Statistics show that up to 50% of infertility problems among couples can be traced to male medical conditions. Nearly one in ten men will face infertility, with problems ranging from issues with sperm production to sperm delivery obstruction. This may come as a surprise since the prevailing notion, for many people, is that female infertility is generally the culprit when a couple encounters trouble conceiving. Drew Tortoriello, MD of Sher Fertility Institute New York in Manhattan explains how to prevent and treat male infertility.
Pinpointing the Problem
A thorough evaluation is the first step to treating male infertility. A number of problems may be at play, some of the most common include:
- Abnormal ejaculation
- Blockage of the vas deferens (following vasectomy)
- Varicocele (varicose veins of the testicle)
- Abnormal hormones
- Testicular exposures
- Abnormal erectile function
Your physician will start by taking a detailed history and ordering a semen analysis. If the results yield a significant abnormality, a reproductive urologist will be involved to help identify the reason for the problem as well as to help coordinate the best treatment. Depending on initial results, further testing may include endocrine labs (blood draw), an ultrasound, or genetic testing. There are a number of approaches to treatment – lifestyle modification, medications, surgery, or IVF with adjunctive procedures to maximize the sperm’s potential. These adjunctive treatments include:
- Percutaneous Epididymal Sperm Aspiration (PESA): This non-invasive technique is used to retrieve sperm if there is a blockage. Tiny needles collect fluid from the epididymis, where sperm is stored after production in the testes.
- Testicular Sperm Aspiration (TESA): Another non-invasive procedure, TESA retrieves sperm directly from the testes.
- Trans-rectal Ultrasound of the Prostate with Seminal Vesicle Aspiration: The most commonly used test to diagnose obstructions within the reproductive system, this procedure involves the use of ultrasound to determine if and where sperm is being blocked.
- Microscopic Testicular Dissection: In order to pinpoint sperm production issues, testis tissue is examined under a high-powered microscope for sperm retrieval.
- Microscopic Epididymal Sperm Aspiration: This procedure is used when there is a blockage; microsurgical techniques are employed to collect a large quantity of sperm from the epididymis.
- Microscopic Vasectomy Reversal/Vasal Reconstruction: It is possible for men who have had vasectomies to become fathers. An intricate, microscopic reconstruction is performed to reverse the vasectomy.
- Microscopic Varicocele Repair: This procedure is the most common surgical treatment for male infertility. Varicose, or enlarged, veins (varicocele) in the scrotum can cause low sperm production and decreased quality, potentially leading to infertility. A microscopic varicocele repair involves ligating the veins to decrease blood flow in the reproductive tract and improve testicular function by lowering scrotal temperature.
If you think male infertility is impacting your ability to have a baby, request an appointment at Sher Fertility Institute New York to meet with a physician and discuss your options. Each patient receives highly individualized treatment. Our goal is to do everything possible to maximize a couple’s ability to achieve a healthy pregnancy.
Steps You Can Take to Prevent Infertility
Not all causes of male infertility are preventable, but there are lifestyle changes you can make to increase your odds of successful conception, and to improve your overall well-being.
- Identify and treat infections. Some sexually transmitted diseases (STDs) including gonorrhea and chlamydia, can cause scarring leading to blockages that prevent sperm from getting where they need to be. Other non-sexually transmitted infections can cause prostatitis that can create inflammation hurting sperm viability.
- Limit exposure to environmental toxins. Certain toxins, such as pesticides, may decrease sperm count by causing female hormone-like effects in men. If possible, avoid x-rays since radiation can impair sperm production. It’s also important to steer clear of mercury, lead-based paint, boron, and other poisonous substances due to their potential effect on sperm production.
- Stay cool. Things like hot tubs, saunas, and very hot showers are best avoided if you are trying to conceive. This doesn’t mean you can’t enjoy an occasional warm soak, just be aware of extreme or prolonged exposure to anything that raises your body temperature significantly. The testes function properly when they are cooler than the rest of the body. When body temperature rises too much the overall number of sperm may decrease, and the motility and morphology may be affected.
- Eat right and exercise. Eat a well-balanced diet and add a multivitamin to your daily routine. Studies have shown that moderate exercise may increase fertility, something as easy as a daily brisk walk is beneficial. Avoiding obesity, which can cause an elevation in estrogen-like hormones, is helpful often in improving sperm parameters.
- Avoid drugs, alcohol, and smoking. Drugs and alcohol have a clear negative affect on fertility. Smoking, and exposure to secondhand smoke, is also detrimental. Cannabis is in particular known to impair sperm health and number.
Maintaining optimum health during your journey to becoming parents is paramount, and it’s important to make those healthy habits stick. You’ll need to be functioning at your best to make it through those first sleepless, joyful months after your bouncing baby arrives!
If you think male infertility is affecting your ability to become pregnant, or if you’d like to learn more about preventing male infertility call Sher Fertility Institute New York at (646) 792-7476 for an appointment.