Up to 15% of all couples are affected by infertility, which is the inability to get pregnant after one year of unprotected, regular sex if the woman is under 35, and after six months if she’s over 35. Problems with the male reproductive system affect 40–50% of those couples.
Although our fertility experts at Columbia Fertility Associates are OB/GYNs, they also diagnose and treat male infertility so you can build the family of your dreams. Columbia Fertility Associates has three convenient locations in Washington, DC, Bethesda, Maryland, and Arlington, Virginia.
Our experts share a few of the more common reasons men are infertile, as well as some treatment options.
Problems with sperm
Your testes produce tiny tadpole-like cells called sperm that mix with your semen when you ejaculate. A normal sperm count ranges from 15 million to more than 200 million sperm per milliliter of semen. You need to produce such high numbers to increase the chances that one of the sperm successfully reaches your partner’s egg and is able to penetrate and fertilize it.
If you don’t produce enough sperm, you have a condition known as oligospermia. In rare cases you might not produce any sperm at all, which is known as azoospermia.
Your sperm not only have to be plentiful, they have to be strong enough to swim into your partner’s fallopian tube and reach the egg. If you’re infertile, your sperm may have poor motility (they don’t move well). They might also be oddly shaped and therefore can’t perform their job.
You may have been born with sperm deficiencies. Other causes of sperm problems include:
- Hormonal imbalances
- Drinking alcohol
- Antibodies that attack sperm
- Chromosome defects
- Exposure to toxins
- Stress or depression
If your doctor finds that you have an underlying health condition that could affect your fertility, such as kidney failure, they first treat that to improve your overall health and see if that affects your sperm count. They treat any infections or hormone deficiencies, too.
Our experts may recommend that you discontinue certain medications that affect sperm count. They might also ask you to change your diet, add more exercise to your routine, and give up smoking or alcohol. If you use saunas, spas, or have other habits that could overheat your testicles and decrease sperm production, they’ll ask you to refrain from those, too.
Problems with tubes and other structures
Even if your testes produce healthy and plentiful sperm, you could have structural problems with your reproductive system that prevent the sperm from being ejaculated. A birth defect or an infection could’ve blocked one of the tubes that the sperm pass through, causing your overall count to be lower than normal.
Your fertility expert may recommend a series of tests to analyze how well your sperm travel and identify any blockages or other problems, such as:
- Retrograde ejaculation
- Tubal defects
- Vasectomy reversal
- Erectile dysfunction
Your doctor may refer you for surgery to unblock the tubes or to resolve a condition called retrograde ejaculation, in which you ejaculate some or all of your semen back into your bladder instead of out of your penis.
If your infertility can’t be treated, or if you don’t respond to nonsurgical or surgical therapies, your fertility specialist may recommend assisted-reproductive technologies (ART). With ART, you may be able to get your partner pregnant with your own sperm, either through ejaculation or extraction. You might also consider donor sperm.