RMANJ’s urologist Dr. James Hotaling is an international leader in the field of male infertility, helping men from around the world resolve their fertility issues.
He is passionate about educating men – and women – about male infertility, especially when his advice can help ease a man’s fertility journey.
So whether you’re struggling to become a first time dad or just looking for more information about male infertility, you’ve come to the right place.
Common. Of all the couples that struggle with infertility (about 1 in 8 couples), half the time there is a male issue involved.
Male infertility is defined as an abnormal sperm count and/or lack of pregnancy after one year of trying. Usually, that inability boils down to a problem with the sperm count, motility or morphology. In addition to the number of sperm a man has, the shape and movement of the sperm (or how well the sperm swims) is also important. A problem in one of these three areas can cause male infertility.
Sperm are tiny, and a sperm sample should contain millions of sperm. Because of this, sperm is measured in ‘concentrations.’ Normal sperm concentration come in a wide range, but 15 million sperm per milliliter is a good benchmark.
While a high sperm count is good, a high ‘swimming’ sperm count is also important. In general, about a quarter of the sperm will swim – so if you have a 50 million strong sperm count, you’ll have about 12.5 million swimming sperm, and it’s the swimming sperm that drive your chances of achieving a pregnancy.
I treat patients who have a low sperm count and low sperm motility, but there is only one per cent of the population that has absolutely no sperm, so that’s very rare. For these patients, we can often do surgical procedures to obtain sperm that can be used for in vitro fertilization (IVF).
One of the most common causes of infertility are dilated blood vessels around the testicle. This condition is called varicocele and results from abnormal closure of the valves in these vessels, leading to pooling of blood around the testicle. As a result, the temperature inside the testicle can change, compromising sperm production. Most men produce a thousand sperm a second, so when you are making that many sperm, anything that disrupts the process can be damaging. This condition is pretty common – 15 per cent of all men have it, and 40 per cent of men with infertility have it.
Another cause of infertility for men is abnormal testosterone. If a man is not making enough of his own testosterone, this can cause problems with sperm production. Alternatively, if a man takes testosterone injections, this can shut down sperm production as it interferes with the hormone pathways necessary to drive sperm production. Low testosterone levels can be treated with medication – such as Clomid –that can help a man augment his own testosterone production.
All men deal different with infertility, but in general, men tend to communicate less about their emotions than women. That said, they experience many of the same feelings as women struggling with infertility: fear, guilt, anxiety, sadness and a sense of failure.
The best way to support a man dealing with infertility is to talk about it – but on his own terms. Let him share the way he is most comfortable. Just letting him know you are there to listen is a great start.
BELLEVUE, WA – March 13, 2024 – Reproductive Medicine Associates (RMA), one of the nation's…