An interview with Dr. Akanksha Mehta, Emory University School of Medicine
Noam: So, I’ve been charged with the task of interviewing you to learn more about male infertility. Can you tell me what is male factor infertility?
Dr. Mehta: Male factor infertility refers to any health issue in a man that lowers the chances of his female partner getting pregnant.
Noam: Is it common?
Dr. Mehta: Yes, it is present in over one third of couples who have trouble conceiving.
Noam: What are some cause of male factor infertility?
Dr. Mehta: Normal male reproductive function is dependent on the interaction between genetic factors, circulating hormone levels, and environmental influences. As a result, many different causes of male factor infertility are possible.
Noam: Is there anything that can be done to help?
Dr. Mehta: Workup for male infertility includes a detailed physical exam, combined with semen analysis, serum hormone evaluation, and, if indicated, additional genetic testing, imaging, or tissue biopsy. Taken together, the results of this evaluation can help identify correctable causes of male infertility.
Noam: So infertility can affect men just as it can affect women?
Dr. Mehta: Historically, discussions about infertility have focused on female factor infertility. However, infertility is clearly a problem shared by the couple, and must be faced as a team. A diagnosis of male factor infertility affects all aspects of a man’s life.
Noam: In what ways does infertility affect a man’s life?
Dr. Mehta: Medically, a diagnosis of infertility can be worrisome because it may be an indicator of a potentially serious underlying medical condition. Psychologically, a diagnosis of infertility can lead to profound feelings of guilt, anger, and low self-esteem.
Noam: Do you have any parting information or advice for someone who may have infertility?
Dr. Mehta: Many male fertility issues can be treated medically or surgically by a urologist. Therefore, couples who experience difficulty conceiving should not hesitate to seek a male fertility evaluation in addition to a female fertility evaluation.
”Couples who experience difficulty conceiving should not hesitate to seek a male fertility evaluation in addition to a female fertility evaluation.Dr. Mehta
Additional Information about Male Factor Infertility:
- Low levels, or complete absence of sperm in the ejaculate, can be due to a blockage or a production problem. Even if sperm are present in normal numbers in the semen, they may be abnormal in their ability to swim to and fertilize an egg. Some of the most commonly encountered male infertility problems are summarized below:
- Blockages in the male reproductive tract can be congenital, or result from prior infection, trauma, or surgery. In many cases, blockages in the reproductive tract can be corrected with reconstructive surgery. When reconstructive surgery is not possible, sperm can be retrieved through an office-based procedure, for use with fertility treatments.
- A varicocele refers to abnormal veins surrounding one or both testes. They have the potential to decrease testicular function, both in terms of hormone production and sperm production. Varicoceles are the most common surgically correctable cause of male infertility, and varicocele repair is associated with improvement in both sperm count and quality.
- Problems with circulating hormone levels can occur for a variety of reasons, but can often be treated with hormone supplementation that supports and enhances testicular function, including sperm production.
- There are many medical conditions and medical treatments that can impair sperm production and sperm quality. Of these, a diagnosis of cancer is probably the most devastating. There are several different options for fertility preservation for men with a history of cancer, as well as those about to embark on cancer therapy, to provide them with options for family building in the future. Fertility preservation is also possible for men with non-cancer based diagnoses that affect their fertility, such as Klinefelter syndrome.
- Sexual disorders, such as problems with ejaculation, can affect the ability of sperm to naturally reach and fertilize the egg in the female reproductive tract. Medications or office-based procedures can be used to treat ejaculatory problems and help couples achieve pregnancy.