FERTILITY PROBLEMS IN MEN

General Information

DEFINITION--The inability to impregnate a female after 1 year of sexual activity without contraception. Infertility occurs in 10% of all couples. Fertility depends on the production of normal quantities of healthy sperm, ability to achieve an erection and to ejaculate sperm into the vagina during sexual intercourse.

BODY PARTS INVOLVED--Genitals; endocrine system; brain.

SEX OR AGE MOST AFFECTED--Males after puberty.

SIGNS & SYMPTOMS--Inability to impregnate a fertile woman.

CAUSES--

Infertility is caused by an absence of sperm, defective sperm or insufficient sperm in ejaculation. Reasons include:

• Anatomical abnormalities of the penis or testicles, including undescended testicles.
• Excessive alcohol intake.
• Urinary-tract infection.
• Hormone disturbance.
• Mumps.
• Use of some drugs, such as antihypertensives, cytotoxic drugs, male hormones and MAO inhibitors.
• Sexually transmitted diseases.
• Injury to the genitals; ejaculatory dysfunction.
• Varicose veins in the testicles.
• Psychological reasons, such as fear of infertility.
• Overheating of the testicles caused by vigorous, repetitive exercise or underwear that is too tight and holds the testicles too close to the body.
• Intercourse problems, e.g., premature withdrawal, poor timing with menses, too infrequent.

RISK INCREASES WITH

• Diabetes mellitus.
• Poor nutrition.
• Family history of Klinefelter's syndrome (See Glossary).
• Smoking (men who smoke produce fewer and less healthy sperm).
• Hot tub use.

HOW TO PREVENT--No specific preventive measures except to avoid risk factors or causes.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Blood studies of hormones; semen analysis.
• Testicular biopsy.
• Special tests of sperm function and quality.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• A variety of treatments are available such as devices that lower scrotal temperatures, intrauterine insemination of concentrated washed sperm and in-vitro fertilization.
• Psychotherapy or counseling for sexual therapy techniques, marital problems or alcoholism.
• Surgery to correct anatomical abnormalities of the reproductive system.

POSSIBLE COMPLICATIONS--Psychological distress caused by feelings of guilt, inadequacy and loss of self-esteem.

PROBABLE OUTCOME--Many fertility problems are minor and reversible. Approach treatment with optimism.

How To Treat

GENERAL MEASURES--

• Heat may decrease sperm production in the testicles. To prevent this: Don't wear tight underwear or athletic supporters that hold the testicles too close to the body, don't take hot baths or extended hot showers, avoid long bicycle rides.
• Have sexual intercourse during the time your partner is ovulating. Don't ejaculate for 3 days prior. Intercourse should occur every 36 hours during the fertile period.
• Don't smoke; avoid alcohol or use in moderation.
• Don't use commercial sexual lubricants (they may kill sperm).
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe medications for any underlying problem discovered during medical testing.

ACTIVITY--Work and exercise moderately. Overexercising can be a factor in infertility. Rest when you tire.

DIET--Eat a normal, well-balanced diet.

Call Your Doctor If

• You want help for infertility.
• Conception doesn't occur within 6 months, despite recommendations and treatment.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.