Definition of Male Infertility
Infertility is a major medical issue in the United States. It affects approximately two to three million, or one in six, couples. Infertility is defined as the inability to conceive after one year of unprotected, adequately timed intercourse.
Approximately one third of the cases are related issues with the male, one third are due to issues with the female, and one third are related to a combination of issues in both the male and female. That means that, in almost 67% of infertility cases, a male fertility problem can be identified. Overall, an evaluation should begin as soon as the couple expresses concern. Ideally, both the male and female should both be evaluated simultaneously.
Symptoms of Male Infertility
The most common male fertility problems involve issues with making and growing sperm. Sperm may:
- Not grow fully
- Not move a particular way
- Be abnormally shaped
- Not be made (azoospermia)
- Be made in very low numbers (oligospermia)
Causes of Male Infertility
The most common cause for male infertility is a varicocele. A varicocele is an abnormal dilation of the veins which drains the testicle inside the scrotum. Variococeles account for 40% of men being evaluated for infertility. However, if a couple has already had a child and is having difficulty having a second (secondary infertility), that number jumps to 80% of male patients. Varicoceles can occur on one side or both sides, but typically occurs on the left side.
It is thought that the pooling of blood around the testicle and the excess heat provided may create problems with the ability for the testicle to produce normal sperm. The treatment for varicoceles is a surgery in which the abnormal veins are tied off, which then allows for improved sperm production in approximately 67% of patients in after 4 months of having the surgery performed.