{"id":20562,"date":"2023-06-13T10:42:29","date_gmt":"2023-06-13T15:42:29","guid":{"rendered":"https:\/\/www.zocdoc.com\/blog\/?p=20562"},"modified":"2023-06-20T12:40:34","modified_gmt":"2023-06-20T17:40:34","slug":"the-mens-guide-to-infertility","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/guides\/the-mens-guide-to-infertility\/","title":{"rendered":"The Men&#8217;s Guide to Infertility"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">On the surface, while starting a family can seem straightforward, the process goes awry more often than you\u2019d expect. Infertility affects roughly <\/span><a href=\"https:\/\/www.who.int\/news\/item\/04-04-2023-1-in-6-people-globally-affected-by-infertility#\"><span style=\"font-weight: 400;\">1 in 6 people worldwide<\/span><\/a><span style=\"font-weight: 400;\">, according to the World Health Organization. In the US, around <\/span><a href=\"https:\/\/www.yalemedicine.org\/conditions\/male-infertility\"><span style=\"font-weight: 400;\">15% of couples<\/span><\/a><span style=\"font-weight: 400;\"> have issues conceiving, and about 50 percent of the time, male infertility is a contributing cause.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you\u2019ve been trying to get pregnant and suspect you\u2019re one of the 15%, don\u2019t panic. There are plenty of tests and treatment options available that can boost your odds of conception. <\/span><span style=\"font-weight: 400;\">Since infertility can stem from an issue from either or both partners, it\u2019s important for both to get tested to determine the roots of the problem.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There may be no obvious signs or symptoms of male infertility\u2014and should you decide to investigate\u2014here\u2019s what that journey might look like.<\/span><\/p>\n<hr \/>\n<h2>Diagnosing male infertility<\/h2>\n<p><span style=\"font-weight: 400;\">Usually, the first step in diagnosing male infertility is a visit with your primary care physician (PCP), who will go over your medical history and do a physical exam to assess your overall health and identify any problems that might be impacting your fertility.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">They will also do a round of blood tests to check hormone levels and rule out other problems that can affect sperm production, followed by a semen analysis to check the amount of sperm you produce, how well they move and what shape they are, says <\/span><a href=\"https:\/\/www.yalemedicine.org\/specialists\/katherine-rotker\"><span style=\"font-weight: 400;\">Dr. Katherine Rotker<\/span><\/a><span style=\"font-weight: 400;\">, a urologist specializing in male fertility at Yale Medicine in New London, Connecticut.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Should anything from this assessment indicate an underlying fertility issue, you\u2019ll be referred to a specialist\u2014in this case, a urologist who specializes in male infertility.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">No special preparation is needed for this appointment, she adds, but knowing the details of your medical history and family\u2019s medical history is a crucial part of the diagnosis process. You should also bring the results of any fertility evaluations your partner has completed so far.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Once you\u2019re there, the urologist will conduct an exam of the penis and surrounding areas. If the idea of an exam makes you squirm, have no fear: \u201cThe exam isn\u2019t painful and is generally very quick,\u201d says <\/span><a href=\"https:\/\/rmanetwork.com\/staff\/philip-j-cheng\/\"><span style=\"font-weight: 400;\">Dr. Philip Cheng<\/span><\/a><span style=\"font-weight: 400;\">, a urologist with Reproductive Medicine Associates of New Jersey. \u201cAny findings will be reviewed and a recommended path forward will be discussed.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Depending on these findings, your provider can make a treatment plan right after the first visit or conduct further testing, such as an ultrasound (to check your testicles and scrotum\u2014the outer casing that protects the testicles\u2014for problems) or genetic tests (to diagnose congenital or inherited conditions).<\/span><\/p>\n<hr \/>\n<h2>Causes of male infertility<\/h2>\n<p><span style=\"font-weight: 400;\">Male infertility is usually caused by some combination of sperm disorders, structural problems or collateral damage from past or real-time health issues. Once all your test results are in, your provider should be able to offer some explanation for your issues.\u00a0<\/span><\/p>\n<p><b>Sperm disorders<\/b><\/p>\n<p><span style=\"font-weight: 400;\">The most common causes of male infertility involve problems with making healthy sperm, including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Low sperm production or motility:<\/b><span style=\"font-weight: 400;\">\u00a0\u201cIf there\u2019s low sperm production or motility, there may not be enough moving sperm present for a healthy, motile and viable sperm to reach the egg, penetrate, fertilize and lead to pregnancy,\u201d Cheng says.