Difficulty conceiving due to an absent or low sperm count, motility, or morphology is referred to as male infertility. Male factor infertility can be caused by illnesses, injuries, persistent health problems, lifestyle choices, and other factors. The inability to have a child can be stressful but male factor infertility treatment options are available.
Causes of Male Infertility or Low Sperm Count
Environmental Exposures
Many men in Louisiana with low sperm counts are found to have some kind of exposure to heat. This can be through hot tub or sauna use, heat exposure through work, or recent high fever. If these exposures can be avoided for 2-3 months, the semen analysis often improves.
Lifestyle Factors
Certain other lifestyle factors or habits can cause low sperm count. Maintaining a healthy lifestyle and weight while trying to conceive will boost your chances of success. The following are the most common dangers to a man's fertility:
Alcohol abuse
Steroids anabolic
Smoking cigarettes
Toxic chemicals, heavy metals, pesticides, paint, and solvents exposure
Obesity
Chronic or genetic disease
While most genetic causes of low or absent sperm production are uncommon, several chronic diseases and/or drugs used to treat them are causes of male infertility. For example, low sperm count can be caused by conditions such as testicular or prostate cancer, diabetes, excessive blood pressure, and peripheral vascular disease.
Anatomic Disorders
Some men with no sperm (azoospermia) have an absent vas deferens which is the tube that sperm normally travel in from the testicle to the ejaculate. These men often carry a genetic mutation that can also cause cystic fibrosis. Sometimes men that have had a vasectomy and then a vasectomy reversal may have scar tissue reform preventing sperm from entering the ejaculate. Some men with low sperm counts will have a dilated vein in the testicle called a “varicocele”. This can be palpated on exam by a urologist. The blood that collects in the vein raises the temperature of the testicle which affects the sperm.
Hormones Imbalances
Hormones, specifically testosterone, is critical for the normal production of sperm. Hormonal imbalances can be caused by disorders of the testicle, pituitary, or hypothalamus. A hormone panel can evaluate the function of each of these structures to help identify a cause.
How to overcome male infertility or low sperm count
Hormonal therapy (Clomid, HCG)
When men with low testosterone levels (<300) are placed on clomid and/or hCG, many will see an increase in their sperm count after 3-6 months.
Surgery (varicocele repair, TESE) (varicocele repair, TESE)
Men with no sperm (azoospermia) can sometimes have sperm retrieved from the testicle with a procedure called a TESE. Men with varicoceles can have the varicocele surgically corrected which results in an improvement in semen parameters for about 50% of men.
IUI (intrauterine insemination)
Intrauterine insemination (IUI) is a procedure where sperm is prepped and washed in a lab and then injected directly into the uterus at the time of ovulation. This results in significantly greater sperm entering the uterine cavity for fertilization of the egg in the fallopian tube.
IVF (in-vitro fertilization) with ICSI (intracytoplasmic sperm injection)
IVF for male infertility is one of the most successful treatment options available. During IVF-ICSI, a single sperm is injected into an egg under a microscope. The fertilized egg or embryo is then cultured for 5 days in the lab at which point it can be placed back into the uterus for implantation.
Sperm donor
Some infertile couples will opt to use donor sperm to conceive. Donor sperm is typically obtained through a sperm bank and can be used for insemination via IUI or IVF-ICSI.
Conclusion
If you are struggling with low sperm count or male factor infertility and looking for the proper evaluation and treatment, Audubon Fertility can help. To learn more about testing and treatment options, please schedule an appointment at 504-475-1458.