Sperm Counts

Can males be responsible for infertility?

By Barbara Pierce

Men’s sperm have been decreasing in number and getting worse at swimming for some time now, many experts say. And it’s getting worse.

“Male infertility is a global population health concern,” said Dr. Ruben Pinkhasov of Upstate Urology at Mohawk Valley Health System, Utica. “There are an estimated 48.5 million couples with infertility issues worldwide.”

Infertility is a common issue. Out of 100 couples in the United States, about 12 to 13 of them have trouble becoming pregnant, according to the Centers for Disease Control and Prevention.

When pregnancy fails to occur within one year of regular unprotected intercourse, this is considered infertility, Pinkhasov said.

However, whether male infertility has actually been falling, therefore causing infertility in more couples, is hard to estimate, added Pinkhasov. He said this is because the definition of what male infertility is varies significantly and data is underreported.

The causes of male infertility:

— When a couple has difficulty conceiving, the woman often carries the burden of infertility.

However, she is not necessarily the cause, said Pinkhasov. Males often share responsibility. Men are solely responsible in about 20% of infertile couples and contributory in another 30% to 40%.

“Male infertility can be due to a variety of conditions,” he said. Some of these conditions can be identified and are reversible, such as obstruction of one or both of the ejaculatory ducts, or the production of little or no sex hormones, or un-descended testicle(s).

Other conditions are identifiable but not reversible, and in many cases, the cause cannot be found.

What if infertility is issue?

“A couple attempting to conceive should have an evaluation for infertility if pregnancy fails to occur within one year of regular unprotected intercourse,” Pinkhasov said.

An evaluation should be done before one year if infertility risk factors are present, such as a history of un-descended testicles, female age of 35 years or older, or the couple questions the male partner’s fertility potential.

In addition, men who question their fertility status, despite the absence of a current partner, should have an evaluation of their fertility potential.

Pinkhasov said treatments for male infertility have been successful.

Identifying and treating those conditions that are treatable may improve the male’s fertility and allow for conception through intercourse.

Even for azoospermic patients, where there is no sperm in a man’s ejaculate, many causes are treatable and fertility can be restored. The patient may have active sperm production restored, or could have sperm production induced with treatment, he added.

Detecting those conditions for which there is no treatment will spare couples the distress of attempting ineffective therapies.

If specific corrective treatment is unavailable, it still may be possible to employ assisted reproductive techniques such as retrieving sperm from other parts of the body. For good pregnancy rates, sperm retrieval is used with in vitro fertilization, the process of combining an egg and sperm in a laboratory dish for fertilization. This combined sperm and egg are called an embryo. The embryo is transferred to the uterus for development.

Alternatively, couples dealing with infertility issues may wish to consider therapeutic donor insemination or adoption, Pinkhasov said. Ask your health care provider for more information about fertility treatment and other resources.

Therapeutic donor insemination is a form of artificial insemination that uses donor sperm from an anonymous or known third-party donor. The donor sperm is inseminated into the woman’s uterus at the time of ovulation, allowing her to conceive.

To produce healthy sperm, the MayoClinic.org offers these suggestions:

— Maintain a healthy weight. Obese men are more likely to have a low sperm.

— Eat a healthy diet.

— Prevent sexually transmitted infections as they can cause infertility in men.

— Manage stress.

— Get moving.

— Don’t smoke. Smokers are more likely to have low sperm counts. If you smoke, ask your doctor to help you quit.

— Limit alcohol. Heavy drinking can lead to reduced testosterone production, impotence and decreased sperm production. If you drink alcohol, do so in moderation. If your testosterone levels are low, you may look for an effective Low T Program.

— Some medications can contribute to fertility issues. Talk with your physician.

— Watch out for toxins. Exposure to pesticides, lead and other toxins can affect sperm quantity and quality. If you must work with toxins, do so safely.

— Stay cool. Increased scrotal temperature can hamper sperm production. Although the benefits have not been fully proved, wearing loose-fitting underwear, reducing sitting, avoiding saunas and hot tubs, and limiting scrotum exposure to warm objects, such as a laptop, might enhance sperm quality.

— Chemotherapy and radiation therapy for cancer can impair sperm production and cause infertility that might be permanent. Ask your doctor about the possibility of retrieving and storing sperm before treatment.

Sperm deteriorate with age, especially after age 50.

— Have sex every two or three days. Frequent sex makes sperm more active and healthier. This suggestion comes from the UK National Health Service.