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Misshapen sperm:<\/b><span style=\"font-weight: 400;\">\u00a0There may be an adequate number of sperm present, but not enough sperm with a normal shape (an oval head with a long tail). <\/span><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/male-infertility\/expert-answers\/sperm-morphology\/faq-20057760\"><span style=\"font-weight: 400;\">Abnormal sperm<\/span><\/a><span style=\"font-weight: 400;\"> have head or tail defects\u2014say, a large head or a double tail\u2014and these defects might affect the sperm\u2019s ability to achieve fertilization and pregnancy.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>No sperm in the semen:<\/b><span style=\"font-weight: 400;\">\u00a0In rare cases, men will have no sperm in the ejaculate, which makes natural conception impossible. \u201cThese cases can be broken down into obstructive (meaning there\u2019s a blockage) or non-obstructive (the body\u2019s not producing sperm),\u201d Rotker says.<\/span><\/li>\n<\/ul>\n<p><b>Structural problems<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Genital tract obstructions can derail the flow of semen and cause male infertility. Among the possible culprits:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Swollen veins: <\/b><span style=\"font-weight: 400;\">Varicoceles, which are thought to be caused by malfunctioning valves in veins in the scrotum (located right above the testicles), can be a potential cause of infertility. Usually, these veins help maintain blood flow to the testicles, but if the valves aren&#8217;t working properly they can become swollen. The enlarged veins are thought to keep the area around the testicles too warm, which can impact sperm production, Rotker says.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Sperm blockages:<\/b><span style=\"font-weight: 400;\"> If your medical history includes a prior vasectomy (a procedure that cuts off the supply of sperm to the semen so as to prevent pregnancy) or congenital problems (such as being born without vas deferens, the ducts that deliver sperm to the semen), these can all interfere with your ability to conceive.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Ejaculation issues: <\/b><span style=\"font-weight: 400;\">Various health conditions\u2014diabetes, spinal injuries, urethra surgery, among others\u2014can cause <\/span><a href=\"https:\/\/my.clevelandclinic.org\/health\/diseases\/23371-anejaculation\"><span style=\"font-weight: 400;\">anejaculation<\/span><\/a><span style=\"font-weight: 400;\"> (when you have an orgasm but no semen is released) or <\/span><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/male-infertility\/symptoms-causes\/syc-20374773\"><span style=\"font-weight: 400;\">retrograde ejaculation<\/span><\/a><span style=\"font-weight: 400;\"> (when semen enters the bladder during orgasm instead of exiting out of the tip of the penis).<\/span><\/li>\n<\/ul>\n<p><b>Underlying health issues<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Certain conditions, past and present, might put you at a higher risk of having male infertility, especially:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Chronic infections: <\/b><span style=\"font-weight: 400;\">Some health issues, such as urinary tract and sexually transmitted infections (chlamydia, gonorrhea) can interfere with sperm production or sperm health, as well as cause scarring that can block the passage of sperm. \u201cMen who\u2019ve had chronic prostatitis\u2014inflammation of the prostate gland\u2014may be at risk for infertility as well,\u201d says <\/span><a href=\"https:\/\/www.havingbabies.com\/physicians\/john-m-norian-md-facog\/\"><span style=\"font-weight: 400;\">Dr. John Norian<\/span><\/a><span style=\"font-weight: 400;\">, a reproductive endocrinologist at HRC Fertility in California.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Poorly controlled medical conditions: <\/b><span style=\"font-weight: 400;\">Obesity, elevated blood pressure and diabetes are some of the conditions that can lead to worse semen parameters and male infertility, Norian says. Poorly controlled hypertension and diabetes can also increase the risk of erectile dysfunction, making it even harder to conceive naturally.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Substance and drug exposures: <\/b><span style=\"font-weight: 400;\">Men who are heavy substance users (alcohol, cigarettes, cannabis), have undergone prior cancer treatment (chemotherapy, radiation) and take certain medications (anabolic steroids, some ulcer and arthritis drugs) are all at higher risk for experiencing infertility. These substances and drugs are gonadotoxic, Cheng says, which means they can cause temporary or permanent damage to the body\u2019s ability to produce sperm.