Male Infertility Treatment

Male infertility is a prevalent issue, and fortunately, in most cases, it is treatable with the help of an experienced men’s health doctor, like urologist Richard Natale. When a couple cannot conceive a child within a year of “trying,” infertility of one or both partners is likely to be the problem. The National Institutes of Health (NIH) reports that infertility is due to the woman in one-third of the cases, the man in another third, and both in the other third.

Our Approach to Male Infertility

Dr. Richard Natale approaches male infertility in a whole health manner. He looks for the underlying medical reasons for male infertility using in-office blood testing, ultrasound imaging, and semen analysis. With these findings, he can address these potential problems. If it is determined that lifestyle factors may impact your fertility, he will recommend changes to improve overall health. Dr. Natale believes in natural solutions to improve one’s health whenever possible.

What Causes Male Infertility?

Male infertility may be structural – that is, due to an abnormality in the testicles themselves, the seminal vesicles, or even the blood vessels within the scrotum. Also, a man’s sperm may be defective in number, shape, and motility, or its ability to move at the proper speed and direction.

Some men experience Low-T. A reduced amount of circulating testosterone, the male hormone, often stems from simple aging (andropause or male menopause) and health-related factors, such as obesity.

Other problems include varicocele (swelling of the veins responsible for draining the testicle), tumors, and infection.

Testicular and sperm disorders include:

• Low sperm production (having less than 39 million sperm total per ejaculation)
• Abnormal shape of sperm, which hinders the ability to fertilize an egg
• Poor sperm motility or ability to move efficiently
• Obstruction in ducts that carry sperm (possible infection or vasectomy reversal failure)
• Low testosteronelevels (under 300 nanograms per deciliter)
• Testicular trauma (e.g., rupture, fracture, contusion, torsion, or dislocation)
• Other possible causes of male infertility include ejaculation problems and erectile dysfunction (ED).
• Poor Sperm Health: Another cause of male infertility is weak or unhealthy sperm. This issue can develop if you have a health issue that causes your sperm to be invalid or slow enough not to access your partner’s egg. There are ways to improve sperm health in many men. However, if this isn’t possible, you can explore other ways to have your children. This will require your urologist and your partner’s gynecologist to work together to get the best outcome.

Many men’s health specialists believe that lifestyle factors, ill-managed chronic conditions, and certain medications can adversely affect male fertility. Examples include:

• Smoking
• Alcohol abuse
• Illegal drug use
• Groin injury
• Heat exposure from saunas, tight underwear, and even bike riding and other sports
• Anxiety, depression, and other mental/emotional health issues
• Diabetes
• Cardiovascular disease
• High blood pressure
• Drugs to treat depression, cancer, and allergies
• Vitamin deficiencies (zinc and vitamin C, as examples)
• Infections, such as prostatitis and STDs

Symptoms of Male Infertility

Infertile men usually experience one or more of the following symptoms:

• Low Libido involves having little to no sex drive. Low libido is often caused by deficient hormones — specifically low testosterone levels. If you notice that your sex drive has dropped significantly, you may have low testosterone. Fortunately, there are ways to raise testosterone levels naturally and through hormone replacement therapy. Treating the issue for most men with low testosterone generally makes them fertile again.
• Erectile Dysfunction: Hormonal or nerve problems may cause erectile dysfunction (ED). If you have diabetes, peripheral neuropathy may cause erectile dysfunction. Other nerve-related conditions such as multiple sclerosis can also be an underlying cause of male infertility.
• Pain in the Testicles, Groin, or Pelvic Area: If you are experiencing chronic or intermittent pain or a lump in the testicles, you may have varicoceles –varicose veins in the testicles and scrotum. Varicoceles are a common cause of male infertility since the condition causes an increase in the temperature in or around the testicles, which can negatively affect sperm formation and motility. Even if varicoceles are not the issue, pain in the area warrants an evaluation by a urologist.
• Many Months of “Trying” Without Causing Pregnancy: Perhaps the most significant symptom of infertility is the inability to get your partner pregnant after a year of having frequent unprotected sex. If this is true for you, see a men’s health specialist for an evaluation and possible treatment.
• Testicle Swelling: Pain and swelling in the testicles are not typical and require medical attention. Epididymitis is a condition marked by swelling of the tube that stores and carries sperm. Not only is this condition painful, but it can also actually cause infertility. Swelling can also be indicative of a testicular infection called orchitis.

How Male Infertility Is Diagnosed

To confirm a diagnosis, your urologist will review your medical history, do a physical exam, and run some tests. Your doctor will also likely order a semen analysis to assess the volume and quality of your sperm.

If the results of your semen analysis are normal, your doctor may order additional tests, such as a hormonal profile to evaluate your testosterone levels; a transrectal ultrasound to check for any blockages, and a scrotal ultrasound to check for any problems inside your testicles. If the test results come back abnormal, your doctor may order a testicular biopsy, which will reveal issues with the transport of semen. If there is no evidence of a blockage, your doctor may rule in a genetic cause or recommend you get your partner checked.

What Lifestyle Changes Can Help with Male Fertility?

Sometimes, changing simple habits works wonders for men and women with fertility issues. For a man, it is best to:

• Refrain from wearing tight underwear or other tight clothes.
• Eat a high-fiber, high-protein, low-fat diet.
• Exercise regularly – ideally, at least 30 minutes five times a week.
• Slim down to within a healthy weight range.
• Stay hydrated.
• Be as sexually active with your partner as possible – have sex at least every other day.
• Reduce your levels of stress as much as possible.
• Stop smoking.
• Limit your intake of alcohol.

Treatment Options Available

The type of treatment will depend on the underlying cause. For instance, your urologist may prescribe antibiotics to address an infection. For erectile dysfunction and premature ejaculation, your urologist may prescribe other medications or recommend different approaches, such as lifestyle changes, hormone therapy, and counseling. Surgery may be necessary to correct varicocele.

When all these modalities have been fully explored but without success, your urologist may resort to assisted reproductive technology (ART), such as in-vitro fertilization (IVF). This generally involves obtaining a sperm sample through normal ejaculation or surgical extraction or from a donor, depending on your preference and specific case. The sperm cells are then injected into the female partner using a tiny needle called a micropipette to initiate fertilization.

Can Young Men and Women Experience Infertility?

According to the U.S. Department of Health & Human Services, healthy couples under age 30 can conceive a child about 40 to 60 percent of the time within three months of trying. However, fertility levels always decline as people get older. Women are much less fertile in their 30s than in their 20s, and the chances of getting pregnant dramatically decrease past 35. A male’s fertility also wanes with age, but the decline happens much more slowly.

Infertility can affect any couple at any age. Up to 15 percent of young couples cannot conceive after many years of trying. Approximately 10 percent of couples will not produce a live-born baby after two years of trying. Interestingly, 7 percent of women in their early 20s are infertile, while 9 percent of women in their late twenties are infertile.

Next Steps

If you suspect you are infertile, consult with a urologist for proper diagnosis and treatment. A men’s health specialist can quickly diagnose male infertility and help get you on the path to parenthood. Patients in North Carolina trust Dr. Richard Natale, a board-certified urologist at Carolina Urology. Call (704) 786-5131 or request an appointment online today. We have offices in Concord and Charlotte, North Carolina.