Male Infertility

Infertility is a condition that affects both women and men. Studies show that in approximately 45% of couples with infertility, the male partner is either the sole cause or a contributing factor to infertility.

There are many possible causes for male infertility. At The University of Kansas Health System, our specialists offer expertise to facilitate care of each couple experiencing difficulties conceiving.

The definition of male infertility is the inability to achieve a pregnancy through natural means for a 1-year period. Sometimes this can be less than 1 year, especially if known problems already exist. Both male and female partners should be evaluated as part of determining an infertility diagnosis.

To most people, male infertility means an abnormality in the number of sperm or how they move. This is not the only definition. Sometimes male infertility is caused by how the sperm works (the function, such as DNA fragmentation) and the products in the fluid around the sperm that affect the sperm.

Known urological and medical conditions that affect a man's reproductive ability include medications, cancer, surgeries, conditions from childhood, infections, vasectomy and more. Many men with infertility issues have been shown to have a previously unsuspected medical condition, including genetic disorders, endocrine diseases and malignancies. Semen analysis alone is unable to identify the men at highest risk for infertility.

The inability to conceive a child is the primary symptom of male infertility. Sperm disorders are the most common cause of male infertility, but many other factors are possible, including infections, hormone irregularities, immune problems, sexually transmitted diseases, genetic diseases, exposure to toxic substances and more.

These symptoms may indicate you are at increased risk of infertility:

• A history of undescended testicles
• Any trauma to the testicles
• Decreased hair on the face or body
• Erectile dysfunction, premature ejaculation or other problems with sexual function
• Pain or swelling of the testicles
• Retrograde ejaculation
• The growth of breast tissue (gynecomastia)
• Varicoceles, or dilated veins in the scrotum

A large number of male infertility cases are unexplained. This is called idiopathic. For this, there are a number of therapies that can be tried to achieve natural conception or improve the effectiveness of any assisted reproductive techniques used.

Many causes of male infertility exist, including hormonal, blockages, genetic, environmental and lifestyle factors or medications, to name a few. In some cases, potentially life-threatening medical conditions such as testicular tumors may be diagnosed as a result of the inability to achieve a pregnancy and lower sperm counts.

The initial exam should involve a thorough history and physical and evaluate some of the risk factors known to cause male infertility. Possible contributors to male infertility include some childhood issues that do not become a concern until later in life like undescended testicle(s) or sports injuries. Other potential factors include infections, smoking, alcohol and drug use, cancer treatments, spinal cord injury and other medical conditions. Blockages of the reproductive tract can sometimes be the cause, in which case reconstruction microsurgery can be performed.

We offer multiple options for male infertility diagnosis and treatment:

• Anti-sperm antibodies
• Post vasectomy check
• Semen analysis
• Semen cryopreservation
• Semen preparation for intrauterine insemination or in vitro fertilization
• Sperm banking
• Sperm identification
• Strict sperm morphology
• Vasectomy reversal and reconstruction
• Viability staining

Treatment options for male infertility need to be determined after thorough evaluation of history and careful examination. Treatment for infertility concerns in men can relate to complex genetic and hormonal issues, ejaculation and erection problems. Other options include the microsurgical correction of blockage problems due to infections, vasectomy and other traumas or surgeries.

At The University of Kansas Health System, we offer several treatment options for male infertility, including:

• Artificial insemination (or intrauterine insemination, IUI)
• Donor sperm
• In vitro fertilization
• Intracytoplasmic sperm injection
• Microsurgical epidydimal sperm aspiration
• Testicular sperm extraction/testicular biopsy
• Varicoelectomy
• Vasectomy reversal

Low sperm counts and/or motility can also be treated with a manipulation of hormones and correction of certain conditions, such as correcting varicocele (dilated veins in the scrotum that are thought to increase scrotal temperature and affect sperm production). Embolization of the veins can also be performed.

We can recommend 1 or multiple options for effective infertility treatment, depending on the cause of infertility.

The University of Kansas Health System is advancing the treatment of men with infertility, especially unexplained cases, with better insight into the reasons for the infertility problem. Our fertility specialists coordinate and collaborate with other specialists throughout the health system – providing individualized care for couples struggling with infertility. Our experts participate in leading-edge research and offer today's most current testing and treatment for male infertility.