your semen sample for sperm morphology and sperm count. Generally, a higher number of normal sperm indicates good fertility. However, this is not a rule of thumb and there can be exceptions to it – men with abnormal semen and low sperm count can still be fertile.
In some cases, the doctor will order an imaging test like an ultrasound. Transrectal ultrasound (TRUS) and scrotal ultrasonography are two kinds of ultrasound tests that are employed to view the pelvic region. The images produced by these tests allow the physician to see the anatomy of the male reproductive system in an effort to pinpoint any problems that may relate to his infertility.
Is it Possible to Correct Male Fertility Problems?
The answer to this question depends upon what is causing infertility. For example, some causes are correctable, others may not be. Varicocele, for instance, is correctable through minor surgery. If the blockage is due to vasectomy, it may be reversed. Problems like erectile dysfunction and premature ejaculation may be treated by a combination of counseling and medication. Hormonal causes can be corrected by medication.
In the scenario that corrective treatment is not possible, there is still hope for the couple to achieve pregnancy. ART, or assisted reproductive technology, can help you achieve your desire of being a parent. Using these reproductive medicine techniques, sperm can be removed from the male testes and inserted into the female genitalia or may be injected directly into the egg in an artificial environment, in what is called in vitro fertilization (IVF) with ICSI (intracytoplasmic sperm injection).
Dreams Fertility: Your Compassionate Partner
Pregnancy is a team effort and it is imperative that if you, as a couple, are unable to achieve pregnancy, you should both seek medical care and guidance. At Dreams Fertility, we have been helping couples achieve their dreams through a wide range of services – from diagnosis to fertility treatments – using a combination of a highly experienced and skilled team and cutting-edge technology. So if you are looking for a “fertility test near me” make sure to visit our site to know more about how we can help.
We acknowledge that getting expert help for fertility problems can be an awkward and daunting prospect for many couples. Our compassionate team understands this and we go out of our way to make the entire process of fertility treatment as hassle-free and comfortable for you as possible. And we also know that time is of the essence. Schedule a consult with one of our physicians today and rest assured in the knowledge that you are in good hands.
Dr. Luis Murrain joined Dreams Fertility in 2021, providing specialty services in Fertility and Reproductive Genetics. With a shared vision that everyone deserves to have the family of their dreams, we are dedicated to helping all of our patients. We believe that families come in all shapes and sizes, and all of them are beautiful. We are proud to have a long history of providing services to all, including gay, lesbian, and transgender individuals and couples on their road to parenthood.