Causes of Infertility in Males and Possible Treatments at Our North Houston Fertility Clinic

The role of sperm is half the battle. Oftentimes, the presence of male infertility is overlooked in a world where female age and its known detriment on egg quality plays such a large part. It’s estimated that 30-50% of couples struggling with infertility are cases of male factor infertility. 

There are four main causes of infertility in males:

1. A hypothalamic or pituitary disorder (1-2%)
2. Gonad disorder (abnormal sperm parameters) (30-40%)
3. Sperm transport disorder (10-20%)
4. Unknown causes (40-50%)

For years, scientists have been in search for additional causes of male infertility. Oligospermia, low sperm count, is the most notable of causes of infertility in couples. However, other “unknown” causes may be playing a larger role than the media gives credit. These may include structural abnormalities such as varicoceles that may reduce sperm production, blockages in the reproductive tract, immunologic disorders, endocrine disorders, and genetic mutations. 

Researchers estimate that genetics could explain up to 50 percent of these cases, but many of the genes involved in male infertility remain unknown. Within the past decade, male infertility workups have more frequently included the investigation of microdeletions and other genetic mutations that are known to be involved to determine the cause of infertility in hopes of preventing its passage, when possible, to future generations. These genetic screenings are more commonly performed in individuals with known abnormalities in semen analysis. Recent news highlights a new genetic variant that researchers have discovered. They found that disruptions in SYCP2 were far more frequent among men with infertility and low sperm count than in the general population. Advancements in techniques that enable gene manipulation give hope to one day fix these errors and improve fertility outcomes. 

In some situations, male sperm parameters are all normal, however male infertility may still exist. Researchers recently have shown that using newer genome-wide DNA sequencing tools, the precise genetic locations of retained histones may be able to shed light on the causes of male infertility in the setting of normal semen analysis testing. At HART Fertility, we provide a multitude of genetic screening options available to you. 

Unfortunately, currently, there are not a lot of interventions that exist to help increase semen parameters if they are abnormal. Studies do show that avoiding exposure to excessive temperatures (saunas, hot tubs, etc), limiting alcohol intake, avoiding hormone supplements, eliminating smoke exposures, and controlling stress can help to improve sperm quantity and quality. Urologists and infertility specialists may attempt treatment with clomiphene citrate to improve semen parameters, however, studies showing the impact of this remains controversial. Less commonly, the use of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) have been shown to improve semen parameters in patients with suspected hypogonadotropic hypogonadism. 

Myths:

• Using your laptop on your lap
• Being too close to the computer or tv screens
• Tight underwear
• Supplements don’t work

Facts:

• Smoking damages sperm through DNA degradation
• Alcohol will adversely affect your sperm
• Weight- both obesity and low body weight can have an impact on sperm parameters
• Avoid excess exposure to radiation and chemical toxins such as pesticides and insecticides
• Vitamin C, Vitamin E, and Zinc have all been linked to sperm quality

Sperm transport disorders may require surgical correction of abnormalities or in some cases use of microsurgical aspiration or extraction via testicular biopsy. These procedures are typically recommended and performed by a certified urologist. Sperm freezing and storage (cryopreservation) may also be implemented for future use. At HART Fertility, we can help you arrange this option.  

Treatments such as intrauterine insemination (IUI) and in-vitro fertilization (IVF) help improve fertility rates in a statistically significant way. IUI involves the placement of sperm directly into the woman’s uterus when she is ovulating. The recommendation is a minimal of 10 million sperm on routine semen analysis testing. IVF may be advised if your sperm counts are low or abnormal motility is noted and techniques used to increase fertilization rates may be implemented. 

Whether your cause of infertility is known or unknown, if you are having difficulty conceiving, please contact us. Evaluation by a fertility specialist is pertinent to optimizing your chances of success. Let the physicians at HART Fertility help give you the best chance at achieving your goals.