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Infertility in men - Highlights
- Highlights
- Introduction
- Causes
- Risk Factors
- Diagnosis
- Treatment
- Assisted Reproductive Technologies
- Lifestyle Changes
Description
An in-depth report on the causes, diagnosis, treatment, and prevention of male infertility.Highlights:
Causes of Male Infertility
More than 90% of male infertility cases are due to low sperm counts, poor sperm quality, or both. The remaining cases of male infertility can be caused by a range of conditions including anatomical problems, hormonal imbalances, and genetic defects.
Sperm Abnormalities
Sperm abnormalities are a critical factor in male infertility. These abnormalities include:
- Low sperm count
- Poor sperm motility (movement)
- Abnormal sperm shape
Risk Factors
Risk factors for male infertility include:
- Variocele, an enlarged varicose vein in the spermatic cord that connects to the testicle
- Aging, which can adversely affect sperm counts and motility and decrease the genetic quality of sperm
- Sexually transmitted diseases, which can causes scarring in the male reproductive system or impair sperm function
- Lifestyle factors such as smoking, substance abuse
- Long-term or intensive exposure to certain types of chemicals, toxins, or medications
Diagnosis
In addition to a medical history and physical exam, specific tests for male infertility include:
- Semen analysis to evaluate the quantity and quality of sperm
- Blood tests to evaluate hormone levels
- Imaging tests to look for structural problems
- Genetic testing to identify sperm DNA fragmentation, chromosomal defects, or genetic diseases
Treatment
Treatment for male infertility should first address any underlying medical condition that may be contributing to fertility problems. Drug therapy may be used to treat hormonal disorders. Surgery is used to repair varioceles and correct any obstructions in the reproductive tract.
If fertility issues remain unresolved, intracytoplasmic sperm injection (ICSI) is commonly used in combination with in vitro fertilization (IVF) to achieve pregnancy when male infertility is a factor. ICSI involves injecting a single sperm into an egg obtained through IVF. The fertilized egg is then implanted back into the woman. Pregnancy success rates depend on many different factors.
Resources
- www.resolve.org -- National Infertility Association
- www.asrm.org -- American Society for Reproductive Medicine
- www.urologyhealth.org -- American Urological Association
- www.afafamilymatters.com -- American Fertility Association
- www.ssmr.org -- Society for the Study of Male Reproduction
- www.sart.org -- Society for Assisted Reproductive Technology
- www.cdc.gov/ART/index.htm -- Centers for Disease Control: Assisted Reproductive Technology Report
References
Bensdorp AJ, Cohlen BJ, Heineman MJ, Vandekerckhove P. Intra-uterine insemination for male subfertility. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD000360.
Jain T, Gupta RS. Trends in the use of intracytoplasmic sperm injection in the United States. N Engl J Med. 2007 Jul 19;357(3):251-7.
Khera M, Lipshultz LI. Evolving approach to the varicocele. Urol Clin North Am. 2008 May;35(2):183-9, viii.
Levine BA, Grifo JA. Intrauterine insemination and male subfertility. Urol Clin North Am. 2008 May;35(2):271-6.
Schiff JD, RamÃrez ML, Bar-Chama N. Medical and surgical management male infertility. Endocrinol Metab Clin North Am. 2007 Jun;36(2):313-31.
Van Peperstraten A, Proctor ML, Johnson NP, Philipson G. Techniques for surgical retrieval of sperm prior to intra-cytoplasmic sperm injection (ICSI) for azoospermia. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD002807.
Zhu JL, Basso O, Obel C, Bille C, Olsen J. Infertility, infertility treatment, and congenital malformations: Danish national birth cohort. BMJ. 2006 Sep 30;333(7570):679. Epub 2006 Aug 7.
- Reviewed last on: 10/21/2008
- Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
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