All About Male Infertility: Signs, Symptoms and Diagnosis

Have you and your male partner tried without success to get pregnant and have a baby?  Most people think the woman is responsible for infertility. In reality, the cause may be linked to male infertility. In fact, about 40 percent of conception problems are attributed to male infertility.

Most of the time, there are no outward signs of male infertility. Yet if the cause of male infertility is hormonal, your partner may have some outward signs such as a decrease in sex drive or reduced hair growth on his face or body.

All it takes is one sperm

No matter how many sperm a male has – or doesn’t have – the sperm have to perform at their best. 

Most common causes of male infertility are related to sperm, including

• abnormally shaped sperm
• sperm with poor motility
• poor sperm quality
• sperm that cannot attach the head to egg
• sperm that cannot penetrate the egg

Low sperm count is a common male infertility problem. Usually men have 20 million sperm per milliliter of semen, while a count of 10 million sperm per milliliter or lower is considered low.

Your partner may suffer from azoospermia, a condition where his ejaculation does not contain any sperm.

This male infertility problem may be caused by infection, testicles that don’t produce sperm a congenital absence of the vas deferens, or a previous vasectomy.

In addition, having a vasectomy may cause anti-sperm antibodies to form and attack sperm, leading to male infertility.

Two conditions that hinder male infertility

Your partner’s testicles must be exposed to the proper temperature in order for sperm production to occur. Two conditions that may not allow this to happen include:

1. An undescended testicle, which keeps the testicles close to the higher body temperature and doesn’t allow them to be cooled properly
2. A varicocele, a condition where a swollen vein in the scrotum doesn’t allow for cooling of the testicles, leading to reduced sperm count and motility

Other male infertility causes

Sometimes hormonal disorders, chromosomal defects, or a deficiency in testosterone production causes male infertility problems.

Infection also causes problems with male infertility. Any infection that causes inflammation of the male testicles, urethra, or prostate can harm sperm production or movement as well.

Sexually transmitted diseases (STDs) can cause male infertility by leading to scarring, which hinders the passage of sperm.

Another cause of male infertility is a male birth defect called hypospadia where the urinary opening is located on the underside of the penis, rather than the tip. Or your partner may suffer from retrograde ejaculation where the sperm enters into the bladder rather than out of the penis after ejaculation.

Lifestyle habits lead to male infertility

Certain lifestyle habits can also affect male infertility, including:

• smoking
• excessive alcohol consumption
• drug use
• being overweight or obese
• over exercise
• poor diet

In addition, exposure to certain toxins, pesticides or lead can also cause male infertility. If your partner has been exposed to radiation and/or chemotherapy due to cancer treatment or for any reason, there can be a significant risk to his sperm production.

Diagnosing male infertility

If your doctor suspects male infertility, he may run some tests to make a definitive diagnosis. You partner may first undergo a routine physical exam and semen analysis.  The semen analysis will analyze the number of available sperm, the shape of the sperm and its movement. If the semen analysis shows a problem, your doctor may recommend further testing.  Other tests for male infertility may include:

• a semen culture to look for infection
• a vital staining test to determine how many sperm are alive in a sample
• a blood test that checks for abnormal hormone levels or genetic disorders
• a sonogram of the scrotum to look for blockages
• a testicular biopsy to see if sperm production is normal
• a test for anti-sperm antibodies
• a contrast dye test of the vas deferens to check for a blockage

Lastly, your doctor may run male infertility tests to see how well the sperm attaches to an egg or is able to penetrate it.

Sources: MayoClinic: Male Infertility. American Society of Reproductive Medicine: Patient Fact Sheet: Diagnostic Testing for Male Factor infertility.