What Is Male Factor Infertility?

Male factor infertility is a medical condition that refers to issues with sperm production and/or function. Male fertility issues are very common and are partially responsible for up to 50% of infertility cases in the United States. In many cases, male factor infertility is highly treatable through lifestyle adjustment, medications, or fertility treatments.

Sperm Disorders and Male Fertility

Semen health is determined by the quantity, motility, and shape of sperm present in a given sample. Ideally, you want to have an ejaculate sample that contains at least 39 million sperm, 40% to 80% of which are strong “swimmers.” The vast majority of sperm in the sample should also have a normal morphology consisting of an oval-shaped head, a cap that covers 40% to 70% of the head, and a tail that has no abnormalities or breaks.

There are several disorders that can impact the sperm’s function:

• Oligospermia: a low sperm count
• Azoospermia: no sperm present in the semen
• Polyzoospermia: an abnormally high concentration of sperm
• Asthenozoospermia: diminished sperm motility
• Hypospermia: a low volume of semen
• Hyperspermia: an abnormally high volume of semen
• Teratozoospermia: a high number of abnormally-shaped sperm
• Necrozoospermia: the presence of dead sperm in a semen sample

Causes of Male Infertility

Male factor infertility can be caused by a wide range of factors, including medical, environmental, and lifestyle factors:

• Chromosome issues, such as Klinefelter’s Syndrome, in which a male is born with two X chromosomes and one Y chromosome.
• Medical conditions that impact testicular function
• Hormonal imbalances
• Varicocele (i.e. swelling in the testicular veins)
• Problems with antibodies attacking sperm
• Malignant and benign tumors
• Structural defects in the male reproductive system
• Medical treatments, such as chemotherapy
• Male sterilization procedures, also known as vasectomies
• Obesity
• Excessive exposure to certain toxins, such as industrial materials or heavy metals
• Excessive heat exposure to the testicles
• Smoking
• Excessive alcohol use
• Drug use, such as recreational steroids and possibly marijuana

Symptoms of Male Infertility

While the main symptom of male factor infertility is the inability to impregnate, there are other signs that can indicate the presence of a fertility issue in men, including:

• Abnormal breast tissue growth
• Reduced body hair
• Pain and swelling in the testicles
• Sexual function issues, such as decreased sex drive, erectile dysfunction, or difficulty ejaculating

How Is Male Factor Infertility Diagnosed?

Male factor infertility is typically diagnosed through a semen analysis test, which helps determine the quantity and quality of a man’s sperm by assessing sperm count, motility, and morphology. The semen is produced by the patient, usually by masturbating into a sterile container or using a special condom. For the most accurate analysis, the sample should be tested within the hour of collection. Other diagnostic measures may include a physical examination, blood tests, hormone evaluation, and genetic testing.

How Is Male Factor Infertility Treated?

In many cases, male factor infertility can be successfully treated through preventative care, medications, or fertility treatments.

Preventative Care for Male Fertility

Lifestyle factors can play a large role in male fertility. Although practicing preventative care is not a guarantee, it can significantly improve the quality and quantity of sperm. Some of the most important lifestyle upgrades that men can make to prevent and/or improve fertility issues include:

• Achieving and maintaining a healthy BMI
• Eating a healthy diet that consists primarily of vegetables, fruits, lean proteins, fiber-rich carbs, and healthy fats
• Reducing alcohol consumption
• Quitting smoking and drug use
• Avoiding prolonged exposure to heat on the testicles
• Avoiding testicular injury
• Practicing safe sex

Medications for Male Factor Infertility

In some cases, patients with male factor infertility may be prescribed medications to help improve their sperm count. For example, if a man is experiencing infertility due to low testosterone, his doctor may give him an injection of follicle-stimulating hormone (FSH) or luteinizing hormone (LH), which can aid the testicles in the production of sperm.

Sometimes Clomid (clomiphene citrate) is prescribed for male factor infertility, but this is considered to be an off-label use. Clomid is most commonly used to treat infertility in women. Taken orally, Clomid works by stimulating the pituitary gland, causing it to produce the hormones responsible for ovulation. In men, Clomid can sometimes improve testosterone levels and sperm count.

Fertility Care for Male Factor Infertility

Fertility treatments can be very useful in cases where male infertility is a contributing factor. Some of these treatments include:

• In vitro fertilization (IVF), in which a concentrated semen sample is combined with an egg in a laboratory to produce an embryo
• Intrauterine insemination (IUI), in which sperm is placed directly in the uterus
• Intracytoplasmic sperm injection (ICSI), in which a single sperm is injected directly into an egg using a micropipette
  
  
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