Greater Boston Urology Blog

Male Infertility: Causes, Symptoms, & Treatment Options

How common is male infertility? According to the National Institute of Health, "One-third of infertility cases are caused by male reproductive issues, one-third by female reproductive issues, and one-third by both male and female reproductive issues or by unknown factors."

Today, Dr. Natalya Lopushnyan joins us on the blog to discuss what causes male infertility, diagnosis, and treatment options.

As with all content on our website, the following information is educational in nature, not medical advice. Always talk to your physician about your specific health care questions and conditions.

What is male infertility?

DR. LOPUSHNYAN: Male infertility is a condition when a man is unable to start pregnancy with a female partner. It also depends on how long the couple has been trying to conceive. It has been shown that the majority of couples (about 85%) will be able to conceive after a year of unprotected sex. We generally don’t start worrying if it has been less than a year. There are some special circumstances, of course. If the man had issues conceiving in the past, if he has a history of cancer, or if his female partner is over the age of 35, we would want to start a work-up sooner.

Can causes male infertility?

DR. LOPUSHNYAN: Male infertility is generally due to low (or no) sperm production, abnormal sperm function, or blockage that prevents sperm delivery. A multitude of medical causes can play a role; however, some lifestyle choices can be important, too. The most common is anabolic steroids (testosterone, etc.). Anabolic steroids, which are used to stimulate muscle growth, can completely wipe out sperm production. Drugs, such as cocaine and marijuana, can also reduce the number and quality of sperm.

Other causes include:
  • Excessive alcohol use
  • Tobacco use
  • Obesity

How is male infertility diagnosed?

DR. LOPUSHNYAN: Many infertile couples have more than one reason for infertility, so it is important to check both partners. Your doctor will generally start with a medical history, physical, and semen analysis. Depending on those results, you may also need hormone testing. Advance diagnostic options sometimes require testis biopsy to find out if there is any sperm production at all.

What types of treatment options exist for male infertility?

DR. LOPUSHNYAN: Treatment will heavily depend on the cause of infertility and the semen analysis. There are certain conditions (not very common) that prevent a man from producing any sperm. In that case, we would suggest using a sperm bank/donor.

In men with certain anatomic issues, for example varicocele, sperm quality and quantity may be improved with surgery. If a man has history of using testosterone or other steroids currently or in the past, we can try to “jump-start” sperm production using certain medication.

What's the overall outlook for men dealing with infertility?

DR. LOPUSHNYAN: Overall, with technology such as in vitro fertilization (IVF), the outlook is very positive. If you produce any amount of functional sperm, it is likely that you will be able to father a biological child. It may require medical/surgical assistance, but it is still possible.

If there's one big takeaway that you want men and their partners to understand about male infertility, what would it be?

DR. LOPUSHNYAN: If you or your partner are concerned or wondering about your fertility status, please do not hesitate to talk to your doctor or find a urologist. It is very easy to check a man’s sperm count and quality, and it may alleviate a lot of stress.

Struggling to conceive? Concerned about male infertility? Let us help.

Schedule an appointment with one of our board-certified urologists to discuss your fertility issues. You are not alone. Let us help!

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