Male infertility is partly responsible for about half of all explained infertility cases, so if a couple is having difficulty conceiving, it’s important to take into consideration both parties’ fertility when trying to diagnose and address any issues that may arise.[1.Mayo Clinic Staff. (2015 August 11). Male Infertility. Retrieved 2015 November 29 from http://www.mayoclinic.org/diseases-conditions/male-infertility/basics/definition/con-20033113] Men, unlike women, can remain fertile throughout their entire lives. Sperm production does decrease as men age, but they can still continue to produce sperm even at elderly ages. [2.Pagano, T. (2014, October 28). Sperm FAQ. Retrieved November 29, 2015, from http://www.webmd.com/infertility-and-reproduction/guide/sperm-and-semen-faq]
There are a number of causes that can contribute to male infertility. In order for a man to be fertile, his hypothalamus and pituitary glands (both of which produce hormones and are found in the brain), as well as his testes, must be functioning properly. The majority of cases of infertility – about 30 to 40 percent – are caused by problems in the testicles, such as dilated veins (variococeles), blockages of the reproductive tracts, or physical damage sustained to the sperm-producing structures of the testicles. Of these medical issues, about 15 to 25 percent are a caused in the genes (which doesn’t necessarily mean that it is inherited)[3.Wang, C. and Swerdloff, R. (2012 October) Patient Information: Treatment of male infertility (Beyond the Basics).]
About ten to 20 percent of male infertility cases are caused by some kind of blockage in the sperm’s pathway, which can be a result of a prior infection. Conditions of the hypothalamus or pituitary glands are also responsible for a small portion (one to two percent) of male infertility cases.
Unfortunately, that still leaves about 40 to 50 percent of infertility cases that have no discernable causes. Couples who choose to go through fertility testing will usually be recommended to have the male undergo a semen analysis. This analysis provides information on the sperm count, sperm motility, shape of the sperm, as well as the volume and concentration of the semen.[4.American Accreditation HealthCare Commission. (2008). Infertility in Men In-Depth Report. The New York Times. Retrieved November 29, 2015, from http://www.nytimes.com/health/guides/disease/infertility-in-men/print.html]
In many cases, doctors will perform a series of semen analysis tests over a period of time to ensure accurate results. Sometimes, even after a man has a semen analysis, it is still impossible to identify a specific cause for infertility. It’s possible that a semen analysis will reveal low motility or sperm count but fail to provide enough information for a doctor to discern the reason behind such issues. In these cases, a doctor may either recommend alternate testing, such as scrotal ultrasounds, hormone testing, and/or specialized sperm function tests. Even if a doctor is unable to determine a specific cause of infertility by that point, he or she may still be able to recommend certain treatments or procedures that could lead to conception.[5.Mayo Clinic Staff: See above.]
There are many resources available specifically pertaining to male infertility, but the best place to start is a healthcare provider. He or she will be able to make recommendations about specialists who are trained to answer questions and go over options about male infertility. A fertility specialist can go over options for couples who are TTC, and can take into consideration the past or current health issues for the male (and, if needed, female) partner.[6.Wang, C. and Swerdloff, R. (2012 October) Patient Information: Treatment of male infertility (Beyond the Basics).]