About a third of all infertility cases are due to male fertility issues. These can range from low sperm count or sperm abnormalities to hormonal imbalances or problems related to reproductive anatomy. Health and lifestyle factors such as stress, weight, and alcohol consumption can also play a role. The good news is that we provide infertility treatment options for most causes.
Male Infertility Causes
Some of the barriers faced by men trying to achieve pregnancy with their partner may include azoospermia (lack of sperm) or varicocele (an enlargement of veins in the testicles). In addition, the presence of anti-sperm antibodies, and abnormalities related to sperm count, sperm motility, or semen volume, consistency, or pH, can be problematic. Or there may be a need to undo the effects of a vasectomy.
Learn more below.
Causes of Male Infertility
Non-obstructive azoospermia is when a man has no sperm in his semen because his body produces abnormal sperm. It’s a very common cause of male infertility. If you have non-obstructive azoospermia, we will usually recommend a procedure called microsurgical testicular sperm extraction (microTESE) to determine:
- If you have adequate level of testosterone in sperm test results
- If you remain azoospermic even though you’ve received treatment and your testosterone levels have been normal for at least four months
Doctors are able to find sperm approximately 70 percent of the time using microTESE.
A varicocele is a dilation of a vein (like a varicose vein) in the scrotum. Many men with varicocele have a low sperm count or abnormal sperm morphology (shape). However, many men with varicocele are fertile. The reason a varicocele affects sperm production and shape might be related to a higher-than-normal temperature in the testicles.
Varicocele can be treated surgically by cutting the veins connected to the varicocele. However, surgery does not always improve fertility and is not recommended for most men, unless there is a large varicocele that can be easily felt. A varicocele that has been present for a long time can cause irreversible damage that cannot be surgically treated.
The immune system produces antibodies to fight foreign substances in the body like infectious diseases and, at times, those antibodies find their way to the male reproductive system.
Anti-sperm antibodies aren’t common but both men and women can make them. When present, anti-sperm antibodies can make it harder for couples to have a baby. But it’s rare for antibodies by themselves to make it impossible to get pregnant.
Anti-sperm antibodies can be caused by several things. In men, an infection in your prostate or an injury to your testicles can set off an immune response when the sperm comes in contact with blood. This can also happen after a testicle surgery like a vasectomy. Women’s bodies can make anti-sperm antibodies if they have an allergic reaction to semen.
If you and your partner are having a hard time getting pregnant, our doctors may recommend fertility tests, including checking for anti-sperm antibodies. This is most commonly done with an immunobead test on sperm at the time of your semen analysis.
A semen analysis is a test that tells your doctor the number of sperm in your semen (your sperm count), whether they are normal (morphology), and how well they swim (motility).
Low Sperm Count
A low sperm count may be caused by certain medications or a medical problem such as a blocked duct, low testosterone level, or a condition in which sperm back up into the bladder. Fever can also reduce sperm count. In some cases, you may have enough sperm, but your sperm may not swim well enough to reach the egg. Also, sperm that are not normal in shape may not be able to penetrate and fertilize the egg. We can treat many of these problems.