Male infertility facts

Did you know that male infertility occurs just as often as female infertility? This may come as a surprise. Many people assume that it's the woman's fault when a couple experiences fertility problems, but that's just one of the many misconceptions that surround infertility and, specifically, male infertility.

Consider these facts on male infertility:

  • There is really no clear winner in the battle of the sexes when it comes to infertility. Infertility equally affects men and women. About 1/3 of infertility cases are related to male factors, 1/3 are related to female factors, and the remaining 1/3 are related to both male and female factors, or are unexplained. Unexplained causes of infertility make up about 20% of all cases.
  • Many cases of male infertility can be treated, allowing the couple to get pregnant.
  • Most cases of male infertility are due to low sperm count (oligospermia) or, rarely, a complete absence of sperm (azoospermia). Other factors that contribute to male infertility include:
    • other problems with sperm, such as sperm that is improperly-shaped or that cannot swim properly (sperm quality) – these may be caused by infections, age, medical conditions, or exposure to chemicals or high temperatures
    • problems with parts of the male anatomy (e.g., undescended testes, varicocele)
    • hormone problems in the testicles or pituitary gland
    • infections (e.g., sexually transmitted infections, mumps after puberty)
    • retrograde ejaculation (a condition where semen travels in the wrong direction and moves into the bladder instead of out of the penis during ejaculation)
    • genetic disorders (e.g., Klinefelter's syndrome)
    • erectile dysfunction (difficulty getting an erection that is adequate for penetration)
    • antibodies that attack sperm – this can occur after an injury, infection, or vasectomy.

During fertility evaluation, it is just as important for your doctor to assess you as it is to assess your female partner. Because of the misconception that infertility is a women-only problem, men may be overlooked or paid less attention when it comes to determining causes of infertility. Fortunately, this kind of thinking is changing.

Doctors have the medical technology to address many of the fertility problems couples face. With proper assessment of both partners, a fertility specialist can make a diagnosis and the couples can decide on how to proceed with their fertility treatment.

Hot tubs, medication use, pesticides, and male infertility

Trying to conceive? You may have heard many myths and truths about how the environment in which you live can affect your fertility. Learn the truth about how high temperatures, medication use, and pesticides affect male infertility.

Hot tubs and saunas may be a nice comfortable place for relaxing after a stressful day at work, but they're not good for your swimming buddies. Hot tubs, saunas, and whirlpool baths can increase the temperature where it matters the most – your testes. This rise in temperature can affect the production and quality of sperm. Although the heat effect on sperm is usually temporary, it is usually best to avoid exposing your testes to hot temperatures while you're trying to conceive. You can take hot showers, though, since your testes aren't submerged in the water.

You should also worry about body temperature when you are ill. Body temperature may increase due to illnesses that cause prolonged fever. High fever has been shown to affect sperm production 2 to 3 months after the illness, which is how long it takes for sperm to mature.

Boxers or briefs? Preventing male infertility may ultimately decide this age-old question. In theory, if you're trying to conceive you should avoid wearing tight-fitting underwear or "tighty whities." Tight-fitting underwear tends to hold the testes closer to the body, which may impede sperm production because of the higher temperature. Although the evidence for this is not very strong, there really is no harm in making the switch to loose-fitting underwear if it may increase your chances of conceiving.

Medication use is another factor to consider. Certain medications may affect the production, movement, and ejaculation of sperm. Many of these medications are used to treat medical conditions such as arthritis, cancer, depression, digestive problems, gout, high blood pressure, infections, and pain. For example, some medications used to treat high blood pressure or mood disorders may cause retrograde ejaculation, one of the causes for male infertility. If you have questions about your medications or are concerned about whether the medication you're taking may be affecting your fertility, talk to your doctor or pharmacist. Don't stop taking your medication without first consulting your doctor.

Pesticide use is another environmental factor that may affect male infertility. Exposure to environmental toxins, such as pesticides, herbicides, and insecticides, can decrease sperm production and quality. Some of these environmental toxins have even been linked to testicular cancer. Long-term exposure to heavy metals such as lead and arsenic may also cause infertility.

