While there are many potential causes of fertility that are specific to women, men can also contribute to the cause of infertility within a couple. In fact, up to 40% trace their infertility at least partially to the male partner. Sperm motility – the movement of the sperm – and sperm morphology – the shape and formation of the sperm and its DNA – are both common factors.
Common Male Factor Causes:
- Age: Fertility starts to decline around the age of 35, as the quality and motility of the sperm diminishes with age
- Sexually Transmitted Diseases: STD’s may damage parts of the body that transfer sperm to the (reproductive tract – replace this)
- Cancer Treatments: Chemotherapy and radiation may contribute to male infertility. These treatments can cause sterility and it is recommended to freeze sperm before going through treatment
- Testosterone and other male hormone substitutes: Performance enhancing additives increase testosterone levels and can be a cause for the loss of sperm production
A healthy sperm count is considered to be 20 million sperm/mL or greater. Anything less is considered low and can affect fertilization. Normal size, shape, and ability to move of the majority of the sperm can also be measured.
Low sperm count, the absence of sperm, or poor sperm health can be a result of some or a combination of the following reasons:
- Poor lifestyle choices
- Genetic predisposition
- Damaged reproductive organs
- Previous or current illness such as cancer of the organs near the groin which have been treated with chemotherapy
- Problems with the pituitary glands that reduces the body’s ability to produce testosterone and sperm
Having low sperm count does not necessarily mean you will have poor sperm health and vice versa. If male factor infertility is suspected, we can test your semen for sperm motility and morphology, with recommendations for next steps. For some men, and for various reasons, sperm is not identified with ejaculation. There can be many causes for a lack of sperm in ejaculate, including absence or blockage of the vas deferens, non-reconstructed vasectomy, or azoospermia, a condition where the semen contains no sperm. In this case, there are procedures to extract sperm directly from the testicles, which can then be used to fertilize eggs, either through intrauterine insemination or in vitro fertilization.
Treating Male Factor Infertility
When surgery or medical therapy are not appropriate treatment options, intrauterine insemination (IUI) or in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) can overcome male factor infertility.
The choice of assisted reproduction usually depends on the male factor severity. IUI is used with mild male factor and involves placement of washed motile sperm in the uterus, in closer proximity to the fallopian tubes where fertilization occurs. IVF overcomes any obstacles to sperm movement in the female reproductive tract by allowing fertilization to occur in vitro, using only a few million motile sperm.
With severe male factor infertility where only, a few motile sperm are present, IVF with ICSI allows for conception with even less sperm, as just one viable sperm is injected into the egg to create an embryo.
In situations where infertility is due to complete absence of sperm, couples have the option of building their families with the use of donor sperm. Screened and quarantined sperm can be obtained from sperm banks for use in assisted reproduction under supervision of a fertility specialist.
At Laurel Fertility Care, skilled Reproductive Endocrinologists are available to help couples dealing with male factor infertility, working closely with male reproductive specialists. If you have any questions or want to know more about treatment options, please contact us to arrange an appointment.