<\/span><\/li>\n<\/ul>\n<hr \/>\n<h2>Treatment options for male infertility<\/h2>\n<p><span style=\"font-weight: 400;\">\u201cThere\u2019s no one-size-fits-all when it comes to treating male infertility,\u201d Cheng says. \u201cThe treatment options you\u2019ll be a candidate for will depend on the specific underlying causes of your fertility issues.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Because male and female <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562258\/\"><span style=\"font-weight: 400;\">causes of infertility<\/span><\/a><span style=\"font-weight: 400;\"> tend to co-exist, it&#8217;s recommended that your partner get tested and treated in tandem for maximum efficacy. <\/span><span style=\"font-weight: 400;\">But even if the exact cause of male infertility isn\u2019t entirely clear, your doctor can still recommend treatments and procedures to boost your odds of conception. <\/span><span style=\"font-weight: 400;\">These might include any combination of the following:<\/span><\/p>\n<p><b>Lifestyle changes<\/b><\/p>\n<p><i><span style=\"font-weight: 400;\">Best for treating: Poorly controlled medical conditions, substance and drug exposures\u00a0<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">\u201cSperm disorders, such as low sperm count and motility, can be further exacerbated by an unhealthy lifestyle,\u201d says <\/span><a href=\"https:\/\/omafertility.com\/location\/st-louis\/careteam\/shvetha-murthy-zarek\/\"><span style=\"font-weight: 400;\">Dr. Shvetha Zarek<\/span><\/a><span style=\"font-weight: 400;\">, medical and practice IVF director at Oma Fertility in St. Louis.<\/span><\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562258\/\"><span style=\"font-weight: 400;\">Lifestyle changes<\/span><\/a><span style=\"font-weight: 400;\">, such as spending less time sedentary, exercising more, eating lots of fruits and veggies, and nixing cigarettes, marijuana and alcohol from your repertoire <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562258\/\"><span style=\"font-weight: 400;\">might not be measurable<\/span><\/a><span style=\"font-weight: 400;\"> ways of boosting your odds of conception, but it stands to reason that if your body\u2019s healthier, your sperm will be too.<\/span><\/p>\n<p><b>Medications and behavioral techniques<\/b><\/p>\n<p><i><span style=\"font-weight: 400;\">Best for treating: Chronic infections, poorly controlled medical conditions and ejaculation issues<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">\u201cSexual dysfunction is one of the most common causes of infertility that I see,\u201d Cheng says. \u201cIf a couple is unable to have intercourse that ends with ejaculation of semen, they will be unable to conceive naturally.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Treatment of erectile dysfunction and premature ejaculation, for instance, can involve a combination of medication and behavioral techniques (such as <\/span><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/abs\/10.1002\/9781118510384.ch4\"><span style=\"font-weight: 400;\">cognitive behavioral therapy<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/premature-ejaculation\/diagnosis-treatment\/drc-20354905\"><span style=\"font-weight: 400;\">Kegel exercises<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It\u2019s also important to be diligent about treating infections as they arise: \u201cSome infections of the genital and urinary tracts can have a negative impact on sperm,\u201d Cheng says.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hormone imbalances\u2014high or low levels of certain hormones or problems with the way your body uses them\u2014can affect how sperm develop too, in which case your doctor might recommend <\/span><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/male-infertility\/diagnosis-treatment\/drc-20374780\"><span style=\"font-weight: 400;\">hormone replacement or medications<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><b>Penile vibratory stimulation (PVS) and electroejaculation (EEJ)<\/b><\/p>\n<p><i><span style=\"font-weight: 400;\">Best for treating: Anejaculation and retrograde ejaculation<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">PVS and EEJ are two <\/span><a href=\"https:\/\/www.urologyhealth.org\/urology-a-z\/s\/sperm-retrieval\"><span style=\"font-weight: 400;\">non-surgical options of retrieving sperm<\/span><\/a><span style=\"font-weight: 400;\">\u2014the former involves placing a special vibrator at the tip of the penis, the latter uses a probe that sends electrical energy to the reproductive tract, with the end goal of causing an erection and collecting the sperm.