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MALE FACTOR SUBFERTILITY AND INFERTILITY

(MALE INFERTILITY OF GENETIC ORIGIN)
Male Factor Subfertility and Infertility

WHAT YOU NEED TO KNOW:

What are male factor subfertility and infertility? Male factor subfertility and infertility are conditions that cause a man to have problems getting a woman pregnant. Subfertility is when a man has been unable to get a woman pregnant after 1 year of regular sex without birth control. Male factor infertility may be caused by a problem in the male reproductive system. The male reproductive system includes the testicles, prostate, penis, scrotum, vas deferens, epididymis, and seminal ducts.


What causes male factor subfertility and infertility? The cause may not be known. The following are possible causes of infertility:

  • Varicocele: The veins in the scrotum are enlarged. This condition may decrease sperm count and cause infertility.

  • Few and abnormal sperm: Problems with the movement, shape, or number of sperm may decrease fertility.

  • Genetics: You may have been born with genes that cause infertility. The genes may affect how sperm are made, how they move, and how well they can travel.

  • Seminal duct blockage: The seminal ducts are tubes that carry sperm from the testicles to the urethra. When these tubes are blocked, there may be no sperm in your semen.

  • Low hormone levels: Hormone disorders in the testicles or tumors in the pituitary gland may cause infertility.

  • Antibodies: A problem in your immune system may cause your body to produce antibodies that attack your sperm.

  • Medicine: Steroids and medicines to treat high blood pressure, cancer, or depression may affect your fertility.

  • Infections: Chronic (long-term) infections in the male reproductive system may affect male fertility.

What are the signs and symptoms of male factor subfertility and infertility? The main sign of female infertility is that you have not been able to get your partner pregnant after 1 year of regular unprotected sex. Other signs and symptoms will depend on what is causing your infertility. If you have a varicocele, you will have a mass or swelling on the scrotum that feels like a bag of worms.

How are male factor subfertility and infertility diagnosed? Your healthcare provider will ask about your current health and your health in the past. He may need to know how long you and your partner have been trying to get pregnant. Tell him when and how often you have sex, and if you have any problems. You will also be asked whether you drink alcohol or smoke, and what medicines you use. You may need any of the following:

  • Physical exam: Your healthcare provider will look for signs of low hormone levels, such as decreased body hair and increased breast tissue. Your healthcare provider will also check the size and shape of your testicles and will look for varicoceles.

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Genetic screening: Genetic testing may be done to look for abnormal genes that cause you to produce a low number of sperm or no sperm at all.

  • Semen analysis: Your healthcare provider will look for problems that may affect sperm movement and function. You will need to ejaculate semen for this test.

  • Sperm analysis: The movement of sperm and how fast they travel through mucus may be tested. The number of sperm may also be counted.

  • Spermatic venography: This test looks at the position of the veins in the scrotum. During this test, a healthcare provider will put dye into your body and take x-rays to look for a varicocele. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.

  • Ultrasound: A scrotal ultrasound uses sound waves to find lumps and other changes in your testicles and scrotum.

  • Urinalysis: This test is done on a sample of your urine after you have ejaculated. It is done to look for sperm in your urine, which may suggest a blockage or problems with your ejaculation.

How are male factor subfertility and fertility treated? The treatment will depend on the cause of your infertility. You may need any of the following:

  • Medicine: Antibiotics may be given to treat an infection of the reproductive system. Hormones, such as testosterone, may be used to treat low hormone levels. Steroids may be used to treat infertility caused by a problem in the immune system.

  • Percutaneous embolization: This procedure may be used to treat a varicocele. The blood flow in the enlarged veins is blocked to stop the flow of blood.

  • Sperm extraction: Sperm may be removed from the testicles or epididymis if a blockage is present. The collected sperm may be saved or used to fertilize a woman's egg.

  • Surgery: Surgery may be done to repair a blockage in the sperm duct or remove a pituitary tumor.

Where can I find more information?

  • American Academy of Family Physicians
    11400 Tomahawk Creek Parkway
    Leawood , KS 66211-2680
    Phone: 1- 913 - 906-6000
    Phone: 1- 800 - 274-2237
    Web Address: http://www.aafp.org
  • American Society for Reproductive Medicine
    1209 Montgomery Highway
    Birmingham , AL35216-2809
    Phone: 1- 205 - 978-5000
    Web Address: http://www.asrm.org

When should I contact my healthcare provider?

  • You have swelling or a lump in your scrotum.

  • You have pain in the groin area that does not go away.

  • You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.