Women’s Health with Minoos Hosseinzadeh, M.D. What Every Man Needs to Know about His Fertility Potential

Infertility is defined as the inability to conceive after one year of unprotected intercourse. Generally, the focus of attention in couples experiencing infertility is placed on female factors, but male factor infertility is just as important and equally as prevalent. In fact, male factor infertility is the sole reason in 20 percent of infertility-related cases, and is also a contributing factor in another 20-40 percent of couples, making it important – and necessary – to test both partners when evaluating couples for infertility.

Aging and Male Fertility
Just as in women, aging has adverse effects on male infertility – although it is not as pronounced in men as it is in women. It has been suggested that for men over the age of 35 attempting to father a child, the probability of achieving a pregnancy in one year is approximately 50 percent less than in men under 25. Men should consider the following risk factors, which are indicators for male factor infertility:

• History of abnormal pubertal development
• History of undescended testicle
• History of testicular trauma
• Cystic fibrosis
• Sexually transmitted diseases possibly leading to ductal blockage
• Diabetes leading to problems with ejaculation
• Mumps after puberty
• Reproductive surgery, including inguinal hernia repair, renal transplant or scrotal surgery
• Use of tobacco, alcohol and drugs
• Exposure to environmental toxins, including heat
• Certain medications

The causes associated with male factor infertility fall into three major categories: Abnormalities of sperm production due to genetic causes, infection or toxins; abnormalities of sperm function; and obstruction in the ductal system. For men, a semen analysis is the most important test to evaluate the nature of the infertility and determine into which of the three categories of causes it falls. The semen analysis assesses the semen volume, sperm count, motility and the morphology, or shape of the sperm.

Available Treatment Options for Men
Men who are experiencing male factor infertility have a number of treatment options available to them. However, these options vary depending on each person’s individual circumstances. A sampling of treatment options includes:

• Drug Therapy – In cases of hormonal imbalance or infections.
• Surgery – In cases of obstruction, to remove varicose veins or to extract sperm for use in assisted reproductive technologies, also known as ART.
• Artificial Insemination – Involves the placement of sperm, taken either from self or retrieved from a donor, directly into the partner’s uterus. In this procedure, the sperm still have to swim to enter the fallopian tubes and find and fertilize the egg(s).
• In Vitro Fertilization – In this procedure, the partner’s eggs are harvested from the ovaries. The sperm is then placed in a dish with the eggs, or one single sperm may be injected directly into an egg. The resulting embryo, or fertilized egg, is then grown in the laboratory for transfer into the partner’s uterus.

Would-be parents who are experiencing infertility should consult their physician about the male and female factors that are contributing to their difficulty conceiving. Patients can maximize their chances by becoming aware of the potential risk factors associated with male factor infertility, and seeking out the myriad treatment options that are making it possible for many couples to begin a family.

OCPC Readers: Email questions to Women’s Health with Dr. Minoos at DrMinoos@OCPCmagazine.com. ____________________________________________________________________________

Dr. Minoos Hosseinzadeh is a nationally recognized specialist in reproductive endocrinology at the largest and most-established locally-based fertility center in Orange County, Calif., Coastal Fertility Medical Center (http://www.coastalfertility.com). Double-board certified in Obstetrics and Gynecology and Reproductive Endocrinology & Infertility, she is also a member of the American Society of Reproductive Medicine, Society for Reproductive Endocrinology and Infertility, American College of Obstetrics and Gynecology and the Royal College of Physicians and Surgeons. She has presented at several national and international fertility meetings and authored numerous papers on hormone replacement therapy and age-related female infertility.