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Struggling to Have a Baby? It Could be Male Infertility

September 04, 2014

As a couple, the next step in your relationship after marriage is often having children. Excited to start a family, you and your spouse try and try to have a baby, yet you still have trouble achieving a pregnancy. You begin to worry. Then, frustration and panic sets in. Now what?

First and foremost, know that you are not alone. On average, one in eight couples has trouble achieving or maintaining pregnancy due to infertility. Infertility is the inability to become pregnant after one year of unprotected intercourse. Approximately one-third of infertility is male-related, one-third is female-related and one-third is a combination of both.

Without seeing a doctor, it’s hard to determine the exact reason that you and your spouse are struggling with infertility. However, the good news is that a majority of these cases are treated successfully with drug or surgical therapy, and only a small percentage require assisted reproduction.

What Are the Main Causes of Male Infertility?

First of all, it’s important to know that nothing is “wrong” with you. Male infertility is a very common problem that can often be overcome. However, it is important to see your doctor to figure out what the cause may be. Below are some of the main causes of male infertility that I typically see in my patients:

Hormonal Imbalances

In many cases, male infertility can be caused by hormonal imbalances within your body. This might include low thyroid hormone levels or low signaling from your pituitary gland, which causes abnormal production of testosterone. Another cause I see among men is elevated prolactin hormone levels. These high levels can reduce sperm production and lead to significant problems with infertility.

While these issues can cause infertility, the percentage of men who are infertile due to hormonal imbalances is usually low, and many of these problems are simply treated with medications.

Physical Problems

Another common reason for male infertility is physical problems with the reproductive organs. For example, you may be struggling with fertility because of damaged sperm ducts. Your ducts could become blocked due to genetic reasons, sexually transmitted diseases (STDs) or a previous vasectomy.

Another physical problem I see among patients is enlarged veins. You may have something called varicoceles, which are enlarged veins around the testicle, that alter the ability to produce good sperm. These veins can also cause low testosterone production. The good news is that infertility and low testosterone caused by enlarged veins can be reversed with surgery.

Similar to hormonal imbalances, the percentage of men who are infertile due to physical problems is also usually low. And fortunately, many of these problems can be treated with surgery.

Physiological Causes

The third—and most common cause—of male infertility is physiological problems, such as premature ejaculation and erectile dysfunction. In fact, erectile dysfunction is the leading cause of infertility in men, and it is normally caused by other diseases, such as high blood pressure, diabetes, heart disease, trauma and stress.

These two physiological causes are responsible for the highest percentage of male infertility. However, while they may be highly common, they’re also highly treatable.

What Do I Do Now?

To determine the exact cause of your infertility, your doctor may need to perform a physical exam, lab tests and imaging tests. This type of evaluation is typically performed by a urologist who specializes in male infertility.

First, your doctor will ask you about your medical history, and a thorough physical examination will be performed. Based on your initial evaluation, lab tests may be ordered. You may also have to give a semen sample, which will be used to evaluate the amount and quality of sperm that your body produces. Your doctor might need to conduct imaging tests as well to check for blocked or poorly developed ducts. This will aid in determining the reason for low production or delivery of sperm.

While this may seem like a lot of different testing that you have to go through, it will ultimately help you get the right treatment to help you and your wife start your family.

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