Doctors for Male fertility issues are a common concern for some couples trying to conceive. These issues may sometimes be overlooked or misunderstood. When experiencing difficulty in developing, seeking the help of a fertility doctor, also known as a reproductive endocrinologist, can be a significant first step.
Causes of Male Infertility
For conception to occur, a man needs to produce healthy sperm that can reach, penetrate, and fertilize the woman’s egg. Here are some possible causes of male infertility:
Varicocele
Varicocele, a condition characterized by the abnormal enlargement of the pampiniform plexus veins, is a common cause of male infertility. It’s similar to varicose veins but located in the testicles and can lead to decreased sperm production and quality. Some varicocele men may experience intermittent testicular aching, especially during strenuous activity or prolonged standing. The primary concern is that the swollen veins may damage sperm, leading to a lower sperm count.
Ejaculation Issues
Ejaculatory dysfunction can lead to low semen volume, thereby not supplying sufficient numbers of sperm for successful conception. One such issue is retrograde ejaculation, where semen enters the bladder during orgasm instead of being expelled. The causes of this problem may include surgery, medications, or poor nervous system health. Signs include cloudy urine after ejaculation and less fluid or dry orgasms. Other ejaculation problems impacting fertility include erectile dysfunction, premature ejaculation, and delayed ejaculation.
Hormonal Problems
Hormones involved in male fertility include follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and prolactin. FSH stimulates sperm production, while LH primarily stimulates testosterone production. Testosterone is indispensable for the development of mature sperm. An imbalance in these hormones can lead to low sperm concentration and reduced libido. Hyperprolactinemia, the condition of having elevated levels of prolactin, can also cause infertility due to its inhibitory effects on the hypothalamus, leading to decreased levels of FSH and LH. Thyroid imbalances can impact fertility by affecting the levels of testosterone, FSH, and LH required for sperm production.
Infections
Bacteria such as Chlamydia trachomatis, Neisseria gonorrhoeae, and Brucella are known to cause male infertility cases. Sexually transmitted infections (STIs) like chlamydia and gonorrhea are common culprits, often presenting no recognizable symptoms while causing damage. Other infections like Mycoplasma, urinary tract infections, and Escherichia coli also negatively impact sperm parameters, affecting fertility.
Lifestyle Factors
Prolonged tobacco use can decrease sperm count and motility. Excessive alcohol intake can lead to decreased testosterone levels, causing erectile dysfunction and reduced sperm production. Illicit drug use, especially anabolic steroids, can shrink testicles and decrease sperm production. Obesity is another major factor; high body fat can interfere with reproductive hormones and contribute to the production of abnormal sperm. Psychological stress can also negatively impact hormonal balance and sperm production, further reducing fertility.
Treatment Options for Male Infertility
Here are some treatment methods that can be used by a fertility doctor to treat male infertility:
Assisted Reproductive Technologies
Assisted reproductive technologies (ART) have revolutionized the treatment of male infertility. Here are different types of assisted reproductive technologies:
In Vitro Fertilization (IVF)
In vitro fertilization is a treatment option doctor for male infertility. It’s often the choice for couples experiencing severe male factor infertility or issues like tubal blockage. The procedure involves fertilizing an egg with sperm outside the body and then transferring the embryo to the woman’s uterus.
Intracytoplasmic Sperm Injection (ICSI)
Another ART includes intracytoplasmic sperm injections. ICSI involves injecting a single live sperm directly into an egg. ICSI can be performed with fresh or cryopreserved ejaculate sperm.
Fertility Preservation
Fertility preservation can be a treatment option for male infertility, particularly for those undergoing aggressive treatments like chemotherapy or radiotherapy that may lead to irreversible sterility. These methods aim to safeguard a man’s ability to father biological children in the future. The most common and effective method is sperm banking, where sperm cells are frozen and stored for future use. For prepubertal boys who are unable to produce mature sperm, testicular tissue cryopreservation is a potential option. This involves freezing a testicular tissue sample containing immature sperm cells.
Consult With a Male Fertility Doctor
When you visit a fertility doctor, they may begin with a comprehensive medical history and physical examination. This may be followed by diagnostic tests, including semen analysis, hormonal testing, and possibly genetic testing to identify underlying issues. Early consultation with a fertility doctor can help identify and address problems effectively, improving the chances of successful conception.