Male Fertility

It’s estimated that up to one-third of all fertility complications suffered by couples are related to problems with a man’s fertility. These may be caused by physical issues that prevent sperm from being ejaculated normally or impact the quality and production of the sperm. Infertility is assessed through semen analyses, physical exams and hormone evaluations performed by the team at the Center for Men’s Health at TUCC.

A semen analysis can detect:

  • Azoospermia, where no sperm are produced or sperm do not appear in the semen.
  • Oligospermia, where few sperm are produced.
  • Problems with sperm motility, which reduce the likelihood of fertilizing an egg.
  • Problems with sperm form and structure.

Two normal semen analyses are typically required to rule out significant infertility problems. Following the semen analysis, your TUCC physician will perform a physical exam to look for any varicoceles (blockage of the spermatic cord).

Hormonal imbalances do not impact the fertility of the majority of men. However, we test the testosterone levels of all male fertility patients at the Center for Men’s Health. Low testosterone is diagnosed through a blood test that determines the level of testosterone and sex hormone binding globulin (SHBG), a protein that tightly binds testosterone and makes it unavailable for use by the target organ.

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Causes of Male Infertility

There are several common causes for male infertility including:

  • Sexually transmitted diseases or other infections.
  • Blockages, birth defects or physical damage. Some men are actually born with blockages in parts of the testicle or other abnormalities that prevent sperm from getting into the semen. Physical trauma to the testicles, prostate, and urethra can also result in fertility issues.
  • Retrograde ejaculation, a disorder in which semen doesn’t come out of the penis during ejaculation and instead enters the bladder. It can be caused by diabetes, some medications and surgery to the bladder, prostate or urethra.
  • Genetic diseases. Rare cases of cystic fibrosis chromosomal disorders can cause infertility.
  • Autoimmune disorders where a man’s immune system mistakenly targets and damages sperm cells as foreign viruses.
  • Hormonal problems. Certain hormonal imbalances such as those occurring in the pituitary and thyroid glands can cause infertility.
  • Erectile dysfunction and premature ejaculation. Learn more about the erectile dysfunction treatment options at the Center for Men’s Health at TUCC here.
  • Varicoceles. A varicocele is a widening of the veins along the spermatic cord that holds up a man’s testicles. It forms when valves inside the veins along the spermatic cord prevent blood from flowing properly. Up to 40 percent of men with known infertility may have varicoceles.
  • Excessive exercise, heat, alcohol, drugs, food and stress as well as exposure to environmental toxins can also impact a man’s fertility.

Diagnosis

Following irregular semen analyses, you’ve been diagnosed with infertility, your TUCC physician will first discuss potential behavioral changes that could improve your chances of conceiving. This could include having sex less often to build up a better concentration of sperm. Retrograde ejaculation can often be treated with over-the-counter cold medicine.

If abnormal hormone levels are detected following a semen analysis, you may be a candidate for hormonal replacement therapy. [Learn more about testosterone replacement therapy at the Center for Men’s Health. – Link to Testosterone Replacement Therapies]

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Resources & Events

The Transurethral Suprapubic endo-Cystostomy (T-SPcC): A Novel Suprapubic Catheter Insertion Device

TUCC physician Lawrence Karsh, M.D., served as a lead investigator in this clinical trial which investigated the first human experience with the Transurethral Suprapubic endo-Cystostomy (T-SPeC®) device, a novel disposable device used for introducing a suprapubic catheter via a retrourethral (inside-to-out) approach similar to the Lowsley technique. The results of this investigation were published in

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