Male Infertility Problems

Infertility, defined as the inability to achieve a pregnancy after one year of unprotected intercourse, affects approximately 15% of all couples in the United States. Although the female is often the first evaluated, male factors alone may be the cause of infertility in 40% of cases and may be combined with female factors in another 10-20%. Hence, it is imperative that the male patient be properly evaluated to determine the cause of the appropriate treatment.

While infertility can cause significant stress on individuals and couples, a logical and thorough approach to evaluating and treating this problem can often provide satisfying results. Evaluation of the infertile male involves a complete history, physical examination and appropriate laboratory testing. The history will include pertinent childhood illnesses, previous surgery, family history, and sexual activity. After completing a physical exam, the urologist will determine which laboratory tests are needed. This will usually consist of a semen analysis and a blood test for hormone levels.

Once the results of the initial evaluation are known, it will be determined if any additional testing is required. Ultrasound tests are often helpful in evaluating men with infertility. Your doctor will discuss any recommended tests with you.

The treatment of male factor infertility falls into three main categories. First, some men will have problems that can be treated with medication. Second, patients have a cause of infertility that can be fixed or improved with surgery. Finally, some couples may be treated with assisted reproduction techniques. These are done in conjunction with a gynecologist or reproductive endocrinologist. These techniques include intrauterine insemination, in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI).

With the recent advances in our ability to evaluate and treat men with infertility, couples who in the past would have been told there was no hope now may have the possibility of achieving a pregnancy. Any couple who has been attempting to achieve a pregnancy and has been unsuccessful should undergo evaluation. In addition to an evaluation of the female partner by her doctor, an evaluation of the male partner by a urologist with an expertise in infertility is essential as well.