What to expect during a male infertility evaluation

An infertility evaluation will start with a complete reproductive, medical and surgical history. The doctor will ask about your sexual health and history, past illnesses, fertility treatments, surgeries or testicular exposure to heat, radiation and chemicals.

During the physical exam, a doctor will assess the build, hair distribution, breast development and external genitalia of the patient. The doctor will pay special attention to the size and consistency of testicles and the structures inside the spermatic cord (the series of long tubes that connect the testicles to the body). 

The semen analysis will include:

• Ejaculate volume - how much fluid is in the sample
• Sperm concentration - how many sperm are in the sample
• Sperm motility - how well the sperm can move
• Sperm morphology - the shape of the sperm 

Ideal Results for a Semen Analysis

According to standards set by the World Health Organization (WHO), the ideal semen analysis results include:

• Ejaculate volume: 1.5 to 5.0 mL
• Sperm Concentration: More than 15 million/mL
• Sperm Motility: More than 45% motile
• Total Motile Sperm Count: More than 20 million
• Sperm Morphology: More than 5% normal (using the Kruger Strict system, which rates how likely it is that sperm can fertilize an egg)
• Leukocytes (white blood cells) to look for infection or inflammation
• Anti-sperm antibodies, which the body’s immune system may create in response to sperm
• Reactive oxygen species (free radicals that damage sperm)
• Sperm DNA integrity to see if there is damage to the sperm’s genetic material

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What you need to know about male infertility

Male fertility – the ability to produce and deliver sperm – is impacted by a variety of medical, environmental and lifestyle causes.

• Medical causes of male infertility. Several physiological factors can negatively impact sperm production, motility and delivery. One of the most common is a varicocele, a swelling of the veins that drain the testicle. Varicocele reduces the quality of the sperm. Other factors may include infections, blockages caused by tumors, chromosomal defects, or hormonal imbalances.It’s important to know that many of these factors are treatable, or don’t interfere with the ability to retrieve sperm for use with assisted reproductive techniques such as in vitro fertilization.
• Overexposure to certain environment conditions can negatively impact male fertility, too. Some industrial chemicals, heavy metals, radiation and/or heat may inhibit sperm production. Damage from environmental factors may be reversible by reducing or eliminating exposure.
• The use of anabolic steroids, cocaine, marijuana or other illicit drugs may reduce sperm count and quality. Excessive alcohol use may also reduce sperm count and cause erectile dysfunction, and tobacco use can inhibit sperm production as well. Stress and obesity can impact sperm and cause hormone changes that inhibit fertility, too. The good news is that lifestyle changes can often improve male fertility.

How is male infertility diagnosed?

The first step towards determining if and how male infertility is a factor is a general exam and semen analysis. During the general exam, the doctor will gather patient history, evaluate current health condition and do an external examination of the male genitals.

The patient will also be asked to provide a semen sample. The sperm will be evaluated for motility, shape and number, and the sample will also be tested for the presence of infections.

Patients may require additional tests, too. Those tests may include ultrasounds, hormonal or chromosomal testing or urinalysis.

Patients can prepare for meeting with the doctor by following all pre-appointment or testing guidelines, including restrictions on ejaculating for at least two days prior to the appointment. Patients should also gather medical history, and ask male family members if they have any conditions that have interfered with their fertility. Make a list of all medications and current conditions and medications or dietary supplements, and a list of lifestyle factors or environmental factors that could influence fertility.


How can men protect their fertility?

Men can protect their fertility by protecting their overall health: avoid illicit drugs and the use of tobacco products, drink alcohol in moderation or abstain entirely, maintain a healthy weight with diet and exercise, and reduce stress. Limit exposure to excessive heat, radiation, chemicals, heavy metals and other toxins.

How can men stay healthy during infertility treatment?

