When you’ve been trying to conceive for longer than you anticipated, you should turn to your doctor. While many pregnancies are achieved with little or no medical assistance, many couples do have difficulty and seeing your OB/GYN early in the game is your best bet for reassurance, or for the recommendation to see a fertility specialist sooner. While you may be inclined to dance your way back to your car after getting a thumbs-up from your OB/GYN and a refill on your prenatals, remember it does take two. So if it continues to take months upon months of trying without success, you may consider an evaluation for male factor infertility.
Male factor infertility can be fairly easy to diagnose once a semen analysis is performed, but this important step is sometimes overlooked or put off. Anxiety and embarrassment about the test itself, or fear of the results may delay diagnosis or treatment – many men fear that a lack of fertility affects their masculinity (so not true!). Many people still view infertility as a woman’s problem, but it is clearly not. According to the CDC, one third of all infertility cases are related to female problems, one third are comprised of male factor conditions, and the remaining third are due to a combination of both or unexplained (idiopathic) infertility. While women can track their menstrual cycles and try at-home ovulation predictor kits, it may be harder to ‘suspect’ male issues, but there may be subtle clues. Smoking, excessive alcohol use and obesity can negatively impact male fertility. In addition, some clues that may lead you to suspect a male factor are:
- Low libido or difficulty maintaining an erection. While both can be caused by stress if experienced only rarely, these problems could also indicate a hormonal or anatomical problem that could be causing infertility if they are experienced often.
- Sparse body hair, low muscle tone, breast growth (gynecomastia) or small testicles. While some men are naturally hairier or more muscular than others, being less so doesn’t mean infertility per se, but some genetic and hormone abnormalities can cause a lack of hair, muscle and smaller testicles. Think of testicles as ovaries- they need to contain the cells necessary for reproduction and they need to secrete hormones, if they seem abnormally small there could be a problem. Another clue is gynecomastia, or male breast growth that can indicate hormonal imbalances.
- Absence of ejaculation with orgasm. While a normal ejaculate is only a 2 -3 milliliters it should contain millions of sperm. If your partner is able to orgasm without releasing seminal fluid, or only releases a super-small amount (a drop or two) it could be an anatomical factor such as retrograde ejaculation (the ejaculate goes into the bladder instead of outward).
- Unusual lumps, bumps, pain or swelling in the genital area. It is possible to have an infection or a varicocele (a varicose vein) in the genital area that will result in increased inflammation and/or heat and cause damage to the sperm being produced.
- A prior infection or surgery in the genital area. Surgery, such as correcting an undescended testicle(s) can leave behind scarring (which can prevent sperm from making its way from the testicles into the seminal fluid). Prior inflammations or infections (like STD’s, mumps or a traumatic injury to the testicles) can result in anti-sperm antibodies-which affect the ability of the sperm to swim well-making it difficult to penetrate an egg and create a pregnancy.
- Inability to conceive a child after a year of regular, unprotected intercourse. Especially if there is no known female factor (this doesn’t rule out idiopathic, or ‘unknown’ infertility, however). You may or may not have ‘symptoms’ of male factor infertility, but if any of the above apply to you a referral to a specialist is warranted. Fertility Solutions physicians have treated hundreds of couples with male factor and combination issues, and are able to offer fertility testing at their in-house state of the art laboratory. The first step is pin-pointing the problem, and then creating a plan to fix it.