Medical conditions and male infertility

There are several medical conditions that can cause male infertility. The good news is there may be treatment options available for some of these conditions. The following are some conditions that can affect fertility and what can be done to improve the chances of conceiving a baby.

Varicocele: This is a condition where swollen veins, similar to varicose veins, are present in the scrotum. Varicocele can affect fertility by causing damage to the testicle or reducing sperm production. Surgery to cut or bypass the vein sometimes helps improve fertility.

Cancer: Cancer and its treatment, including radiation and chemotherapy, can damage or kill sperm. The degree of this impact varies, but sometimes it is severe. The closer radiation treatment is to the testicles, the higher the risk of infertility. The first priority is to cure the cancer, even if doing so may cause infertility. Sperm production can return after cancer treatment, but it may take up to several years. A man can consider freezing his semen at a sperm bank or fertility centre before starting chemotherapy or radiation therapy. This way, even if sperm production does not completely return after cancer treatment, he and his partner can still use his stored frozen sperm to conceive a child.

Erectile dysfunction: Erectile dysfunction (difficulty getting an erection that is adequate for penetration) or other sexual problems such as premature ejaculation can often be treated using medications or behavioural therapy.

Spinal cord injury: Men may experience fertility problems after a spinal cord injury, including the inability to ejaculate, abnormal sperm production, and obstruction of the ducts that carry sperm throughout the male reproductive system. These men are still producing sperm, so they can still become fathers despite their injuries. Men can use devices to stimulate ejaculation, and doctors can use other methods to retrieve sperm for use with assisted reproductive technology.

Depending on what's causing the fertility problem, treatment options can mean medications or surgery. That's why it's important to find the cause – a proper screening and assessment by the doctor can reveal a potentially correctable medical condition. In many cases, treating the underlying medical condition improves fertility.

If the condition is not treatable or reversible, don't lose hope – if there is adequate sperm, assisted reproductive technology can be used to help a couple conceive.

Male infertility and lifestyle

Living a healthy lifestyle is important to your fertility. Lifestyle factors can affect a man's fertility, and many of these factors are things that a man can control. Leading a healthy lifestyle improves not only your chances of conceiving but also your overall health. Here are some lifestyle factors that can have an impact on male fertility:

  • Smoking: Smoking tobacco decreases sperm size and movement and can damage the genetic makeup of sperm cells. It may also have a negative effect on seminal fluid (the fluid that is ejaculated along with sperm). Talk to your health care provider about ways to quit smoking.
  • Alcohol: Excessive alcohol can decrease sperm production. Moderate alcohol use doesn't appear to affect fertility.
  • Obesity: Being overweight or obese may be associated with male infertility. Maintain a healthy weight by incorporating physical activity and a healthy diet into your life.
  • Age: Unfortunately, this is a factor for which you can't do anything. There is a gradual decline in fertility for men older than 35 years.
  • Stress: The amount of sperm you produce may decrease if you experience excessive or prolonged periods of emotional stress. Going through infertility can be discouraging and last a long time, which can add to the stress a couple may be feeling. Consider talking to your doctor to find out ways to manage your stress.
  • Nutrition: A diet low in vitamin C, folate, selenium, and zinc may contribute to infertility. Make sure you eat a well-balanced, nutritious diet that follows Canada's Food Guide. Each day, ensure you get 8 to 10 servings of fruits and vegetables, 8 servings of grain products, 2 servings of milk and alternatives, and 3 servings of meat and alternatives.
  • Recreational/illegal drug use: Marijuana and cocaine use decrease the number and quality of sperm, while anabolic steroids (used to build muscle strength and growth) shrink testicles and stop the hormone production that's needed to make sperm.

These lifestyle factors may affect your fertility, but there may be other causes for infertility as well. If you and your partner have been trying to conceive for one year or more (or 6 months if the woman is over 35) with no luck, you should both consider talking to your doctor and having your fertility assessed. Going to a doctor will help you determine the cause of any fertility problems you may have and give you a chance to talk to the doctor about what you can do to increase your chances of conceiving.