Causes of Infertility in Men
Many people often view infertility as a women's health issue. However, it impacts both men and women. According to the American Society for Reproductive Medicine, 20% of infertility cases are due to male factors alone.
Navigating male factor infertility can feel overwhelming. When the desire to start a family is met with unexpected difficulties, it's normal to experience confusion, frustration, and emotional strain. But don't lose hope. Working with your doctor to identify the root cause can illuminate a path toward growing your family.
Below, we'll discuss the leading causes of male factor infertility to help you better understand the conditions that may impact your family planning journey.
What is Male Infertility?
The World Health Organization (WHO) defines male infertility as the inability of a man to make a fertile woman pregnant after at least one year of regular, unprotected intercourse. The most common male infertility factors are azoospermia (no sperm production) and oligospermia (low sperm count). Other factors that impact fertility include low sperm motility or malformed sperm that struggle to reach the egg, preventing pregnancy.
Causes of Infertility in Men
Genetics
Research shows that genetic disorders cause approximately 2%-8% of male infertility cases. These conditions cause male infertility by disrupting sperm production and quality. The most common genetic causes of male infertility are chromosomal abnormalities. Other genetic issues, such as deletions or mutations in the genome, can also cause infertility. Your doctor may recommend genetic testing if you have a very low sperm count, no sperm in semen, physical abnormalities, or if you and your partner have experienced multiple miscarriages.
Some of the most common genetic disorders associated with male infertility include the following:
Cystic fibrosis
Klinefelter syndrome
Y chromosome microdeletion
Chromosomal Translocations
Noonan syndrome
Structural
Structural abnormalities in the reproductive tract can block the flow of sperm and seminal fluid. These issues may be present at birth, caused by infections, or result from surgery. One common and treatable cause of male infertility is a varicocele, an enlarged vein in the testicles.
Similar to varicose veins, varicoceles cause blood to pool in the scrotum, raising testicular temperature. Even a slight increase in temperature can harm sperm production and testosterone function. Luckily, the surgery to treat varicoceles called a varicocelectomy offers promising results.
A recent meta-analysis by Wang et al. found that men who had clinical varicocele repair had much higher pregnancy rates compared to those who didn't get treatment. Without treatment, the pregnancy rate was 17%. Different types of varicocele surgery resulted in pregnancy rates of 42% for subinguinal microsurgical, 35% for inguinal micro, 37% for inguinal open, and 37% for laparoscopic procedures.
Other structural causes of infertility include:
Undescended testicles
Defects of tubules that transport sperm
Vasectomy
Certain Infections
Hormonal
The right balance of hormones is essential for proper sperm production and function. When there is an imbalance in hormones like testosterone or gonadotropins, including luteinizing hormone (LH) and follicle-stimulating hormone (FSH), infertility can occur.
Issues with glands that produce or are influenced by these hormones can cause hormonal imbalances. Key glands involved include:
Thyroid
Hypothalamus
Pituitary
Prostate
Testes
If you are experiencing fertility challenges, your healthcare provider will likely test your hormone levels with a blood sample.
Lifestyle
Many factors related to your fertility may feel out of your control. However, lifestyle also plays a huge role in your sperm's quality and motility. This means if you've been struggling to conceive, there may be actions you can take today to improve your fertility down the line.
Lifestyle factors that impact male fertility include the following:
High-stress lifestyle
Overweight
Poor diet
Alcohol Intake
Recreational Drug Intake
Exposure to heat around testicles
Medications
While most medications are safe for those trying to conceive, some can negatively affect fertility. Often, these effects are temporary and can be reversed once the medication is discontinued. Sperm development in the testicles typically takes about 50-60 days, so it can be beneficial to allow 2-3 months for your body to produce new sperm without the influence of certain medications. Before making any changes to your medication regimen, talk with your doctor to ensure it is safe and appropriate for your situation.
Medications that may impact male fertility include the following:
Alpha-blockers
Antidepressants
Chemotherapy medication
Narcotics
Testosterone replacement
Ketoconazole
5-alpha-reductase inhibitors
Your Fertility Care Partner
Male factor infertility doesn't have to end your hopes of growing your family. At Beverly Hills Reproductive Center, we help patients become parents through personalized fertility care and family-building support. Request a consultation today to discover how we can help.