For Male Fertility, Hormones Matter
Male-factor infertility refers to men who are unable to conceive naturally after at least 12 months of consistent sexual intercourse with a partner. About 15% of men struggle with infertility and are linked to at least 30% of all cases involving couples. Most cases are due to poor sperm health. Low sperm count, poor sperm motility, or morphology are common reasons for infertility. Men require a healthy balance of hormones to produce high-quality sperm. If there is a hormone imbalance, sperm production can suffer. Identifying hormone imbalances sets the stage for treatment that can boost fertility and ultimately lead to pregnancy.
These hormones support male fertility
Men produce multiple hormones that are vital for healthy sperm production. When people think of male fertility, testosterone comes to mind. Testosterone does help with male virility, sperm production, and sexual characteristics in men. While essential, however, other important hormones that impact fertility. Follicle-stimulating hormone (FSH) stimulates sperm production in the testes. Luteinizing hormone (LH) triggers the production of testosterone. Both FSH and LH are released by the pituitary gland but only happens thanks to gonadotropin-releasing hormone (GnRH) released by the hypothalamus. In other words, male fertility depends on this delicate dance between the hypothalamus, the pituitary gland, and the testes. Other hormones like estradiol, insulin, and prolactin play supportive roles in male reproductive health.
Signs your hormones are off-kilter
Men can experience changes and symptoms that can indicate hormone imbalances. Low testosterone levels can signal decreased libido, erectile dysfunction (ED), and decreased motivation. Some men may notice a loss of muscle mass, increased body fat around the midsection, and insomnia. Cognitive symptoms like difficulty concentrating or memory problems can also occur. Some men will have trouble conceiving or notice a decrease in semen volume during ejaculation. These symptoms can vary widely and can even be intermittent. If the goal is to increase fertility while improving general health, these symptoms should prompt a visit to the doctor. There are 3 useful treatment options available if male-factor infertility is a challenge.
1. Medication to reboot your system
A blood analysis can reveal a severe deficiency in hormones like testosterone, FSH, LH, and GnRH. These markers can vary by individual based on factors such as age, pre-existing conditions, and use of medications. A fertility specialist or endocrinologist can create a custom hormone replacement therapy (HRT) to improve symptoms and fertility. Clomiphene citrate is a common hormone drug that increases FSH and LH production and, therefore, fertility. If there are potential pituitary gland issues, gonadotropins can be used to provide direct doses of FSH and LH. Consistent monitoring through blood tests can determine effectiveness and optimize treatment.
2. An hCG over TRT protocol
Low testosterone can reduce sexual desire and disrupt sperm production. As a result, the higher levels of estrogen can disrupt fertility. Testosterone replacement therapy (TRT), which provides synthetic doses of testosterone, can help with most symptoms but can severely impact fertility. The high dose of testosterone will reduce LH production, thereby disrupting sperm quantity. An hCG medication may work in this case to mimic LH. This can stimulate testosterone production without reducing sperm count. Aromatase inhibitors can also help balance testosterone-to-estrogen ratios. The medical team will determine which combination of hormone medication will provide the best possible outcome.
3. Consider assisted reproductive technology (ART)
Some men will need additional support to increase the chances of pregnancy with a partner. There are several strategies called assisted reproductive technology (ART) that can support male-factor infertility. Intrauterine insemination (IUI) inserts a concentrated sperm sample into a woman’s uterus to assist with pregnancy. If multiple cycles of IUI fail, in vitro fertilization (IVF) is a more effective method. Sperm and egg samples are combined outside of the body in a fertility laboratory. The resulting embryos are then surgically implanted into the uterus, usually one per cycle, to achieve pregnancy. IVF, along with strategies like intracytoplasmic sperm injection (ICSI) and genetic testing, can support the family planning process.
Spot and snipe those hormone imbalances
Hormones play a vital role in male fertility. A severe imbalance of testosterone, FSH, LH, or other key hormones may be the underlying reason for conception troubles. Hormonal imbalances present multiple symptoms and can be spotted by men and doctors. If hormone troubles lead to infertility, there are treatment options, like medication, IUI, and IVF, that can help. Each step has different requirements, with IVF being the most complex and demanding for couples. However, this may be the most effective solution in some cases. Male-factor infertility is treatable with the proper diagnosis and fertility team guiding the process.