Infertility treatment can be stressful, both on individuals and on the relationship, and that stress can have a rebound effect that exacerbates fertility issues. Communication and boundaries are key. Talk about and agree upon how much you are willing to invest financially and emotionally into the process. Connect with each other, and seek support from friends, family or a professional counselor. Support groups can also be very helpful. Turn to healthy options for stress management, including prayer, meditation, and exercise.

For male infertility treatment, low sperm count, azoospermia get free online consultation today.

Male Infertility – Causes for Male Infertility

Causes of male infertility include overall health and certain physical or hormonal conditions that can affect delivery, quantity and quality of sperm. Generally, the first step in determining cause of infertility in the male involves semen and sperm analysis. Some causes of infertility in men include:

• Sperm abnormalities­: Size, shape, volume, and motility (movement ability) are important factors in male fertility.
• Infection: Sexually transmitted diseases (STDs) or inflammation of the prostate or testicles.
• Varicocele: An enlarged vein in the man’s scrotum that can affect sperm quality.
• Hormone imbalance: Hormonal levels that are too low or high may cause a problem with sperm quantity or quality.
• Blockage of the sperm duct:­ The vas deferens transports sperm for ejaculation, and sperm will not reach the egg.
• Retrograde ejaculation: This causes sperm to travel backwards into the man’s bladder during ejaculation rather than out through the tip of the penis.
• Undescended testicles (cryptorchidism): If not corrected, this can lead to low sperm production.
• Injury or trauma: this can cause damage to the testicles and production of sperm.
• Problems with sexual intercourse: Psychological and/or physical factors may make intercourse difficult or impossible for some men, as can erectile dysfunction (ED), hypospadias, premature ejaculation, and painful intercourse.
• Cancer of the reproductive organs: Cancer can cause infertility, as can cancer treatments such as radiation or chemotherapy.

General Health Issuses

General health issues that affect male fertility can be caused by:

• Age: Older men may be less fertile.
• Diet: Body cells, including sperm cells, cannot function properly in an acidic and toxic environment. When the diet is nutrient poor and chemically loaded, the body eventually becomes toxic and disease follows. Specific issues include excessive caffeine intake and deficiencies in such nutrients as vitamin C, selenium, zinc, and folic acid.
• Lifestyle: Excessive stress, anxiety, lack of sleep, and exercise all adversely affect fertility. Infertility itself can sometimes become a long-term, discouraging problem, therefore producing more stress.
• Substance abuse: Alcohol or drug dependency can be associated with poor health and reduced fertility.
• Diseases: Those affecting reproduction can be infectious, such as STDs and viral infections like mumps, or they can be inflammatory, autoimmune diseases like multiple sclerosis. Certain conditions, such as diabetes, thyroid disease, Cushing’s syndrome, or anemia may affect fertility.
• Environmental exposure to pesticides and other chemicals: Herbicides and insecticides may cause female hormone-like effects in the male body and may be associated with reduced sperm production and testicular cancer. Lead exposure may also cause infertility.

For male infertility treatment, low sperm count, azoospermia get free online consultation today.

Poor sperm & lifestyle impact male infertility

For many men, infertility is often related to low sperm count, poor sperm motility or poor morphology. These can prevent sperm from doing its part, swimming to and penetrating the female egg in the fallopian tube awaiting fertilization.

Not enough sperm production can cause male infertility. Hormonal imbalances can be the problem. It’s important for a fertility specialist to either identify or rule this out as the cause. Medications can sometimes solve this problem.

Similarly, sperm that does not have the proper quality can also result in male infertility. A sperm’s morphology usually denotes poor fertilization quality. Sperm’s motility, its ability to move through the female reproductive system to reach the egg for fertilization, can also lead to male infertility. This can include the ability to attach itself to the egg once it has reached it.

The following factors can contribute to male infertility causes as described above.

Weight

Being underweight or overweight can impact male fertility—especially when these issues are related to malnutrition and physical inactivity. Changing your diet and getting more exercise can improve your fertility, help you maintain a healthier weight and bring hormones into balance.

