Understanding the Menstrual Cycle
Polycystic Ovary Syndrome (PCOS)
Asian Patients Have Lower Rates Of Pregnancy And Live Birth Than Caucasian Patients
Male Factors
Another estimated forty percent of infertility cases are due to male factors, including: low sperm counts, low sperm activity, and low sperm morphology. Morphology describes the percentage of normal looking sperm. There are many causes of male factor infertility. Decreases in the number of sperm may be caused by: excessive use of alcohol, tobacco, or other illicit drugs; infections of the genital organs such as the prostate or urethra; sexually transmitted diseases that can cause sperm blockage; exposure to toxins and chemicals in the environment; exposure to radiation; testicular exposure to overheating such as a prolonged high fever; genetic disorders such as Klinefelter’s syndrome, cystic fibrosis, or a defective gene on the Y chromosome. Abnormal sperm may be caused by inflammation of the testicles; twisted or swollen veins in the scrotum (varicocele); abnormally developed testicles; exposure to toxins and chemicals; and increased testicular temperature.
Male infertility may also occur from physical or structural abnormalities such as premature ejaculation; retrograde ejaculation (semen forced back into the bladder); erectile dysfunctions; and any structural abnormalities that affect the testes, tubes, or other reproductive structures. Blockage of the duct that carries sperm or genetic defects called deletions are also causes of male factor infertility. The effect of aging is not clear, however there is some evidence of decreased sperm quality with advancing age, especially after age 70.
The effects of medications on sperm quality and count have not been extensively studied, and many medicines are commonly prescribed without knowing whether they impair fertility. Known medications that may affect male fertility include: steroids, cimetidine (Tagamet), sulfasalazine (Azulfidine), salazopyrine, colchicine, methadone, methotrexate (Folex), phenytoin (Dilantin), corticosteroids, spironolactone (Aldactone), clonidine (Catapress), thioridazine (Mellaril), and calcium channel blockers(for high blood pressure)
Other medical conditions such as severe injury, major surgery, diabetes, HIV, thyroid disease, liver or kidney failure, heart attack, and chronic anemia may effect sperm quality.
Treatments for male factor infertility may include: antibiotic treatment for infection, or hormone treatment if a hormone imbalance is identified; avoiding radiation and environmental toxins, chemicals, pesticides, and lubricants; avoiding excessive alcohol, smoking, and drug abuse; therapy to treat ejaculation problems; and surgery to correct structural abnormalities. Dietary supplements such as Proxeed and Fertile One are formulated to enhance male fertility and may improve overall sperm quality.
One way to overcome male factor problems is through the use of artificial insemination. This is a procedure in which a man’s sperm is inserted into a woman’s vagina, cervix or uterus around the time of ovulation. An advanced technique called intra-cytoplasmic sperm injection or ICSI, in which a single sperm is injected directly into an egg to achieve fertilization, is highly effective. It is often used in cases with very low sperm counts. For men with very low counts or absent sperm, sperm donors represent another option. Even for men with no sperm, some new techniques to directly acquire the sperm from the testes or the ducts that deliver sperm have been used with great success.