Defining Infertility

Infertility is the failure to conceive after 1 year of unprotected sex. Approximately 11% of women and 9% of men have trouble conceiving. Infertility presents differently in men and women due to differences in the reproductive system. In men, infertility affects the testicles and sperm.

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What causes male-factor infertility?

Male infertility occurs due to a variety of reasons. One of the reasons could be a genetic disorder like myotonic dystrophy. Another reason could be an untreated sexually transmitted disease (STD) like chlamydia. Environmental factors like heavy drug and alcohol use and cigarette smoking can cause infertility. Some men develop infertility due to cancer treatments like radiation or prolonged exposure to harmful chemicals.

What is a low sperm count?

The medical term for low sperm count is oligospermia. A normal sperm count has 15 to 200 million sperm per 1 milliliter of semen. Low sperm count is defined as less than 15 million sperm in 1 milliliter of semen. If there is no sperm whatsoever present in the semen, this is called azoospermia. A semen analysis can be used to determine sperm count.

The semen analysis

The semen is collected through ejaculation and sent to a lab for testing. The sperm is collected at a private facility, like a doctor’s office, and the sample is placed in a sterile container. However, patients can also collect the sample at home if preferred. Patients should refrain from sexual activity for up to a week before collection.

Analyzing the sample

A semen analysis evaluates the quality and quantity of sperm by assessing concentration, total motility, progressive motility, vitality, and morphology. Motility is the movement of sperm. This is important because the sperm needs to swim to fertilize the egg. Low motility can contribute to infertility. Vitality refers to the amount of live sperm in a given sample. A normal vitality rate is 50%. If the sperm is dead, the sperm cannot fertilize the egg. Morphology is the shape of the sperm. Each sperm has a head, midsection, and tail. Abnormally shaped sperm can cause issues with fertility.

Next steps

Once doctors have identified a low sperm count, treatment options can be identified. If infertility is caused by a medical condition, then this condition must be treated or managed. For example, varicocele is a condition causing enlargement of the veins in the scrotum. Doctors treat this condition by performing surgery to cut some of these veins to reduce enlargement. The doctor might also suggest trying in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or intrauterine insemination (IUI) to improve success.

Talk to the doctor

Patients struggling with male-factor infertility should speak to a doctor about the causes of infertility and the best treatment options. Pregnancy is usually still possible with the proper fertility intervention, even when the sperm quality isn’t great.

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