Lifestyle

Aside from diet and exercise habits, several lifestyle factors can affect male fertility. Drinking alcohol, smoking cigarettes or marijuana, and not managing stress can possibly reduce fertility by lowering sperm count or causing abnormal development of sperm. Exposure to excessive heat can affect sperm production and function. Exposure to environmental toxins in the workplace could be a risk factor for infertility as well.

Blockages

In some cases, there may be a blockage that prevents otherwise healthy sperm from getting into the ejaculate fluid. The blockage may have no symptoms and be repairable through surgery. Causes may include infection, injury or congenital defects.

Varicoceles 

Varicoceles are similar to varicose veins and they develop in the scrotum, causing increased temperatures that can reduce sperm production. Symptoms may be present, though the condition could go unnoticed until infertility is diagnosed.

Other factors may be involved, such as:

• Diseases involving the heart, liver and kidneys, as well as cancer
• Trauma to testicles
• Surgery in the groin area can reduce blood to the testicles
• Erectile dysfunction, the inability to maintain an erection through ejaculation.

For male infertility treatment, low sperm count, azoospermia get free online consultation today.

Male infertility tests and diagnosis

Most infertile couples, usually have more than one cause of infertility. Therefore, they have not managed to conceive even after a year of trying. Men who have issues that may result in infertility, do not show any signs or symptoms and need to get tested. In some cases, the cause of infertility may not be identified.

Diagnosing male infertility involves:

• A clinical examination with a complete medical history physical examination- to rule out any physical cause for infertility or clinical signs of any hormonal dysfunction.
• Semen Analysis- This is the most common male fertility test. What is checked is:
  • Sperm count
  • Motility of the sperm-the ability to swim
  • Velocity or forward progression of the sperm
  • Morphology of the sperm-size and shape of the sperm
  • Total semen volume
  • The liquefaction of the semen- the change from the normal gel-like state at ejaculation to a liquid state

A sample of semen is collected by masturbating and ejaculating into a special container at the doctor’s office or by using a special condom to collect semen during intercourse. The semen should then be examined within a few hours, to achieve the most accurate results.

After your semen is collected, it is sent to the laboratory to measure the number of sperms present in it and to check for abnormalities in its shape. The laboratory will also check for signs of infections in your semen. Very often, the sperm counts fluctuate from one specimen to another. In many cases, semen analysis tests are done over a period to gain accurate results. If your sperm analysis is normal, your doctor might recommend you to do a thorough test of your partner, before he conducts any more male fertility tests on you.

Your doctor may also recommend a few additional tests to help identify the cause of infertility. They are:

• Hormone testing: Hormones that are produced by the pituitary gland, the hypothalamus and testicles, play a vital role in the sexual development and sperm production. Abnormalities present in other hormonal or organ systems might also cause infertility. However, a blood test measures the testosterone level and other hormones that can cause male infertility.

• Genetic Tests: If your sperm concentration is extremely low, there could be a possibility of a genetic cause. However, in such cases, a blood test can reveal if there are changes in the Y chromosome which can lead to male infertility. Genetic testing can also be ordered to diagnose numerous congenital or inherited syndromes.

• Ultrasonography: Performing an ultrasonography test on the man’s scrotum helps to find out if there is any obstruction in the testicles. It can also be used to check the presence of varicocele or other abnormalities with the supporting structures of the reproductive system.

• Analysis of the urine: Presence of some amount of sperm in the urine indicates that sperms are travelling into the bladder instead of coming out. This helps to determine whether the person is suffering from retrograde ejaculation or not.

• Testicular biopsy: This involves collecting samples from the testicles and conducting tests on it. It helps to identify problems with the sperm production processes. However, it is not commonly used to identify fertility problems.

Issues with fertility can be easily treated with various tests or minor surgery. Though in some cases, where infertility is caused by genetic issues, it is important to seek an expert’s advice to get the right information and treatment.

For male infertility treatment, low sperm count, azoospermia get free online consultation today.

