Understanding how the male body works to facilitate reproduction is just as important as understanding the female’s side of the story.

Perhaps because most infertility diagnoses begin with a woman’s gynecologist, most couples are unaware of the fact that the man may be the sole or contributing factor in up to half of the cases of infertility.

Male factor problems can fall into a problem with production or obstruction. Production problems can start with erectile dysfunction. If this is the case, hormonal levels for testosterone, follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, and prolactin should be checked. Whether normal or abnormal we often refer men to a local reproductive urologist, Dr. Steven Shaban at Associated Urologists of North Carolina. Other problems with production may be related to testicular varicose veins, environmental exposure, and prior history of testicular or other cancer.

Obstructive issues are ones that impair the transport of sperm from the testes to the seminal ejaculate. Prior trauma or infection, surgery, failed vasectomy reversal, or congenital absence of the vas deferens are all causes of obstructive azoospermia, or lack of sperm in the ejaculate.  Again, consultation with Dr. Shaban or another reproductive urologist is recommended.

The best test for male fertility is a semen analysis. At Carolina Conceptions we ask our male patients to refrain from ejaculation at least two but not greater than five days prior to submitting a specimen. The ejaculate can be produced at home and brought to the office if delivered within approximately 30 minutes after ejaculation. Appointments are available for all weekdays, as well as the first and third weekend of each month.

Results will often be emailed back to the patient on their appointment day. If abnormal, we suggest that the process be repeated in six to eight weeks. If the sperm count is extremely low, we will ask that in addition to hormone values, he consider a chromosomal analysis which can contribute to low sperm counts in up 20% of cases.

Treatment options for male factor infertility include intrauterine insemination or in vitro fertilization with sperm injection (ICSI).

For more information about semen analysis:

Male factor infertility

The male infertility evaluation starts with a semen analysis and a medical history.  A second semen analysis is usually requested if the first one is abnormal.  Those with consistent abnormal results are referred to a urologist who specializes in male fertility.  We refer to Dr. Stephen  Shaban at Associated Urologists of North Carolina.   Mild abnormalities can often be treated with medications and intrauterine insemination (IUI).  More severe sperm abnormalities often require in vitro fertilization (IVF).