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- Check out the Following Creating a Family radio Shows:
- Other Creating a Family Resources:
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How Common is
Male Infertility:
Approximately 10-15% of all infertility is caused solely by male
infertility. In another 30-40% of couples trying to conceive
unsuccessfully, male factor infertility is a contributing
cause.
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Physical Causes
of Male Infertility:
- Varicocele. A varicocele is a varicose vein in the
scrotum can cause reduced sperm count and motility. Often can be
surgically corrected.
- Undescended testicle. Undescended testicles are exposed
to higher body temperatures and sperm production can be
impaired.
- Trauma to the Testicles
- Prior vasectomy or vasectomy reversal
- Erectile Dysfunction
- Retrograde ejaculation (where semen enters the bladder
rather than exits through the penis)
- Blocked ejaculatory ducts
- Misplaced urinary opening
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Diseases and
Conditions Causing Male Infertility:
- Cancer and its treatment. Both radiation and
chemotherapy treatment for cancer can impair sperm production,
sometimes severely. The closer radiation treatment is to the
testicles, the higher the risk of infertility.
- Anti-sperm antibodies, which can form after a
vasectomy
- Testosterone deficiency (male hypogonadism).
- Klinefelter's Syndrome. In Klinefelters Syndrome
a man has two X chromosomes and one Y chromosome instead of one X
and one Y.
- Diabetes
- Thyroid Disease
- Liver Disease
- Kidney Disease
- Sickle Cell Anemia
- Sexually Transmitted Diseases (STDs). STDs such as
Chlamydia, gonorrhea, and genital herpes can cause scarring and
block sperm passage.
- Mumps after Puberty. Can impair sperm production.
- Infections (e.g., prostatitis, epididymitis,
orchitis)
- High Fever
- Down Syndrome
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Lifestyle
Factors Affecting Male Fertility:
- Emotional stress
- Extremes of Weight. (Obesity or Extremely
Underweight)
- Alcohol. Moderate alcohol use does not affect male
fertility, but excessive use reduces male fertility.
- Recreational Drugs. For example, research has found that
cocaine, marijuana, and methadone may reduce sperm count.
- Tobacco Use. Some studies have shown that smokers have
lower sperm count than non-smokers.
- Anabolic steroids taken to bulk up muscles can cause the
testicles to shrink and sperm production to decrease.
- Saunas and Hot Tubs
- Bicycling for long periods, especially on a hard seat or
poorly adjusted bicycle.
- Laptops Computers. There is some evidence that the heat
generated from a laptop computer sitting in your lap can decrease
sperm production.
- Excessive exercise may lower sperm count.
- Work that requires long periods of sitting with limited
ability to move around.
- Restrictive pants or underwear that cause a build up of
heat around the testicles. Research has shown that it does not
matter whether a man wears boxers of briefs.
- Sexual Lubricants. Some lubricants, such as Astroglide,
K-Y jelly, petroleum jelly/Vaseline, lotions, and saliva have been
shown to reduce sperm movement.
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Environmental Factors Affecting Male
Fertility:
- Pesticides, Herbicides, and Insecticides. May cause
reduced sperm production and testicular cancer.
- Lead exposure may cause male infertility.
- Mercury exposure may cause male infertility.
- Certain medications, such as cimetidine and phenytoin.
Certain medications to treat high blood pressure or arthritis.
- Exposure to diethylstilbestrol (DES) in utero. DES was a
medication given to pregnant women in the 1940s through the 1960s
to prevent miscarriage. There is some evidence that sons of these
woman may have fertility problems.
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Signs and Symptoms
of Male Infertility:
- The inability of the mans partner to conceive a child
after one year of trying.
- Difficulty reaching an orgasm or difficulty maintaining an
erection.
- Pain, swelling or a lump in the groin or testicles.
- Decreased facial or body hair, enlarged breasts, or other signs
of a chromosomal or hormonal abnormality.
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Diagnosis
of Male Infertility:
Diagnosing
male infertility usually involves:
- General physical examination and medical history.
- Semen analysis. Semen is generally obtained by
masturbating and ejaculating into a special container at the
doctor's office. It is however possible to collect the sample at
home and bring it into the doctors office, or to use a
special condom to collect semen during intercourse. Check with your
doctor about these options. Usually more than one semen sample will
be requested over a period of time. Semen will be tested for:
- Sperm Concentration (over 2 cc is normal)
- Sperm count (over 20 million per cc or 40 million total
is normal).
- Sperm morphology (percentage of sperm that have a normal
shape- it is not uncommon to have a high percent that are
misshapen)
- Sperm motility (percentage of sperm that can move
forward normally- greater than 50% is normal)
- Standard semen fluid test (thickness, color)
- Total Volume of the Ejaculate
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Treatment
of Male Infertility:
At least one-half
of male fertility problems can be treated. Treatment methods depend
on the cause. In some cases, the male partner and the female
partner are both sub-fertile rather than infertile. In cases such
as this, treating one partner may be enough to achieve a
pregnancy.
