Male Infertility

What Is It?

Infertility is the inability to achieve a normal pregnancy. About one in seven couples in the United States is unable to conceive a child after trying regularly for one year. Some couples will have success in the second or third year of trying, but couples that cannot conceive after three years are very unlikely to ever succeed unless they seek medical assistance.

Infertility in a couple may be caused by the male partner, the female partner or both. Studies suggest the male partner alone is infertile in about 20 percent of cases and that both partners have fertility problems about 30 percent of the time. Therefore, the male partner plays a role in about half of all couples that have difficulty conceiving a child. In about 15 percent of cases, infertility tests are completely normal in both partners, despite the fact that the couple cannot conceive a child.

Male infertility has a wide variety of causes, which can be broken down into several major groups:

• Hormonal problems, such as low levels of testosterone or thyroid hormone
• Problems with the testicles, including abnormal growth or development, or damage from trauma and infections
• Problems with the flow of sperm within the male reproductive organs, including blocked tubes that transport sperm, genital infections, varicose veins (varicoceles) within the scrotum, or problems with ejaculation
• Abnormal sperm function
• Inherited or chromosomal disorders, including cystic fibrosis and Klinefelter's syndrome
• Toxic exposures, such as radiation or industrial chemicals
• Medications and drugs, including psychiatric medications, alcohol, and anabolic steroids used for body-building
• General illnesses, including kidney disease, cirrhosis and malnutrition

In up to 50 percent of infertile men, no specific cause can be identified.

In most cases, infertility is a benign (harmless) problem and may respond to treatment. However, about 1 percent of infertile men have serious medical problems (hormonal problems, infections or tumors) that require medical attention.

Symptoms

Most infertile men will not have any symptoms. A man with hormonal problems may notice a change in his voice or pattern of hair growth, the development of breasts, or difficulty with sexual function.

Diagnosis

When a couple is infertile, the man and woman usually are evaluated together. Even if one partner has previously conceived a child, he or she should be evaluated because a new cause of infertility may have developed.