Impotency vs. inFertility in Males

Male fertility issues may be the result of:

• Low sperm count, low quality, low motility of sperm
• Not producing any sperm
• Physical inability to ejaculate semen from the body

Impotency

Impotency is a man's inability to achieve and maintain a penile erection to perform sexual intercourse. This condition is also referred to as erectile dysfunction (ED). For a man to achieve and maintain an erection, several systems in the body must work together, including the nervous system and cardiovascular system. Should any of these systems be compromised, achieving and maintaining an erection becomes difficult. Impotency is often the result of the following health issues:

• Heart disease or other vascular issues
• Emotional or mental health issues such as depression
• Stress
• Diabetes
• High blood pressure
• Medications
• Obesity
• Abuse of drugs or alcohol
• Nerve damage

While the condition does make it difficult for a man to have sex, it does not mean that a man is unable to produce sperm to conceive a child. A man can produce healthy sperm even if he is impotent.

Male Fertility

A man’s fertility describes his ability to produce quality sperm in quantities able to fertilize an egg. If a couple has tried to get pregnant for more than one year, they are deemed to be infertile and should seek medical treatment. In one of three cases, both the male and female partners are impacted by fertility issues. A number of things cause infertility in men, including:

• Treatment for cancer
• Chronic diseases such as diabetes
• Alcohol or drug abuse
• Untreated sexually transmitted diseases
• Abnormalities in the male reproductive organs
• Genetic issues
• Injury to the male reproductive organs
• Illness experienced as a child with a high temperature

For male infertility treatment, low sperm count, azoospermia get free online consultation today.

Understanding Male Infertility

In at least half of male infertility cases, doctors cannot identify an exact cause. For the remaining cases,infertility is either due to environmental, genetic or other identifiable factors.

Common Environmental Causes of Male Infertility:

• Excess heat, for example due to the male’s occupation, such as truck drivers, welders, or firefighters, or habits, such as excessive use of the hot tub or tight clothing.
• Drugs, including certain antibiotics and prescription medicines, anabolic steroids, alcohol, marijuana.
• Toxicants, such as pesticides, herbicides, heavy metals, lead, mercury, or paint
• Stress
• Excess exercise, including bicycling
• Chronic disease, such as anemia, malnutrition, cancer, neurological disease, or  diabetes
• Dietary deficiencies, such as zinc, vitamin C, folic acid
• Varicocele, a condition in which the veins enlarge inside the scrotum
• Diseases of the male genital tract, including infection, cancer, trauma, or retrograde ejaculation
• Surgery on the male genital tract, such as for the treatment of undescended testicle, or hernia
• Obesity

Genetic Causes of Male Infertility:

• Mutations inside the genes that determine the male sex, called the Y-chromosome
• Other irregular changes in the genes. For instance, some men have a condition called Klinefelter’s XXY syndrome in which they have an extra copy of the female-sex determining genes (the X chromosome)
• Hormonal issues, such as: diabetes, high levels of the milk-producing hormone prolactin, or problems with the hormone-producing organs like the thyroid or adrenal gland

Male Infertility Treatments:

Not all male infertility is permanent or not treatable, it is not uncommon for men to treat infertility through one or a combination of actions.

• Avoiding damaging environmental factors, such as smoking, heat exposure, heavy exercise, toxicants, certain drugs, or excessive alcohol
• Reducing stress
• Taking medications,which include antibiotics (if an infection is suspected); fertility medications (Clomiphene, Human Chorionic Gonadotropin (hCG) or LH/FSH injections)
• Vitamins, such as folic acid, zinc, or L-carnitine
• Antioxidants
• Alternative medicine. However, certain types of herbs may be harmful. Acupuncture is generally not harmful or helpful.
• Surgery, such as reversing a vasectomy or repairing a condition called varicocele, in which the veins inside the scrotum become enlarged
• In vitro fertilization, which is usually done via a process called Intra-Cytoplasmic Sperm Injection (ICSI)

For male infertility treatment, low sperm count, azoospermia get free online consultation today