Male Infertility Treatments
Environment and Lifestyle Smoking can decrease sperm movement and cause abnormally shaped sperm. Marijuana, cocaine, and alcohol lower sperm count and contribute to impotence. Sperm production and motion decrease when the testicles are at too high a temperature. This can occur with a fever, excess weight, jacuzzis, working conditions that are hot or require long hours of sitting, or with tight pants.Hormone production may be disrupted by strenuous exercise.
Testicular Disease Sometimes the cause of the disease in not known. We do know, however, that if a male contracts the mumps after puberty, the sperm making cells in the testicles may be damaged, meaning the man’s ability to produce healthy sperm is reduced, or destroyed. Sexual function is not affected. Many forms of cancer can temporary or permanently effect the ability to produce sperm.
Donor insemination of sperm is an option when no sperm are being produced. If some sperm are being made, intrauterine insemination (IUI) or in-vitro fertilization may be considered. Some men produce very small amounts of sperm in the testicles but they do not reach the semen. These men are candidates for testicular biopsies and intracytoplasmic sperm injection with invitro fertilization.
Hormone Deficiencies The main hormones associated with sperm production are testosterone, follicle stimulating hormone (FSH), and lutenizing hormone (LH). If there are high levels of FSH in the blood, sperm production in the testis may be absent or reduced.If a deficiency or overproduction of hormones exists, medication may be used to help correct the problem. Thyroid hormones and adrenal hormones may be checked as well.
Varicoceles A varicocele is a varicose vein around the testicles. If this vein enlarges, it produces heat that can reduce sperm production. This is a common condition which causes no discomfort or health threat. These veins may be occluded (tied off) by either surgery or by a radiologist going through a vein in the upper leg or neck to occlude the varicoceles.
Success rates are high in eliminating the varicoceles, and semen quality is improved in most men. About half the men that have their varicoceles fixed will impregnate their wives by natural means within one year of the repair. Please view our page on varicoceles for more information.
Antisperm Antibodies As discussed previously, antisperm antibodies may be produced that cause the sperm to clump or become immobile when a persons immune system attempts to destroy sperm, thinking that they are a foreign substance. In men, this can be caused by infection, trauma, or a vasectomy.
This condition may be treated by several methods such as cortisone, sperm washing which increases sperm concentration, intrauterine insemination, or in vitro fertilization. Duct System Obstruction Sperm may be blocked by an obstruction in the vas or the epididymis or ejaculatory duct. This can be congenital or caused by a vasectomy. If the blockage is complete on both sides, the semen will not contain sperm.
If no sperm are in the semen, a fructose test may be given to see if there is a duct system blockage. FSH levels will be measured, the testes may be biopsies to check sperm production, and x-rays may be taken. Your doctor will determine if you may benefit from surgery to unblock the obstruction. The surgery’s success depends on many factors, including the cause of the obstruction and the length of time obstructed. For more information on the operations, please read our pages on vasectomy reversal.
Infection Infections in the male reproductive tract sometimes cause no symptoms other than infertility. If your doctor finds white blood cells in your semen, he may treat you with antibiotics or other drugs to clear up your infection.
Ejaculatory Problems , Premature ejaculation, delayed ejaculation, or anejaculation (the inability to ejaculate) may prevent the semen from being ejaculated into the vagina. Medications can be used to produced or delay ejaculation and achieve pregnancy if no other medical problems exist that would hinder conception.
Hypospadias This is a condition that some men are born with. The opening of the urethra is on the underside of the penis instead of at the end. In severe cases, semen cannot be correctly deposited into the vagina. Treatments include; insemination if the sperm are healthy, or surgery to correct the condition.
Retrograde Ejaculation In this disorder, semen is released into the bladder during ejaculation, where it is harmlessly washed out during urination. Little or no semen may come out of the urethra during ejaculation. Some men are born with this condition. Others may develop it because of diabetes, multiple sclerosis, or prostate surgery. Some medications also cause the disorder.
Retrograde ejaculation may be treated by inseminating the woman with sperm removed from the urine, or with oral medications which may improve the condition.
Medications or Drugs As stated previously, nicotine, alcohol, and illegal drugs may be toxic to sperm. Other drugs affect ejaculation or hormones. Your doctor will need to know all drugs and medications you have taken.