A Closer Look at Male Infertility

Is it just us, or does the infertility conversation feel distinctly female? It goes without saying that the egg donation industry can be described as having a women-driven market, but that doesn’t mean that all of this is just a woman’s issue. In recent years, we have gained a more concrete understanding of male infertility, and majorly debunked the myth that only women need help when it comes to creating a family. In fact, approximately 20 percent of infertile couples are unable to conceive because of the male partner alone. Surprised? We bet you are! Which begs the question, just how common is male infertility and why are men so frequently left out of the fertility conversation?

Male Infertility is as Common as Female Infertility

One in eight couples in the United States have trouble conceiving, while it is estimated that 45.8 million couples are impacted by infertility worldwide. This is a common issue with rates that continue to rise year after year; meaning we can no longer look at infertility as one group of people’s issues, because really, it has the potential to affect all of us. Overall, one-third of infertility cases are caused by male reproductive issues, one-third are caused by female reproductive issues, and one-third are caused by both male and female reproductive issues or by unknown factors. We know that infertility affects men and women equally, but much of the conversation has been woman-dominated. Don’t get us wrong, it’s amazing and inspiring that women choose to speak out and let others know they aren’t alone in their fertility struggles, but the fact is, we’ve only been hearing one side of the story.

Causes of Male Infertility

There are many factors, known and still unknown, that contribute to male infertility. Many cases of male infertility come with an “unknown cause” diagnosis, which is partially due to the very large gap in the number of men who are evaluated for infertility. With more than a million women making infertility-related office visits each year, it’s said that only 20 percent of their partners receive any infertility evaluations. Additionally, many of these evaluations only focus on conception and do not dive into the root causes of male infertility. Further studies and cultural attention will help with diagnostics, with some of the more known causes of male infertility including:

• Varicocele – This is the most common cause of male infertility, and oftentimes goes unnoticed due to a lack of symptoms. The good news is, it is also 100 percent reversible! A varicocele can be defined as swelling of one or several of the veins in charge of draining the testicle and may be responsible for a decrease in sperm quality.
• Hormone imbalance – Male infertility can result from testicle disorders themselves or from an abnormality that begins affecting other hormone systems including the adrenal glands, thyroid, hypothalamus, and pituitary. There are a number of possible underlying causes of low testosterone (male hypogonadism) and other male hormonal problems.
• Problems with sperm/the release of sperm – If a man makes too much or not enough sperm, or has sperm that does not move correctly, it will make it difficult for them to efficiently fertilize an egg. Failure to adequately release sperm into the vagina due to erectile dysfunction, complications from surgery, premature, or retrograde ejaculation also contribute to fertility issues in men.
• Blocked tubes – Many different tubes carry sperm, and blockages can occur at any point within the testicles, in the tubes that drain the testicle, in the epididymis, the vas deferens, near the ejaculatory ducts, and in the urethra. Blockage can result from various causes, like inadvertent injury from surgery, prior infections, trauma, or abnormal development relating to cystic fibrosis or similar inherited conditions.
• Infection – Some infections can interfere with sperm production or sperm health and even cause scarring that blocks the passage of sperm. These are characterized as inflammations, and some sexually transmitted infections, including gonorrhea and chlamydia.
• Lifestyle issues – Things like excessive alcohol consumption, smoking, a poor diet, and poor sleeping habits have shown to significantly affect fertility. It is thought that men who exhibit unhealthy behaviors are more likely to have an abnormal semen analysis.

Putting an End to the Infertility Double Standard

The topic of fertility can be touchy no matter what your gender, especially since an open dialogue surrounding infertility has not been socially encouraged – even less so in men than women. As a result, men that have trouble conceiving feel ashamed or that they have been robbed of their masculinity, when in reality, this is a problem that affects much of the population (and the world). So, what do we do? Well, we encourage men to get their semen quality examined annually to check if there’s a decline. As we know, women have a monthly cycle that gives feedback on their fertility status, whereas men only find out there is an issue when they can’t conceive. The likelihood that a man will show no symptoms in regard to infertility is why men and doctors should be openly discussing fertility during check-ups. With such a significant, emotional, and culturally-loaded topic, it is vital that we all stay active in the conversation so we can break down the stigmas together. YOU ARE NOT ALONE!

Sources: HHS.gov, UNCHealthCare.org, AmericanPregnancy.org