Sings & Symptoms

Male infertility symptoms may include:

  • The inability to conceive a child
  • Problems with sexual function — for example, difficulty reaching orgasm (delayed ejaculation) or difficulty maintaining an erection (erectile dysfunction)
  • Pain, swelling or a lump in the testicle area
  • Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality

It is suggested to see a doctor if you:

  • Are unable to conceive a child after a year of regular, unprotected sexual intercourse
  • Have erection or ejaculation problems, low sex drive, or other problems with sexual function
  • Have pain, discomfort, a lump or swelling in the testicle area.
  • Have a lower than normal sperm count (fewer than 20 million sperm per milliliter of semen)
  • Have a history of testicle, prostate or sexual problems
  • Have had groin, testicle, penis or scrotum surgery

Risk factors linked to male infertility:

  • Being age 35 or older
  • Smoking tobacco
  • Abusing alcohol
  • Using certain illegal drugs
  • Being overweight or underweight
  • Having certain past or present infections
  • Being exposed to toxins
  • Overheating the testicles
  • Having a prior vasectomy or vasectomy reversal
  • Being born with a fertility disorder or having a blood relative with a fertility disorder
  • Having certain medical conditions, including tumors and chronic illnesses
  • Undergoing medical treatments, such as certain medications, surgery or radiation for cancer
  • Bicycling for prolonged periods, especially on a hard seat or poorly adjusted bicycle

Our physicians are certified through the American Board of Urology.

Conception Factors

Conception is a complex process that depends upon many factors: the production of healthy sperm by the man and healthy eggs by the woman; unblocked fallopian tubes that allow the sperm to reach the egg; the sperm's ability to fertilize the egg when they meet; the ability of the fertilized egg (embryo) to become implanted in the woman's uterus; and good embryo quality. Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman's hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result.

Male infertility can be related to a man's inability to produce sperm cells, known in medical terms as azoospermia. Or it can be related to the production of low or poor quality sperm, oligospermia. Other problems that can occur include malformed sperm that cannot live long enough to fertilize the egg and genetic diseases that impair fertility.

Additional Factors

The medical issues are only one side of the story behind male infertility. It is much more difficult to describe the psychological and emotional impact infertility has on a couple who want to have children. Many times, the desire to conceive a child becomes the total focus of their lives. Feelings of depression, loss, grief, inadequacy and failure are common in men as well as women trying to conceive.

Individuals or couples experiencing any of these feelings are encouraged to seek professional help from a counselor or psychologist experienced in dealing with infertility issues. A professional can help you deal realistically with the situation and provide support even while you are going through treatment.

Diagnosis & Treatment

Diagnosis begins with a complete physical examination of the man to determine his general state of health and identify any physical problems that may impact his fertility. The doctor also interviews the couple about their sexual habits. If the physical examination and history do not indicate any reason for the couple’s inability to conceive, the next step is to conduct testing to identify the cause of infertility.

With modern technology and methods, the number of treatment options for male infertility has expanded. Depending on the cause of infertility, a surgical procedure may be necessary to correct a defect or remove an obstruction. The most common procedures performed here include vasectomy reversal and varicocele repair which are performed in an outpatient setting. In either procedure, the surgeon reconnects the vas deferens, the tube in the scrotum through which the sperm passes.

Blockages in the vas deferens are repaired with a similar technique. The vas deferens is surgically split, the blockage is removed, and the ends of the tube are reconnected. When the original vasectomy was performed many years previously, an additional blockage may have formed in the epididymis, the coiled tube that lies against the testicle where sperm cells mature. Blockage at the epididymis also can occur due to infection or injury. Whatever the cause, the surgeon will fix the problem by bypassing the blockage in the epididymis in a procedure called a vasoepididymostomy.