Infertility is not being able to conceive after a year of regular, unprotected sex. About one-third of infertility is caused by male factors and one-third are caused by female factors. In the remaining cases, the cause is unknown or is due to problems with both partners.
Men are considered infertile if they:
Portions of the brain called the pituitary gland and hypothalamus, as well as male reproductive organs such as testes affect fertility in men. Problems in any of these areas may decrease fertility.
In about half of the cases, a cause cannot be found. Some factors that can contribute to infertility include:
These factors increase your chance of developing infertility:
Tell your doctor if you have any of the above risk factors.
During the first visit, you and your partner will both be evaluated. The doctor will ask about symptoms, medical history, and work history. Your doctor will look for potential exposure to certain chemicals. Your doctor will also look for physical problems that might cause infertility.
The following tests will be done:
Treatment depends on what is causing the condition. Treatments can be costly and lengthy. They often are not covered by insurance.
Lifestyle changes may include:
Ask you doctor if a daily antioxidant supplement may help.
If you have a hormonal imbalance, your doctor may prescribe medication. Clomiphene citrate (Clomid, Serophene), for example, is an anti-estrogen drug. In combination with vitamin E, it may help increase sperm count and improve sperm movement.
Surgery is done for conditions like varicocele that can affect fertility. Treatment of a varicocele does not always restore fertility.
Surgery may also be done to reverse a vasectomy. This reversal is not always successful.
ART involves using human sperm and eggs or embryos in a lab to help with conception. The eggs and sperm can be from you and your partner or donated. ART methods include:
Infertility cannot always be prevented; however, the following steps may help:
American Society for Reproductive Medicine
The Hormone Foundation
RESOLVE: The National Infertility Association
Men's Health Centre
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Jorgensen N, Carlsen E, Nermoen I, et al. East-West gradient in semen quality in the Nordic-Baltic area: a study of men from the general population in Denmark, Norway, Estonia and Finland. Hum Reprod. 2002;17:2199.
Male risks. Protect your fertility website. Available at: http://www.protectyourfertility.org/malerisks.html . Accessed September 14, 2012.
Reproductive health. The National Institute for Occupational Safety and Health website. Available at: http://www.cdc.gov/niosh/topics/repro/ . Accessed September 14, 2012.
Swan SH, Brazil C, Drobnis EZ, et al. Geographic differences in semen quality of fertile US males. Environ Health Perspect. 2003;111:414.
Vasectomy. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated May 2011. Accessed September 14, 2012.
9/2/2009 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Ghanem H, Shaeer O, El-Segini A. Combination clomiphene citrate and antioxidant therapy for idiopathic male infertility: a randomized controlled trial. Fertil Steril. 2009 Mar 5. [Epub ahead of print]
2/14/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Showell M, Brown J, Yazdani A, Stankiewicz M, Hart R. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2011;(1):CD007411.
Last reviewed September 2012 by Adrienne Carmack, MD
Last Updated: 09/26/2012