Male Factor Infertility

Definition - What does Male Factor Infertility mean?

Male factor infertility refers to infertility stemming from problems with healthy sperm reaching the and fertilizing egg. There are two major categories of male factor infertility: problems with sperm production, and problems with delivery of the sperm to the egg.

Between 1/3 and 1/2 of cases of infertility are thought to be due to problems with sperm.

FertilitySmarts explains Male Factor Infertility

Successful conception requires that healthy sperm be delivered to a receptive egg within the uterus. If healthy sperm is not produced, or if sperm are not properly delivered to the egg, inability to conceive may result.

Problems with sperm production can arise from a variety of causes, including:

  • Drug and alcohol use
  • High scrotal temperature
  • Low levels of testosterone
  • Medication side effects
  • Autoimmune conditions
  • Congenital conditions

Many of these problems are treatable. Lifestyle changes can correct issues caused by drug and alcohol use use; problems with high scrotal temperature may be alleviated by changing clothing style or refraining from activities such as hot baths. Low testosterone levels can be medically corrected, and changes may be able to me made to medication regimens.

Autoimmune infertility, in which sperm or sperm-producing cells are attacked by the body's own immune system, may be improved using immunosuppressants or anti-coagulants which prevent antibodies from binding to sperm.

Certain congenital (born with) problems may be more difficult to treat. Anatomical features, such as swollen scrotal veins, may cause abnormally high scrotal temperature that is not corrected with change of clothing or activities. Chromosomal problems, such problems with the sex chromosomes, may lead to unhealthy sperm that cannot produce a healthy pregnancy.

Alternatively, male-factor infertility may occur in situations where healthy sperm are being produced, but are not being delivered effectively into the uterus. Causes of sperm delivery problems can include:

  • Blockages to vas deferens or urethra caused by past surgery, injury, infection, or congenital malformation. These blockages may be treated surgically, though the formation of scar tissue in post-surgical healing can present
  • Failure of closure of the neck of the bladder during sex, which may result in sperm being delivered into the bladder instead of being ejaculated. This can be treated with medication to improve the functioning of these voluntary muscles.

In cases where treatment does not improve problems with sperm delivery, sperm may be artificially removed from the testes by doctors and introduced to the uterus, or used to fertilize eggs outside of the uterus through in vitro fertilization.

If male-factor infertility is suspected, the following tests may be ordered:

  • A sperm sample to check for the number and health of sperm in the ejaculate.
  • A blood test to check for hormone levels and other medical problems.
  • An ultrasound to examine the urethra, vas deference, and blood vessels.
  • A testicular biopsy to examine for tissue abnormalities.
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