The cause of infertility may be due to a problem with the man’s reproductive system, or a problem that involves both partners. The cause of male infertility is often unknown. However, some causes have been identified, include problems related to:
- sperm production
- the anatomy or structure of the man’s reproductive organs
- the man’s immune system
Sperm Production Disorders
Male infertility may occur if sperm are produced in low numbers, or f many of the sperm produced are abnormal in shape or not able to move well. Abnormally shaped sperm may not be able to penetrate and fertilize an egg. Sperm that do not move well may not reach the egg. Some causes of sperm production disorders may include genetic defect, infection, testicular trauma, hormonal imbalance, or exposure to radiation and certain medications.
Anatomical or structural problems
Anything that blocks the pathways in which the sperm travel may cause infertility. Structural problems may be caused by scar tissue that formed as a result of a previous surgery or from an infection in the pathways. Varicose veins that develop in the testes may also interfere with sperm production. Some structural defects may be congenital (from birth).
Immune System Disorders
Some men develop antibodies to their own sperm, which may attack and weaken the sperm. Also, the antibodies may attach to the sperm and interfere with their movement or their ability to fertilize the egg.
QUESTIONS & ANSWERS
What initial tests will by doctor use to evaluate my fertility?
After reviewing your medical history and the results of your physical examination, your doctor will order a semen analysis to evaluate your sperm. If the analysis is normal, your doctor may also want to check for a hormonal imbalance (testosterone, FSH, LH) and for genetic defects.
What tests are used to diagnosis infections and immune system disorders?
If you semen analysis shows sperm clumping or signs of infection, your doctor may order a semen culture, prostate fluid culture, and urinalysis. To evaluate immune system disorders, your doctor may order an anti-sperm antibody test, which may be performed on your semen, through a blood test, or both.
What tests are used to diagnose structural problems that may result in infertility?
The “fructose test” can help your doctor evaluate a structural problem or a blockage of the seminal vesicles or the duct that connects the seminal vesicles to your ejaculatory duct. If there is no fructose in your semen, there may be a structural problem.
What are the next steps in my infertility workup?
If your doctor diagnoses a structural problem, surgery may be an option. If you have an infection or an immune system disorder, medications may help. Quite often, the reason for male infertility is unknown, so your doctor may speak to you about other options, such as intrauterine insemination (IUI), in vitro fertilization (IVF), and other similar procedures.