If you and your partner have been trying to get pregnant for a year without success, one of you may have a fertility problem. Although the blame for infertility has often been attributed to a problem with the woman, the truth is infertility can be an issue for either partner.
Here’s a quick review of the reproductive process, plus what you need to know about male infertility and how it can affect your chances of getting pregnant.
Most women are familiar with their own reproductive system. Every month your body prepares your uterus to receive a fertilized egg. Around the middle of your cycle, your ovaries release an egg. This is ovulation.
If you have sex and a sperm reaches the egg to fertilize it, the egg can implant in the wall of your uterus so you can become pregnant. If the egg is not fertilized, it leaves your body during your menstrual period.
That cycle repeats every month during your childbearing years.
Many women are less familiar with what happens in their partner’s body that makes getting pregnant possible. A man’s reproductive system is different from a woman’s. Most of it is on the outside of the body instead of inside.
Men produce sperm in their testicles. During sex, sperm travel through small tubes that carry them from the testicles to the urethra, which is the tube that runs through the penis, and also carries urine out of the bladder.
Along the way, sperm are mixed with fluids from other glands to create semen. Semen contains nutrients needed by sperm to be healthy, and for energy that will move the sperm toward the egg once they are in the woman’s body.
During orgasm, semen containing approximately 150 million sperm is ejaculated through the penis into the woman’s body. Sperm then swim to the egg and penetrate the outer layer to complete fertilization and start a pregnancy.
In women, infertility may be caused by issues that prevent eggs from being released, prevent eggs from reaching the uterus, or prevent fertilized eggs from successfully implanting in the uterus.
Most causes of male infertility are involved in the process of either making or delivering sperm:
- Since men produce sperm in their testicles, they must have at least one functioning testicle in order to produce healthy sperm. Undescended testicles or high fevers can affect sperm production. Varicose veins in the scrotum, which are called varicoceles, can also limit blood flow to the testicles and reduce sperm production.
- Chemotherapy to treat cancer as well as certain medications such as anabolic steroids and anti-seizure drugs can also affect sperm production.
- Genetic problems and hormone imbalances can also result in abnormal sperm or low sperm production.
Low sperm count
Some men who produce normal sperm do not have a normal amount of sperm in their ejaculate. Fewer than 15 million sperm per milliliter of semen, or less than 39 million per ejaculation, is considered low. A low sperm count decreases the chances that you will get pregnant.
- Low sperm count may be due to a blockage caused by a genetic abnormality or a physical problem that keeps sperm from traveling out of the testicles to the penis.
- In some cases, the body perceives sperm as a foreign entity and produces antibodies to attack and kill sperm before they reach the penis.
- Lifestyle factors that can result in low sperm count include diet, exercise, drug or alcohol use, and infection.
Problems with ejaculation
- Premature ejaculation means orgasm and ejaculation occur sooner than desired. In some cases, this may mean before physical intercourse begins, which can limit the chances for sperm to reach an egg to fertilize it.
- Erectile dysfunction or impotence is the inability to achieve or maintain an erection long enough to have sex.
- Retrograde ejaculation means orgasm occurs but semen travels back into the bladder instead of out through the penis. This can be caused by certain medications, surgeries, prostrate issues and diabetes. Retrograde ejaculation does not affect the sensation of orgasm and does not need to be treated unless it interferes with attempts to get pregnant.
Low sperm motility
Once ejaculation occurs and sperm enter a woman’s body, they must essentially “swim” through her reproductive system in order to find the egg, penetrate it and complete fertilization. A man who produces an adequate number of sperm can still be infertile if his sperm are not effective. There are two basic issues with sperm motility.
- Low percentage of motile sperm – If fewer than 40 percent of sperm are active, the odds of achieving pregnancy are reduced.
- Quality of motility – If the sperm are not good swimmers, they may never reach the egg or penetrate it. Sperm should be actively trying to move forward, not moving slowly or sluggishly.
Other possible causes of male infertility include hormone imbalances, genetic diseases such as cystic fibrosis, and sexually transmitted diseases such as chlamydia or gonorrhea.
Treating male infertility
The first step in solving any fertility issue is getting an accurate diagnosis of the problem. In most cases, both partners should undergo testing for infertility issues in order to quickly find the problem so your attempts to get pregnant can move forward.
In the case of male fertility, this most often begins with providing a semen sample in the doctor’s office for testing. Your doctor will look at the number of sperm in the sample as well as the motility of the sperm. The appropriate next steps for treatment will depend on what the semen sample shows.
Problems with ejaculation may be resolved by correcting whatever is limiting ejaculation, such as changing medications or adding medications to help sustain erections.
Some men with low sperm count find that having intercourse every other day, rather than every day, around the time their partner is ovulating may help increase their sperm counts to improve their chances of getting pregnant.
Some couples choose to try aggressive medical intervention, such as intrauterine insemination or in vitro fertilization. If you are not ready for this level of medical assistance, or if you are not able or willing to spend the money required for those treatments, over-the-counter (OTC) treatments are also available.
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