Treatments
for male infertility may include:
- Timing and Frequency of Sexual Intercourse. Having sex
every other day around the peak fertile time for the woman is the
most effective. See our page on Ovulation
tracking
- Surgery. A varicocele or an obstructed vas deferens can
often be surgically corrected.
- Treating infections with Antibiotics.
- Treatments for sexual performance issues. Erectile
dysfunction or premature ejaculation can often be treated.
- Hormone treatments and medications. In cases where
infertility is caused by high or low levels of certain hormones or
problems with the way the body uses hormones, your doctor may
recommend treatment with hormone replacement or medications that
change hormone levels.
- Artificial Insemination Also know as intrauterine
insemination (IUI). The sperm is washed and inserted with a
catheter through the womans cervix. It is inexpensive and
non-invasive; therefore it is often the first step of choice. The
woman may or may not be medicated with ovulatory inducing
drugs.
- In vitro fertilization (IVF) The egg is removed from the
woman and put in a Petri dish with the mans sperm. The
resulting embryo is then transferred after 3 to 5 days to the
womans uterus with the hope that it will implant.
- IVF with Intracytoplasmic Sperm Injection (ICSI). Rather
than let the sperm penetrate the egg in the Petri dish naturally,
an embryologist manually inserts one sperm into the egg.
Alternative
Medicine, Supplements, and Herbs for Male infertility
Although the evidence is limited, the Mayo Clinic has reported that
the following herbs and supplements may increase male
fertility.
- Vitamin C
- Zinc (only if you have a deficiency)
- Selenium
- Vitamin E
- Vitamin B-12
- Asian ginseng
- L-arginine
- L-carnitine
There is little
research that has shown what quantity should be taken to increase
male fertility. As always, talk to your doctor before taking any
herbal remedies or supplements. Megadoses are often harmful and
some supplements interact poorly with medications.
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Books, Article, and Other Information Related to Male
Infertility:
- Wonderful essay about male
infertility from the guys perspective-The
Age of Mechanical Reproduction by Paul Ford. It is both
poignant and funny and ultimately uplifting. He and his wife are
now the parents of girl/boy twins.
- Good article on Sperm Morphology by Fairfax Cryobank.
- Great information on Male Factor in Infertility by Ferring
Fertility.
- Women's Health Resource: Male
Infertility Good basic information.
- The
Urology Channel is a good starting place for researching male
factor infertility.
- If you are looking for a good
summary article on the causes and treatments of Male factor
infetility, you can do no better than Common causes of male factor infertility, and what
can be done to help men become fathers.
- Experiencing Infertility: An
Essential Resource by by Debby Peoples Harriette Rovner
Ferguson (2000) does a good job of covering the psychological
affects of infertility on men, including when their is male factor
infertility.
- Overcoming Male Infertility:
Understanding Its Causes and Treatments by Dr. Leslie Schover
and Dr. Anthony Thomas (1999) Although this is a bit dated, the
information is still mostly spot on. It was written by a clinical
psychologist (Schover) and a urologist (Thomas), and their combined
expertise is what makes this book shine. I especially liked the
combination of research and science with personal and practical.
This is one book that assumes you have a brain and a heart.
- Center for Male
Reproductive Medicine and Microsurgery at the Weill Medical
College at Cornell University has an informative website that
provides resources on all aspects of male infertility. The
information is fairly technical, so I would suggest going to the
more general sites mentioned above first, then coming to this site
to learn more about a specific problem.
- The Digital Urology
Journal is a peer reviewed online journal with articles on male
factor infertility. The primary audience for this journal in not
the lay public, but most are easily understood by anyone with a
passing knowledge of the subject. "Management of Male Infertility" is a good overview of
the topic. Unfortunately, it is not dated and a look at the
references leads me to believe that it is not a recent article, but
the information is still relevant.
- On March 6, 2010, Good Morning
America did a story on
"Men, Too: Infertility Is Not Just a Female Problem". Healthy
Young Men Face Infertility and Battle Social Stigma. Check out this
great article and video.
- Was George Washington infertile?
One of George Washingtons greatest sorrows was the lack of a
biological child. As Washington historian W.S. Randall said,
He was content with Martha, but mystified why, year after
year, he and Martha could produce no Washington heir. The
esteemed medical journal,
Fertility and Sterility, tackles this weighty question;
a little late for George, but interesting reading for anyone
suffering from male infertility.
- Hope To Be
Daddy: A Guy's Infertility Voice: One man's running journal and
history with infertility issues (battling male factor infertility
and endometriosis).
- Hope
Restored video on embryo donation by Embryo Adoption Awareness
Center
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