Struggling with getting pregnant? You’re not alone. Infertility is a common problem among couples, and though we talk about it as a women's issue, men deal with it, too. When infertility due to problems in men, it’s known as “male factor infertility.”

The fact is that fertility issues are just as likely to arise from problems in men as they are in women. It’s estimated that 30-50% of couples struggling with infertility are cases of male factor infertility. 

What is infertility?

85% of couples get pregnant within one year of trying. Those who don’t are labeled infertile. Fertility declines with age, so for couples 35 and over, if they are not pregnant, then they should have an evaluation after six months.

Because of this, male-female partnerships trying to conceive have a gauge of their (in)fertility. What about gay men seeking biological parenthood? There isn’t a clear guideline. However, there is testing that can be done and, depending on the results, some solutions that may optimize your chances of genetically-related children. 

Fertility is determined by a number of factors, including hormone health, sperm quality and structural issues that may impact the sperm’s ability to fertilize an egg. Before stepping on the path to parenthood, talk with your doctor about your options for testing.

One place to start that’s relatively quick, easy and cost-effective is a semen analysis. Sperm quality has seen a decline even in healthy, fertile men. The last ten years has shown a global decrease in normal sperm count and an increase in low sperm count. This follows a trend that was first observed over 40 years ago. 

No one can say the cause of decreasing sperm count, making it even more important to get your (or your partner’s) sperm analyzed early. 

What determines sperm quality? 

Sperm quality provides a window into the overall health and well-being. It’s negatively impacted by lifestyle factors like smoking and alcohol consumption, and improved by good diet, exercise and sleep. It tends to decrease with age. 

Sperm quality is not the ultimate decider of fertility--we’ll get to other potential problems in a moment--but there’s no doubt that it’s essential to conception and growing a healthy baby.

Your analysis will measure three main factors:

• Count, or the concentration of sperm in a given amount of semen. More isn’t necessarily better, but less is problematic. Anything below 15 is considered low. 
• Morphology, or the size and shape of the sperm. Sperm must be a certain shape to be able to penetrate an egg. You want 4% of your overall sperm count to be a normal shape.
• Motility, or a sperm’s ability to swim, as measured by the percentage of moving sperm in a semen sample. Ideally about half will be motile.

The analysis will also provide information on the chemical makeup of your semen sample, indicating if the environment is too alkaline or too acidic; too thick or watery; and if the volume is right. Too little could indicate a blockage or production issue in the seminal vesicles.

Your doctor will help determine your course of action. Note that spermatogenesis, the process by which new sperm are created, takes about 3-4 months. If you make any lifestyle changes in hopes of improving quality, expect  it will take about that long to show up on your next analysis.

What are some common causes of male infertility?

Some of the most common causes of male infertility are:

• Sperm production disorders
• Production of sperm can be inhibited in men who have had a vasectomy. It can also come from a varicocele, or enlarged vein(s) in the scrotum. Typically a varicocele is easily repaired.
• Structural abnormalities
• Sometimes the reproductive tract gets blocked, which can partly or completely block semen (and the sperm inside). Blockages can result from surgeries and/or infections, and sometimes they’re present from birth. 
• Immunologic disorders
• Endocrine (hormone) disorders can keep sperm from successfully meeting and fertilizing the egg in the woman’s genital tract.

Other tests are available, including blood work and more in-depth testing of sperm and DNA. You may wish to have more tests done, or your doctor may call for them. Of course,  if you have any concerns about your health, or if you experience difficulty with ejaculation, talk to your doctor right away to address any problems early.

What can I do if I’m infertile?

First, know that it can be a difficult journey and you’re not alone. There is nothing wrong with you and you still have options for your family. 

Many couples with male factor infertility successfully grow their families through assisted reproductive technologies like IVF. 

It isn’t the only option that’s available, however. 

• Sperm freezing can preserve high quality sperm (if you’re concerned about the effects of aging, about to undergo chemotherapy treatment, starting on hormones for a gender transition--or any other number of factors). 
• Sperm retrieval enables men with little or no sperm in their semen (azoospermia), or who have issues ejaculating, to still use their sperm in IVF.
• Sperm donors enable couples to have babies biologically or through a surrogate. 
• IVF and surrogacy can together provide an option for couples, especially gay fathers, to have the families they’ve always dreamed of. 

Read more about male infertility treatment options ►

And finally, we cannot encourage you strongly enough to take care of yourself. Good health helps sperm. Studies have shown that alcohol intake--even just a few beers a week--negatively impacts IVF outcomes. It isn’t just about your reproductive health, though. 

Trying to conceive is often a stressful experience for couples, and especially for the individual with a diagnosis of infertility. The best thing you can do (for yourself and each other) is take good care of yourself. Getting adequate sleep, exercise  and nutrients (both by diet and supplements) is important for your mental health and your relationship. 

We have a team of specialists ready to assist you in growing your family. Let us worry about the testing, the results and providing the best options for your family. Your job is to ensure that you’re healthy and happy so you have the best chance at successful procedures. And, when they are successful, that you’re in good enough physical and emotional shape to go on the wildest journey of your life.