On your path through fertility care, it’s easy to forget that men are half the equation–50% of infertility cases are male factors. This is unfortunate because testing for male infertility is a simple, low cost, and non-invasive procedure. More importantly, most causes can be successfully treated.
To eliminate the stress and time of the research process, we created an easy to understand 10 step explainer about male infertility causes and treatment options for couples trying to get pregnant.
1. Infertility Impacts 15% of All People
Infertility is defined as the inability to conceive a child within one year of unprotected sexual intercourse. What’s not always appreciated is that in 50% of the cases, men play a significant role in the couple’s infertility. Another way of looking at this is that 7% of men suffer from infertility. Illness, injury, age, chronic health problems, lifestyle choices, and other factors can contribute to male infertility.
2. How Babies are Made – Sex Education
Sperm are created from primordial germ cells in the testes. Combined with nutritive fluid from the prostate gland, around 300 million sperm form the ejaculate. On the female side, women ovulate once per month, sending an egg down into the uterus. Sex anytime within the five days before ovulation may lead to a pregnancy. Sex at other times, even the day right after ovulation, will not lead to conception. After conception, the combination of the sperm and egg leads to embryogenesis (the first stages of new life).
3. Common Causes of Male Infertility
Male factor infertility contributes to the couples infertility in about 50% of the cases.
A few causes are:
- Varicocele (enlarged veins in the testicles)
- Undescended testicle
- Infection in the testicle or prostate
- Chemotherapy for cancer
- Anabolic Steroids
- Genetic Abnormalities
An estimated 20-35% of men are “diagnosed” with unexplained infertility. Meaning that all the diagnostic tests look normal for them and their spouse, however, they are still unable to conceive without knowing why.
4. Factors that Increase Risk of Male Infertility
A number of risk factors are linked to male infertility, including:
- Smoking tobacco or marijuana
- Drinking alcohol excessively
- Being overweight
- Exposure to environmental toxins
- Having past or present infections
- Overheating the testicles
- Having medical conditions, including tumors and chronic illnesses
- Taking medication or undergoing medical treatment such as radiation for cancer
5. Unexplained Infertility
Unexplained infertility is idiopathic and affects 20-35% of all infertile couples. Unexplained infertility is when the cause remains unknown even after all the available diagnostic testing has been completed. This usually includes the semen analysis in the man and the assessment of ovulation and fallopian tubes in the woman. To be clear, abnormalities are still likely to be present in cases of unexplained infertility, but not detectable by current diagnostic methods.
6. The Semen Analysis Test
The semen analysis is a fundamental lab test for testing infertility that counts the number of sperm in a given sample, the motility of those sperm (can they move properly?), and the morphology (do they look normal?). This test also typically looks for signs of infection (i.e., so-called “round cells” in the semen sample). Although the semen analysis is a reasonable first test for assessing the male, it does not provide a very accurate read on the fertility of the man. In other words, just because your semen count is normal doesn’t necessarily mean you’re fertile. Remember, a large proportion of infertile men are diagnosed with unexplained infertility.
7. DNA Fragmentation Testing
DNA fragmentation is the separation or breaking of DNA strands into pieces. It can be done intentionally by laboratory personnel or by cells, or can occur spontaneously. Spontaneous or accidental DNA fragmentation is fragmentation that gradually accumulates in a cell. It can be measured by e.g. the Comet assay.
8. Advancements in Testing for Male Infertility
Advancements in diagnosing male infertility has been very limited over the last several decades. In fact, the last major advancement was the discovery of DNA fragmentation as a biomarker for helping understand IVF cycle failures, which was discovered in 1980. Episona believes that the discovery of the association between aberrant sperm DNA methylation and male infertility will revolutionize how we diagnose men’s reproductive health.
9. Treatment of Male Infertility
The goal of fertility treatment is conception, pregnancy, and the birth of your child. if surgical approaches, such as varicocele repair, do not correct the infertility, more aggressive techniques are usually the next step. In these cases, sperm are typically collected from the ejaculate and introduced to the egg through intrauterine insemination (IUI) where sperm are injected into the uterus, in-vitro methods (IVF), or injected directly into the egg (IVF-ICSI). Success rates and costs vary for each technique, but typically IVF and IVF-ICSI are more successful, statistically, than IUI but cost about 10X as much.
10. Approaching Infertility & Treatment
Coping with infertility can be difficult and the journey through treatment can be long and stressful. Specifically, it’s an issue of the unknown – you can’t predict how long treatment will take and what the outcome will be. The emotional burden on the couple is considerable. Talking with your partner about expectations and putting together a mutually agreed upon plan will help weather the process. Decide in advance how many and what kind of procedures are emotionally and financially acceptable for you and your partner and determine a final limit.