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The Basics of Male Factor Infertility


It’s Not Just a Woman’s Problem

Throughout history people have thought of infertility as something that happened only to women—and if men were affected by it, it was shameful.  The woman usually took the blame and was called “barren.”  But a man who couldn’t father children was held to be “less of” a man.

Modern medicine has done much to turn this upside down.  It’s now known that about one-third of infertility cases are caused by women’s problems, one-third by men’s problems, and the remaining one-third have problems on both sides, or have no apparent cause.

The emotional aspects of infertility affect men as well.  Let’s take a look at the physical causes and emotional effects of infertility in men.

Male Factor Infertility

For men, fertility is all about the sperm: its quality, quantity, and delivery to the woman’s uterus.  Common tests for male factor infertility are semen analysis, a physical exam, and blood tests.  These tests are used to determine sperm volume, its shape (morphology) and ability to swim (motility), and to determine if there are physical problems with the testicles.

One of the most common problems is varicocele.  This happens when the veins on a man’s testicle(s) are too large. This heats the testicles, and the heat can affect the number or shape of the sperm, according to  Sometimes men have genetic problems that affect their sperm or the delivery system.  Environmental and lifestyle factors can also damage sperm, including heavy alcohol use, drugs, smoking, exposure to environmental toxins, and having had mumps or had radiation treatment or chemotherapy for cancer.

Emotions of Infertility

Just like the physical causes of a couple’s infertility, men as well as women experience the emotional  side of having trouble conceiving.  Men tend to react differently than women do, often stifling their emotions and not reacting unless they are at the doctor’s office or in the bedroom, according to RESOLVE, the National Fertility Association.  But not being able to father a child easily can make men feel inadequate, angry, or hurt.  The male partner also has to cope with the female partner’s emotions, which often involve grief, loss, anxiety and depression.  Both partners may feel guilty that they can’t just get pregnant “like other people do.”

If a couple has begun fertility treatment, they’ve embarked on an emotional roller coaster.  Every IVF cycle is a cycle of excitement and fear, hope and, in some cases, disappointment and grief.  For some people, the feeling of loss of control over their bodies is the most distressing aspect.

What Can You Do?

The good news is, many causes of male factor infertility can be treated or can be accommodated in fertility treatment.  Lifestyle changes like losing weight, stopping smoking and cutting back on alcohol can make a difference in sperm health.  There are many fertility treatment options, from intrauterine insemination (IUI) in mild cases, to IVF treatment with ICSI, intracytoplasmic sperm injection.  IVF with ICSI allows the sperm to be injected into the egg, bypassing any physical issues.  When you consult a reproductive endocrinologist, the test results of both partners will help your doctor develop a personalized treatment plan for you both.

Dealing with the painful emotions of infertility is also part of fertility treatment.  These emotions are very normal, and very common.  Most fertility centers offer counseling and support groups to help couples cope with the anxiety and stress of infertility and fertility treatment.  RESOLVE also has support groups in several cities.  And in large metro areas there are therapists who have experience counseling people struggling with infertility, both men, women and couples.