Infertility in Men - Highlights

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:

• Varicocele, 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 cause 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

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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 may be used to repair varicoceles 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.

Review Date: 10/21/2010
Reviewed By: 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).