When people think of someone who may have infertility, a picture of a man is not the typical poster child for this disease. It may be surprising to some to know that 30% of infertility cases are related to male factor issues. Yet, a recent study showed that only 41% of Ob/Gyn physicians even considered a urological evaluation of the male partner and only 24% would routinely refer men to the urologist before ordering a semen analysis. Infertility is often a couple’s problem, one that must be faced as a team.
Many men who are diagnosed with male factor infertility, face an emotionally complex journey. Some experience a gambit of emasculating feelings from guilt, anger, and low self-esteem. It is essential to recognize that the male partner may be experiencing a level of emotional pain that is not different from the female whose self-worth and femininity is wrapped up in motherhood. A couple facing infertility, be it male factor, female factor, a combination or unexplained, need to communicate about what is happening to them.
Male Factor Problems
There are many factors that can contribute to male infertility. Some of these problems can be structural abnormalities, sperm production disorders, ejaculatory disturbances and immunologic disorders. Perhaps it is best to break them out into 2 categories: Productive Factors and Obstructive Factors. In some cases of male infertility, the production of sperm is impacted whereas in obstructive issues cause problems with transporting the sperm to the semen.
Here’s a breakdown of the many different types of male factor problems that can pose an issue to conceiving:
It is possible that there can be an abnormalities of the reproductive tract, leading to potential obstructions that partially or totally block the flow of sperm and/or seminal fluid. Some of these abnormalities may be present at birth (congenital), others may have occurred after infection of the urogenital tract, whereas others may have resulted from previous surgery.
- Congenital defects
Sperm production disorders
This occurs when the production of the sperm is inhibited.
- Sperm production problems
These prevent sperm from reaching the female.
- Retrograde Ejaculation
Immunological disorders can prevent sperm from meeting and successfully penetrating the egg in the female genital tract.
- Endocrine disorders
- Antisperm antibodies
Other Things to Consider
Male infertility sometimes is the only initial symptom of significant medical problems such as brain tumors, thyroid gland disease, diabetes, multiple sclerosis, and genetic diseases. There has been a growing concern that infertility may actually be a forerunner to the testicular cancer since it is more common in infertile men than in the general population. Integration of testicular cancer screenings into the routine evaluation of infertile men has been strongly suggested.
It’s all about being proactive and advocating that you/ your male partner is tested for possible male factor disorders by a doctor or urologist.
How do you Diagnose Male Factor?
Step 1, set up a consult with your doctor or urologist. For many men that is the hardest part of the process. An evaluation of the man must be performed by a urologist with a special interest in male infertility. The reason for this is that new diagnostic and treatment methods including technically challenging sperm retrieval procedures require special training and expertise. Best to stick with the pros who know what they are doing.
If you think you may have male factor, ask your doctor for a referral to a urologist/ male infertility specialist so both partners will have a necessary and timely diagnostic work-up before beginning any treatment for infertility.