The Ultimate Guide to Male Infertility

Male Infertility, What is it?

According to the Urology Care Foundation, male infertility is any health issue that lowers the chances of impregnating a female partner.

They say that over one third of infertility problems are due to the man.  These difficulties often stem from sperm production or sperm delivery.

They MayoClinic defines male infertility as basically anything related to sperm health to overall health issues, i.e. low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm, illnesses, injuries, chronic health problems, lifestyle choices, etc.

We will get into the different types of male infertility throughout this post, but notice that problems with sperm are not the only things that can cause male infertility.

There could be underlying health issues or genetic disorders that can affect fertility as well.  This is true for the fertility of both males and females.

You can check out my own personal infertility story and my underlying health issues here.  Our infertility issues were all on me. ☹

**This post contains affiliate links where if you use the link to make a purchase I will get a small commission at no cost to you** Disclosure policy 

What are the symptoms of infertility in males?

It is possible that the only symptom of male infertility is simply the failure to conceive.

However, there could be a hormonal imbalance, dilated veins around the testicle, a condition that blocks the passage of sperm, or another type of undetected disorder.

These are symptoms of male infertility besides the inability to conceive according to the MayoClinic:

  • Problems with sexual function – difficulty with ejaculation, small volumes of fluid ejaculated, reduced sexual desire, erectile dysfunction (not able to maintain erection)
  • Pain, swelling, or a lump in the testicle area
  • Recurrent respiratory infections
  • Inability to smell
  • Abnormal breast growth
  • Decreased body or facial hair, other signs of hormonal abnormality
  • A lower than normal sperm count (if you are worried about sperm count, you can use this spermcheck to test the presence of sperm at home. This doesn’t take the place of doctor testing, but it is certainly a great place to start if you have been trying to conceive for a while.)  This test says it is for after a vasectomy, but it is the same concept.

If you or your partner seems to be displaying any of these symptoms, you should contact your doctor.

If you don’t need a referral for your insurance purposes, you can contact a urologist directly.

Sperm Disorders

Sperm can be not fully grown, oddly shaped, not move the right way, low count, or no sperm at all.  These can be conditions you are born with or simply a cause of lifestyle choices.

According to the Urology Care Foundation, smoking, drinking alcohol, and certain medications can lower sperm count.

If you have had a long-term sickness, maybe the mumps when you were younger, or you have low testosterone, you could have a low sperm count.

As you can see, there are varying degrees of how sperm can be affected by health and lifestyle choices.

Let’s dive in below with different types of sperm disorders and whether they can be reversed or not.

Varicoceles

This sperm disorder refers to the swollen veins of the scrotum. These veins are responsible for draining the testicles.  It is described as varicose veins of the scrotum.

It is thought this disorder causes infertility because of abnormal testicular temperature regulation.  Basically, the testicles get too hot and are unable to make good sperm.

In healthy testes, a man’s body heat must be below core body heat for ideal sperm function, maturity, and production.  It is said that the temperature of the scrotum is at least 5 degrees lower than the abdomen or pelvis regions.

This lower temperature helps produce good quality sperm.

Most men will experience no symptoms for Varicoceles.

It typically comes to the forefront when you begin trying to conceive and are unsuccessful.

Diagnosis 

During a self-exam or a routine doctor exam, Varicoceles can be discovered.  The Urology Care Foundation describes the veins as “bags of worms”.

This term, to me, sounds as if it is pretty obvious to spot.

If you think you might have this, contact your primary care doctor, or if you don’t need a referral, contact a urologist directly. Discuss your treatment choices.

It is worth noting that majority of men don’t actually have issues if you do have these enlarged veins.

Retrograde Ejaculation 

This is when semen goes backward in the body.  (I will give you a second to process that because I certainly needed it.)

The semen doesn’t go through the penis but through the bladder instead.

This happens during orgasm when the muscles and nerves don’t close.

Males with this may be producing good quality sperm, but it doesn’t reach the vagina.

Signs of Retrograde ejaculation are dry ejaculation or less fluid and cloudy urine after ejaculation.

Diabetes, medications, spinal cord injuries, and surgery of the bladder, prostate, or urethra can be culprits of Retrograde Ejaculation.

