Infertility has traditionally been thought of as a woman's problem. But as
it turns out, we men don't get off that easily. About one out of every three
cases of infertility is due to the man alone, and we're somehow involved in
infertility about half the time.
A diagnosis of male infertility can be one of the hardest challenges a man
can face. For some, it can be devastating. After all, the necessity of
reproduction is one of the few things on which both Darwin and the Bible agree.
Not being able to father a child can make a guy feel like he’s failing at one
of his most primal responsibilities.
It may seem a peculiar American vanity that men have in-boxes full of hair
loss treatment offers and spend billions of dollars on hair loss treatments
each year. Not so. As Gersh Kuntzman illustrates in his book Hair! Mankind's
Historic Quest to End Baldness, chrome-dome anxiety has tormented us for
ages. Caesar's laurel wreaths? Classic red herring, Kuntzman says.
Baldness is biblical, too -- from the Maccabees to Samson and Delilah (a
story Kuntzman calls "practically a commercial for Propecia")...
Unfortunately, some men have to cope with the reality that nothing can be
done about their infertility. But for other men, advances in male infertility
treatment offer real help.
Understanding male infertility: Sex Ed 101
To better understand infertility, here's a refresher course on the birds and
the bees. (Anyone caught giggling will have to stay after class.)
Sperm are made in the testicles. They're then stored inside yards of
“plumbing” called the epididymis, which lies on top of each testicle. Sperm are
nourished by semen, which is made by glands along the way. When the magic
moment arrives, about 150 million sperm are ejaculated in a half-teaspoon of
semen through the penis.
This whole process hinges on there being proper levels of testosterone and
other hormones as well as correct signaling from the nervous system.
Women ovulate — send an egg down into the uterus — once a month. This
happens about 14 days after menstruation. Sex any time in the five days before
ovulation can create a pregnancy. Sex any other time, even the next day after
ovulation, will not result in conception.
“We generally advise couples to seek fertility evaluations if they are
unable to conceive after 12 months of unprotected intercourse,” says Lawrence
Ross, MD, president of the American Urological Association. About 85% of
couples will have had a pregnancy by that point. “If they are over 30, they
should seek evaluation after six months.”
Common causes of male infertility
The “male factor” contributes to infertility around half the time, and about
one third of the time, it's the main cause of infertility. Most often, the
problem lies in the process of either making or moving
Any of the following can cause a man to have a low sperm count or abnormal
Varicocele — an abnormal collection of bulging veins above the testicle;
they’re the most common cause of correctable male infertility, accounting for
38% of cases
Infections in the testicle (orchitis), the prostate (prostatitis), or
elsewhere in the body that causes a fever
Chemotherapy for cancer
Medicines such as anabolic steroids or anti-seizure medicines