<\/span><\/p>\n<p><b>Assisted reproductive technology (ART)<\/b><\/p>\n<p><i><span style=\"font-weight: 400;\">Best for treating: Low sperm production or motility, abnormal sperm, obstructive and non-obstructive azoospermia\u00a0<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">ART treatments involve obtaining sperm, either through normal ejaculation or surgical extraction, and using it to boost your chances of conception through procedures like:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Intrauterine insemination (IUI)<\/b><span style=\"font-weight: 400;\">, the process of placing the sperm at the entrance of the cervix or directly into the uterus.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>In-vitro fertilization (IVF)<\/b><span style=\"font-weight: 400;\">, where eggs are surgically retrieved from the ovaries and combined with sperm in the lab to make embryos to be inserted into the uterus. \u201cIVF is a great option for men with very low sperm counts,\u201d Cheng says.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Intracytoplasmic sperm injection (ICSI)<\/b><span style=\"font-weight: 400;\">, a procedure that involves hand-selecting viable sperm and individually injecting them into each egg\u2014an especially helpful option for men with misshapen sperm, Cheng says. The resulting embryos are eventually inserted into the uterus.<\/span><\/li>\n<\/ul>\n<p><b>Microdissection testicular sperm extraction (microTESE)<\/b><\/p>\n<p><i><span style=\"font-weight: 400;\">Best for treating: Non-obstructive azoospermia.<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">When there\u2019s no sperm in the semen due to a production problem, a procedure called microTESE can be done to retrieve sperm directly from the testes, Cheng says. It involves making a small incision and using a microscope to hunt for sperm, with retrieval rates of 40% to 60%, according to the <\/span><a href=\"https:\/\/www.mayoclinic.org\/medical-professionals\/urology\/news\/microsurgical-testicular-sperm-extraction-microtese-more-accessible-for-couples-who-are-infertile\/mac-20532220\"><span style=\"font-weight: 400;\">Mayo Clinic<\/span><\/a><span style=\"font-weight: 400;\">. The sperm can either be used right away to fertilize an egg or frozen for a later infertility treatment.<\/span><\/p>\n<p><b>Seminal vesiculoscopy (SV) or transurethral resection (TR)<\/b><\/p>\n<p><i><span style=\"font-weight: 400;\">Best for treating: Ejaculatory duct obstructions.<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">Some men or people assigned male at birth have a blockage of sperm at the ejaculatory ducts that can be relieved through a small procedure, Cheng says. SV uses a small telescope to reach and remove the duct blockage, while TR involves cutting out the blockage.<\/span><\/p>\n<p><b>Varicocelectomy<\/b><\/p>\n<p><i><span style=\"font-weight: 400;\">Best for treating: Varicoceles.<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">\u201cSurgical treatment for enlarged veins in the scrotum can lead to improvement in sperm parameters in about <\/span><a href=\"https:\/\/my.clevelandclinic.org\/health\/treatments\/24234-varicocelectomy\"><span style=\"font-weight: 400;\">2\/3s of patients<\/span><\/a><span style=\"font-weight: 400;\">,\u201d Cheng says. The procedure involves sealing off the affected vein and redirecting blood flow into healthy veins.<\/span><\/p>\n<p><b>Vasectomy reversal<\/b><\/p>\n<p><i><span style=\"font-weight: 400;\">Best for treating: Vasectomies.<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">A vasectomy reversal allows couples to conceive naturally, with pregnancy rates post-surgery ranging from 30% to over 90%, depending on the type of procedure, according to the <\/span><a href=\"https:\/\/www.mayoclinic.org\/tests-procedures\/vasectomy-reversal\/about\/pac-20384537\"><span style=\"font-weight: 400;\">Mayo Clinic<\/span><\/a><span style=\"font-weight: 400;\">. The process involves putting the vas deferens back in business so they can deliver sperm from the testicle into the semen.<\/span><\/p>\n<hr \/>\n<h1 style=\"text-align: center;\">Need a doctor&#8217;s appointment? Find one on <a href=\"https:\/\/www.zocdoc.com\/\">Zocdoc<\/a>.<\/h1>\n","protected":false},"excerpt":{"rendered":"<p>If you\u2019re having trouble conceiving, here\u2019s how doctors can help you get to the bottom of what\u2019s going on and map out a treatment plan.<\/p>\n","protected":false},"author":109,"featured_media":20563,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[227],"tags":[103,100,81,83],"class_list":["post-20562","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guides","tag-prep","tag-mens-health","tag-preventive-care","tag-wellness","reviewer-dr-nassim-assefi"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>The Men&#039;s Guide to Infertility - Guides<\/title>\n<meta name=\"description\" content=\"If you\u2019re having trouble conceiving, here\u2019s how doctors can help you get to the bottom of what\u2019s going on and map out a treatment plan.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zocdoc.com\/blog\/guides\/the-mens-guide-to-infertility\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Men&#039;s Guide to Infertility - 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