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Common causes of fertility problems in men
By the BabyCenter editorial staff
Between 10 and 15 percent of all couples in the
United States have fertility problems. (About 35 to 40 percent
of cases can be attributed to problems in the man, 50 percent
to problems in the woman, and the rest to unexplained causes and
multiple factors involving both partners.) If you've had unprotected
sex for more than a year (or six months if you're over 35) without
conceiving, see your doctor. Nearly 90 percent of fertility problems
can be pinpointed and the vast majority treated. Read on to learn
about the common culprits, typical treatments, and percentages
of couples who go on to become pregnant. (Keep in mind that the
percentages may vary, since one couple can have multiple problems.)
Blocked tubes
If your vas deferens or epididymis tubes are blocked or damaged,
they can prevent your sperm from getting to your partner's egg.
• Possible symptoms: None.
• Possible solutions: Surgery to repair an obstruction
or obtain a collection of sperm, followed by in vitro fertilization
(IVF) or intracytoplasmic sperm injection (ICSI).
• Success rates: About 50 to 80 percent of men have sperm
in their semen after surgery, but less than half impregnate their
partner within a year. About 25 to 40 percent of couples conceive
with IVF or ICSI.
Varicocele
Varicocele (enlarged veins, similar to varicose veins, in the
scrotum) increase the temperature in the testes to the point of
inhibiting sperm production.
• Possible symptoms: None. (The problem may be detected
through a semen analysis and a physical exam.)
• Possible solutions: Surgery to repair the varicocele.
• Success rates: About 30 to 35 percent of men impregnate
their partner within a year of surgery.
Irregular sperm
If you have little to no sperm, poor sperm motility (its ability
to move), or abnormally shaped sperm, it may not be able to fertilize
your partner's eggs on its own.
• Possible symptoms: None.
• Possible solutions: Fertility drugs, artificial insemination
with donor sperm or with your own if your count, shape, and motility
are not too abnormal, or intracytoplasmic sperm injection (ICSI).
• Success rates: Nearly 25 percent of men impregnate their
partner with fertility drugs and artificial insemination; 5 to
20 percent succeed with an artificial insemination cycle; and
24 to 32 percent succeed with ICSI.
Sperm allergy
Your body can develop antibodies that kill your own sperm, most
commonly after a vasectomy, testicular torsion (where the testicle
twists inside the scrotum), infection, or trauma.
• Possible symptoms: None.
• Possible solutions: Artificial insemination or assisted
reproductive technologies (ART). (Immunosuppressive drugs such
as cortisone and prednisone are sometimes used, but many doctors
don't recommend them.)
• Success rates: About 20 to 40 percent of men impregnate
their partner with treatment.
Unexplained fertility problems
Your doctor may diagnose you with an "unexplained fertility
problem" if he or she can't pinpoint the cause of your trouble
conceiving. Some experts think environmental toxins may be contributing
factors, but have confirmed no direct links between fertility
and these possible problems.
• Possible symptoms: None.
• Possible solutions: Fertility drugs with artificial insemination
or assisted reproductive technologies (ART) procedures such as
in vitro fertilization (IVF).
• Success rates: About 7 to 17 percent of couples with
unexplained fertility problems conceive with fertility drugs and
artificial insemination. About 20 percent conceive with in vitro
fertilization. After three years of treatment, the chance that
a couple will conceive decreases by about 20 to 25 percent each
year.
Combination fertility problems
A couple is said to have "combination" fertility problems
when both the man and the woman have fertility trouble, or when
one partner has multiple problems.
• Possible symptoms: Symptoms vary, depending on causes.
• Possible solutions: Treatments vary, depending on causes.
• Success rates: Rates vary, depending on causes.
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