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Male Infertility: Treatable, and More Common Than You Might Think

The medical community defines infertility as the inability of a man and a woman to conceive a child after one year of unprotected intercourse.

Infertility can be caused by certain medical conditions and lifestyle habits on the part of the woman, the man, or both. According to the National Institutes of Health, infertility is attributable to the man in about one-third of cases and to the woman in about the same number of instances. Sometimes no cause can be found. The good news is that infertility often is treatable.

Male infertility should not be confused with erectile dysfunction, which is the inability to get or keep an erection long enough for sex and tends to be easily treated.

Although a man’s age can affect fertility – the quality of sperm may diminish after age 40 – this varies widely depending on the individual and is much less of a factor than with women. A woman’s ability to conceive and carry a child declines continuously and falls faster after age 35.

“A man’s fertility doesn’t change that much with age,” says UAB Medicine urologist and fertility specialist Peter Kolettis, MD. “Still, for men who are trying to conceive with a partner, I recommend that they exercise and lead a healthy lifestyle. They should limit alcohol and not smoke. Anything that’s good for your health could help fertility.”
 

Common Causes

When the issue is on the male side, it’s often a problem with sperm production or function. An estimated 1-2 percent of all men have no sperm in their semen, or about 15 percent of men actively trying to conceive.

The most common causes of male infertility include:
  • Physical problems with the testicles (the organs that produce sperm)
  • Blockages in the ducts that carry sperm
  • Hormone problems, including testosterone replacement therapy
  • A history of high fevers or mumps
  • Genetic disorders, usually unique to the individual man rather than being inherited
  • Certain medical conditions and treatments, including cystic fibrosis, cancer, and chemotherapy
  • Lifestyle factors such as alcohol/drug use and smoking
  • Environmental factors, such as exposure to certain toxins
Dr. Kolettis says evaluating infertility begins with medical examinations of both partners. If specific issues are found, they frequently can be treated with surgery or medication. Sometimes, lifestyle changes can improve fertility. For those who do not have a condition that can be treated, procedures such as intrauterine insemination or in vitro fertilization may be used to help a couple get pregnant.

At UAB Medicine, infertility is treated with a team approach that includes a urologist, reproductive endocrinologists, specialized nurses, and laboratory scientists. A variety of conventional treatments are available, along with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). ICSI and IVF are similar in that eggs and sperm are collected from each partner, but the fertilization processes are different. Our fertility experts will determine a treatment plan that is best suited for each individual man.

To make an appointment with UAB Medicine Urology Services for a male infertility evaluation, call 205-996-8765.