How does lifestyle affect male fertility?

In many cases, male fertility can be addressed through lifestyle changes such as smoking cessation, decreased alcohol consumption, and improvement of overall health habits. For other cases, medications for male infertility includes drugs to improve sperm production, treat hormonal dysfunction, cure infections that compromise sperm, and fight sperm antibodies.

Other lifestyle factors include:

1. Certain medicines such as anti-depressants
2. Radiation treatment and chemotherapy for cancer
3. Environmental toxins, including pesticides and lead
4. Oxidative DNA damage
5. General health problems

What are common treatments for male infertility?

A male-fertility problem may be a simple as a hormone imbalance requiring hormone therapy. If so, a specialist can routinely treat any hormonal problem and utilize other specialists if needed.

If there is a structural or anatomical problem, an urologist traditionally treats the condition.

For men with oligospermia (low sperm count) and no other fertility factors in either partner, intrauterine insemination (IUI), one of two kinds of artificial insemination, can be a successful pathway to pregnancy.

Other cases benefit from the more precise treatment of in vitro fertilization (IVF), particularly when supplemented with intracytoplasmic sperm injection (ICSI), a laboratory process in which a specialist isolates a single sperm and then injects it directly into the egg.

In untreatable cases of male infertility, couples may elect to use donor sperm.

How does sperm washing work?

Sperm washing isolates and prepares the healthiest sperm for insemination.

Sperm and washing medium are combined and spun rigorously (centrifuged) and the process is repeated if necessary. The process separates sperm from white blood cells and fatty acids (prostaglandins) in the semen that may hinder sperm motility. It also concentrates sperm, which increases the chance for conception.

When do doctors have to perform sperm retrieval?

For men with spinal cord injuries or other neurological dysfunctions, electroejaculation is a procedure that can be used to produce ejaculation. An electrical rectal probe generates a current that stimulates nerves and induces semen to emit from the urethra for collection.

In other cases, urologists obtain sperm from the testes or epididymis when obstruction, congenital absence of the vas deferens, failed vasectomy reversal, or inadequate sperm production causes azoospermia.

A common technique is called micro epididymal sperm aspiration (MESA), in which a surgeon makes an incision in the scrotum and gathers sperm from the epididymis, the elongated, coiled duct that provides for the maturation, storage, and passage of sperm from the testes.

Percutaneous epididymal sperm aspiration (PESA, or fine needle aspiration) is similar to MESA but does not involve microsurgery. A physician uses a needle to penetrate the scrotum and epididymis and draws sperm into a syringe.

Testicular sperm extraction (TESE), the removal of a small amount of testicular tissue, is used to retrieve sperm from men with impaired sperm production, or when MESA fails.

Is age a factor in male infertility?

Increasing numbers of studies on age-related infertility in men indicate that passing years have an effect. As men age, testosterone production declines and this translates into reduced sperm production and a greater number of abnormally shaped sperm.

Research has also indicated that some genetic disorders are increased with paternal age. Men should seek medical counseling about this issue if they are older than 50 years.

Can male infertility affect offspring?

Some male-factor infertility causes have no added effects on offspring over naturally occurring rates. These include azoospermia (no measurable sperm) from a vasectomy or failed vasectomy reversal; infection; the inability to ejaculate due to a spinal cord injury; psychological causes; and retrograde ejaculation.

However, in cases of a congenital absence of key parts of necessary organs or of testicular insufficiency or failure (such as low to zero sperm counts and motility), additional tests may help rule out a genetic cause for problems that may affect offspring.

This can be important because there are many more genetic abnormalities associated with male infertility than in the female.