Immunologic Infertility 

This type of infertility is when a male makes antibodies that attack his sperm.  This can be a result of injury or infection.

Antibodies typically help keep the bad guys at bay however every now and again antibodies receive the wrong signals and attack things they shouldn’t. (Example: Autoimmune diseases)

The antibodies don’t allow the sperm to move or function normally.  This can make it hard for sperm to reach the fallopian tubes.

Good news? This one is extremely rare.

Obstruction 

Simply put, the sperm cannot leave the body at ejaculation because it is being blocked.

This can be due to multiple infections, swelling, or developmental defects.

Hormones 

Low hormone levels can affect the quality of sperm.

This can be easily tested by your primary care doctor, endocrinologist, urologist, or reproductive specialist.

Low testosterone is the main hormone that would be tested, but there could be other hormonal imbalances worth checking out and considering as well.

Chromosomes 

This can be an inherited disorder.

For example, a male could be born with two X chromosomes instead of one X and one Y chromosome which can cause abnormal development of the reproductive organs.

What causes male infertility?

Male infertility can be caused my many factors some of which have been discussed above.

There are also environmental and lifestyle factors that can affect fertility.

Environmental Factors of Male Infertility 

  • Industrial chemicals long term exposure to certain chemicals can contribute to low sperm count. i.e. benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials

and lead

  • Heavy metal exposure over exposure to metals like lead and cause infertility
  • Radiation or x-rays although it is possible for it to return to normal, radiation exposure can decrease the production of sperm. However, high doses and over exposure can lead to the permanent reduction of sperm production.
  • Overheating the testicles as talked about previously, when the scrotum area is overheated sperm is not properly produced. It is good to avoid saunas or hot tubs if you are trying to conceive.

Lifestyle Factors of Male Infertility 

  • Drug use the use of Anabolic steroids and affect the testicles and the overall production of sperm. Cocaine or marijuana only temporarily affect sperm quality. So, if you are trying to conceive limit your consumption of cocaine or maryjane (insert eye roll)
  • Alcohol use limit alcohol consumption when trying to conceive. Try to not drink in excess. Alcohol abuse can lead to erectile dysfunction, low testosterone levels, and low sperm production
  • Smoking Tobacco First hand or second hand smoke can affect male fertility. Try to stop smoking or lessen the amount of tobacco smoked a day when trying to conceive.
  • Emotional Stress Stress whether you are male or female is something you need to attempt eliminate. Heavy loads of stress on the regular can affect your fertility
  • Depression Severe depression in men can cause low libido and erectile dysfunction which can both affect your fertility. Some times depression medication can cause these as well.
  • Weight Maintaining a healthy weight can help keep hormones in check and sustain healthy sperm.

How is male infertility diagnosed?

If you and your significant other have been trying to conceive for at least one year without success, you should contact a specialist to start the testing process.

Physical Exam 

Male infertility can be diagnosed through a physical exam and medical history.  The doctor will go over sexual history and development.  They will ask about past illnesses and surgeries.

Semen Analysis 

So, a semen analysis is actually how it is in the movies. (Lol!) At least, one thing they do is semi accurate. 😊 You will ejaculate into a container and the doctor will send it off to be examined.

They will be looking at the number of sperm in your sample, the shape of your sperm, and its motility.

According to the Urology Care Foundation, if your semen is normal, it will turn from a pearl colored gel to a liquid within 20 minutes.

If it does not do this, this could be a sign of issues with your sex glands.

During the analysis, if the lab does not find sugar in your sample, it could be a sign of a blocked ejaculation duct, or there are no vesicles for semen to travel.

Ultrasounds 

Sometimes, after you have given a semen sample, the results of the analysis will call for more testing.

Scrotal Ultrasound 

This gives the doctor a picture of what is going on inside.  The doctor will be able to tell if you have varicocele or other problems with the testicles or other structures.

Hormone Testing 

If you are seeing a fertility specialist, they will take blood the same day you give your sperm sample.

This is a simple blood test to check your hormone levels including your testosterone.

