Infertility is not being able to get pregnant after having regular sexual intercourse without birth control for at least 1 year (or 6 months if the woman is 35 or older). Infertility can be caused by problems in a man’s or a woman’s reproductive system. Problems in the man’s body are responsible for about half of the cases of infertility.
What is the cause?
Most often a man is infertile because he doesnâ€™t make enough healthy sperm. Some of the reasons for this may be:
Alcohol or drug abuse
Exposure to chemicals or radiation
Being in hot-tubs too much
Severe injury to the testicles
Wearing tight underwear, such as jockey shorts, all the time
Having sex too often (every day) so there is not enough time to develop mature sperm
A genetic problem you were born with
Sometimes the sperm are not normal. For example, they may not be able to move properly or their lifespan may be too short. A normal sperm has a lifespan of about 3 days. Abnormal sperm can result from:
An infection that causes irritation and swelling of the testicles, such as mumps or a bacterial infection
A varicocele, which is a swelling of veins in the scrotum (the sac that holds the testicles)
Abnormally developed testicles
Sometimes the problem is getting the sperm into the woman’s vagina. This problem may be caused by:
Infection of the genital organs, which can block the passage of sperm
Ejaculation that happens too early during sex
Retrograde ejaculation (semen is forced back into the man’s bladder), which may be caused by diabetes, some medicines, or treatments for prostate or urethra problems
Inability to keep an erection, which may result from a disease or side effects of a medicine
Other possible causes of male infertility are:
Severe injury, major surgery, or an illness such as diabetes or cancer
Problem with the penis, which may be something you are born with or a problem caused by an injury
Medicines such as steroids
Using lubricants during sex (lubricants can make it harder for the sperm to reach the egg)
The natural loss of fertility that happens as men get older, especially after age 40
How is it diagnosed?
At first, you and your partner will probably see your healthcare provider. Your provider may refer you to a specialist.
You and your partner will have thorough physical exams. You will be asked about:
Your sexual history, including previous pregnancies
Your medical and family history
Medicines that you take
Your use of drugs, alcohol, and tobacco
Your diet and exercise habits, which may help your healthcare provider diagnose other problems that can lead to infertility, such as diabetes
Exposure to chemicals, such as weed killers and pesticides
Your sexual practices, such as how often you have sex, whether you use lubricants, and if you have any problems during sex
Tests may include:
Test of semen to check the number and quality of sperm
Test of other fluids from your penis
Ultrasound scan, which uses sound waves to show pictures of the bladder and scrotum to help identify problems that may prevent ejaculation
How is it treated?
Treatment for infertility depends on the cause. Treatment may include:
Taking hormones for a hormone imbalance
Taking medicine to help you make more sperm
Taking an antibiotic for an infection
Taking medicine or having therapy to help with ejaculation problems
Having surgery to correct a problem in the testicles or to remove a blockage of the tubes that carry the sperm
If your sperm count is low, artificial insemination may be an option. Semen will be collected at several different times and stored until there are enough sperm. The semen is then put in your partner’s uterus during the most fertile time of her menstrual cycle.
If artificial insemination doesnâ€™t work, you may want to consider using sperm donated by another man. Use only sperm banks that properly screen for sexually transmitted diseases and infections (STDs and STIs) and other illnesses in the donor and his family.
In vitro fertilization is a procedure that may be done if your sperm count is low or your partner’s fallopian tubes are blocked or damaged. For this procedure, eggs are removed from the woman and fertilized with sperm in the lab. The fertilized eggs are then put back into the woman’s body.
Sometimes both partners need treatment. Looking for and treating causes of infertility can be stressful for a couple. It can put unusual strain on your relationship. Counseling may help.
How can I help prevent infertility?
To lower your risk of infertility:
Prevent sexually transmitted diseases and infections (STDs and STIs) by using latex or polyurethane condoms. Also, have just 1 sexual partner who is not sexually active with anyone else.
Donâ€™t have sex every day.
Donâ€™t use lubricants during sex. It can make it harder for sperm to reach the egg.
Limit the amount of alcohol you drink to no more than 1 to 2 drinks a week.
Donâ€™t overuse prescription and nonprescription drugs.
Donâ€™t smoke or use illegal drugs.
Avoid exposure to radiation, industrial chemicals, weed killers, and pesticides.
Avoid long, hot showers and frequent use of hot tubs and saunas. High temperatures can lower your sperm count. It also may help to wear boxer shorts rather than jockey shorts.
Keep your genital area clean to prevent infections.
Get prompt treatment if you have signs of an infection, such as bleeding, discharge, swelling, sores, or itching in your genital or rectal area.
Take any hormones, antibiotics, or other medicines as prescribed by your healthcare provider.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-02-02 Last reviewed: 2014-12-11
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Katz V., G. Lentz, R. Lobo, D. Gershenson. Comprehensive Gynecology. 5th ed. Mosby Elsevier, 2007. Accessed on June 5, 2010 from http://www.mdconsult.com.
Schorge, J., J. Schaeffer, L. Hoalvorson, B. Hoffmen, K. Bradshaw, F. Cunningham. Williams Gynecology. 1st ed. The Mcgraw Hill Companies, Inc. 2008. Accessed June 5, 2010 from http://www.accessmedicine.com.