Exploring male fertility problems
When evaluating couples who are having difficulty conceiving, it is not uncommon to find that the male partner may have an abnormal semen analysis. In fact, 40% of the causes of infertility are due to the male. It is very important to take a medical history from the man in the initial appointment. This is the first step to solve male fertility problems.
Lifestyle choices causing male fertility problems
Some men use anabolic steroids for body building. Steroids suppress the hypothalamic pituitary area lowering the stimulation of the testicle. As a consequence, sperm production can drop dramatically. This is similar to a woman using an oral contraceptive agent (birth control pill).
Other men smoke cigarettes or marijuana. Marijuana lowers the production of testosterone. It also increases the production of estrogen, a compounding negative effect on sperm production. Likewise, smoking has a detrimental effect on sperm function.
If the man is overweight, his excess fat increases the conversion of the male’s testosterone to estrogen. Fortunately, these adverse effects are usually reversible. Therefore, changing these social habits and improving the man’s general health can lead to an improvement in sperm production.
Physical examination of the male partner
When the evaluation of the semen is abnormal, the man should go to a local urologist for an evaluation. Usually the urologist will perform a “pelvic exam.” This consists of examination of the testicles and a rectal exam to evaluate the prostate gland.
The prostate gland produce approximately 1/3 of the semen (the liquid portion of the ejaculate). Inflammation of the prostate gland can result in the production of inflammatory white cells. These white cells can result in the development of reaction oxygen species (ROS) in the semen. ROS can cause male fertility problems.
Varicoceles are one of the common findings of the male examination. This is a swelling of the testicular vein in the scrotum. Occasionally, the urologist may recommend varicocele repair. However, results of the procedure have been mixed with some men showing an improvement of the sperm motility and morphology.
Hormone evaluation and Low-T. Also, it is important for the evaluation of the male to include a hormonal evaluation. A serum FSH and a serum testosterone are critical to ensure that the testicles are functioning properly.
Clomid use for male fertility problems
If a man has a low serum testosterone with either a low or normal serum FSH, he is a candidate for clomiphene therapy. Clomiphene acts on the hypothalamic-pituitary area of the brain. It stimulates the release of FSH and LH. These hormones stimulate the ovary in women and the testicle in men. Therefore, this medication can be helpful for men.
Our doctors may also recommend intrauterine insemination (IUI) or in vitro fertilization (IVF) to help with male fertility problems. Contact us to learn more.