Post-ejaculation Urinalysis 

This test checks your urine for sperm.  If there is sperm present in your urine, it can be a sign of retrograde ejaculation.

See above for the definition of retrograde ejaculation

Genetic Tests

In our experience, only certain genetic testing was done depending on what the insurance would cover.

I have to also believe this will depend on medical history and your race.

Genetic testing might be ordered if there is an extremely low sperm count.

This is done through blood work.

Testicular Biopsy 

The doctor will take a sample from the testicle to decide if sperm production is normal.

This test can help determine if there is a blockage or other problems with transporting sperm.

Sperm Function Tests 

According to the MayoClinic, these tests are not done regularly and don’t usually change the course of treatment.

However, these tests can determine how long sperm survive after ejaculation, how well they penetrate an egg, and if there are problems attaching to the egg.

Transrectal Ultrasound

This test checks your prostate and for blockages in the tubes that carry semen.

They will insert a wand (heavily lubricated) into the rectum.

Ladies this is a vaginal ultrasound through the rectum if you want to explain it to your man.

Are there treatments for male infertility?

Your doctor has gathered all the data and now can recommend a course of treatment based on the results.

Yay! Right?!

Surgery 

You can correct Varicocele surgically.

A vas deferens that is obstructed can also be surgically repaired.

To reverse a vasectomy, you will have to undergo surgery.

When semen is not present in the semen analysis, sperm is obtained directly from the testicles.

The doctor will use specific sperm-retrieval techniques.

Treating Infections

Antibiotics are given to treat infections in the reproductive system.

This does not mean fertility will return once antibiotics are done.

Treatments for sexual intercourse problems 

Your doctor might prescribe medication or recommend counseling for erectile dysfunction or premature ejaculation.

Hormone Treatments 

Your doctor will give medications to help with hormone levels depending on the results of your blood work.

Assisted Reproductive Technology (ART)

This process retrieves sperm through normal ejaculation, sperm retrieval techniques, or sperm donors all depending on your situation and test results.

If you have retrograde ejaculation, this is an option for you if medications do not work.

This is typically done when considering In Vitro Fertilization (IVF) or Intrauterine Insemination (IUI).

Can you reverse male infertility?

You can reverse some male infertility with the help of medications and other medical procedures.

As with many medical protocols, not everything is a guarantee.

If a treatment doesn’t work, a couple always has the option of assisted reproductive technology or sperm donor.

Natural remedies for male infertility

I feel like this one is obvious, but many sites list it under home remedies.

Have sex more frequently and when ovulation is occurring.

You don’t have to have sex every single day or every other day all month; it isn’t necessary, but to each their own. 😉

However, if your significant other is tracking their periods and know when they ovulate, you can have more planned intercourse closer to ovulation.

Consider increasing sex frequency 3-4 days before ovulation.

If your significant other is not sure when they ovulate, this ovulation predictor kit will give you an idea as to when she will ovulate.

Avoid lubricants like K-Y Jelly or Astroglide.  Don’t use lotions or saliva.  None of these are good for the sperm.

But, pre-seed lubricant is considered an excellent alternative.

It is a lubricant that is suppose to help the sperm attach to the cervix.

Supplements for Male Infertility 

The supplements given below is a list put together by the MayoClinic.  They specifically state that these do NOT treat certain infertility issues.  But, they could help the quality and count of the sperm.

Everything is worth trying because you never know what can help, but you should consult your doctor before starting any supplements.

Lifestyle 

Maintaining an active and healthy lifestyle can always help with fertility.

You can check out my post on how to boost fertility to find some suggestions on food and other lifestyle choices to make to help fertility.

Can you prevent male infertility?

Obviously, infertility caused by genetics or illness cannot be prevented.

Again, keeping up with a healthy and active lifestyle can help prevent future fertility issues.

Regardless of your situation, you should limit alcohol and tobacco use, eat a healthy diet of all food groups, work out at least 30 minutes a day, etc.

Resources

MayoClinic

Urology Care Foundation

Male infertility though not easy to hear there are many causes that can be treated, so there is hope.

I would love to hear your story! Email me or comment below about your fertility journey.

 

Share this with your friends who may be dealing with infertility. 

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