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Male Infertility and Sexual Issues

Approximately 15 percent of couples in the U.S. are infertile, meaning they are not able to conceive even though they have been having unprotected sexual intercourse for more than a year. An equal number of cases are caused by male and female factors, while for another third the cause is unknown or from problems with both partners.
Male infertility is due to a low sperm count, immobile or misshapen sperm, or a blockage that prevents sperm from reaching its destination. Illness, injury, chronic health issues, lifestyle choices, and other factors can play a role in male infertility.

Causes

Sperm must be produced - at least one testicle must function properly and the body must produce testosterone and other hormones to trigger sperm production.

Sperm must be carried out of the body - once produced in the testicles, fragile tubes transport them until they mix with semen and are ejaculated out of the body.

There needs to be enough sperm in semen - if the number of sperm is low, the odds of conceiving are reduced.

Sperm must be shaped correctly and be able to move - if either is abnormal, sperm may not be able to reach and penetrate your partner's eggs.

Risk Factors

  • Genetics
  • Chemotherapy
  • Overheating of the testicles
  • Spinal cord injury
  • Past infections, including sexually transmitted diseases, mumps and prostatitis
  • Malnutrition
  • Exposure to toxic chemicals and heavy metals (e.g., lead and cadmium)
  • Radiation treatment
  • Tobacco and drug use
  • History of undescended testicles

Diagnosis• Semen analysis - to analyze the amount, number, shape and movement of sperm

  • Blood tests - to determine levels of certain hormones needed for sperm development
  • Ultrasound - to examine structures in the body, including enlarged veins around the testicles
  • Fertilization tests - to determine how well sperm can penetrate an egg
  • Biopsy - to test a tissue sample from a testicle

Treatment

Treatment for male infertility largely depends on the cause of the condition and can include:

  • Lifestyle changes - avoiding tobacco and drug use, maintaining a healthy weight, and changing the timing of sexual activity
  • Medication - anti-estrogen drugs like Clomid that are combined with vitamin E to help increase sperm count and improve sperm movement
  • Assisted Reproductive Technologies -- artificial insemination, in vitro fertilization, and other techniques that use sperm and eggs in a lab to help with conception

Treatments for infertility can be lengthy and expensive, and are often not covered by insurance.

Contact Information

Beth Israel Deaconess Hospital-Needham
148 Chestnut Street
Needham, MA 02492
781-453-3000