It takes two to tango, right? This is true beyond activities that involve your dancing shoes, and one such activity is reproduction and fertility. When you think of fertility or issues with infertility, your brain may first jump to issues that people with vaginas experience, but they aren’t the only ones!

People with male reproductive organs also experience infertility issues. The formal definition of ‘infertility' depends on how old you are. If you are 35 or younger, Infertility is defined as the inability to conceive after a year of frequent, unprotected sexual intercourse for a year or more. If you are 35 and older, the period of time used is shortened to 6 months of regular unprotected intercourse.

Dealing with infertility can be disheartening, stressful, and even a bit scary. Knowing the common issues, some early warning signs or symptoms and what type of doctors or treatment to pursue is helpful for couples who are  struggling with infertility can help you access the right information and care. Then you can get back to the fun stuff - tangoing.  

Common Male Fertility Issues

Male reproductive infertility has to do with sperm - the production, the quality and the dispersion. To get your partner pregnant, those with male reproductive organs must first have the ability to produce healthy sperm. When this does not happen, the overarching term of “male infertility” is used.  Sperm is produced in the testicles, and are then transported until they are mixed with semen and ejaculated.

There needs to be enough sperm in the semen, which is usually referred to as your sperm count. A sperm count fewer than 15 million sperm per milliliter of semen, or about 39 million sperm per ejaculation, is considered low. This condition is called oligozoospermia. Finally, the sperm must be mobile and functional in order to reach, penetrate and fertilize an egg.

It may be difficult to know if you or your partner suffer with male reproductive organ infertility until you are trying to get pregnant. Sometimes, there may be underlying issues, often hormonal or genetic, that may be blocking the passage of sperm, or interfering with the development of healthy sperm.  These can include:

• Difficulty with ejaculation or low volume ejaculation
• Decreased sexual desire
• Erectile dysfunction
• Pain or a lump in the testicle area
• Recurrent respiratory infections
• Inability to smell
• Abnormal breast growth
• Decreased facial or body hair

Additionally, those with male reproductive organs can get their sperm count checked to see if the count might be less than normal. Being overweight or obese, and consuming tobacco, are also related to male infertility.

Seeing a Doctor About Male Infertility

Infertility is common - it impacts about 1 in 7 couples who are engaging in frequent, unprotected sexual relations for over a year. And half of these cases of infertility are due to male infertility. 

Luckily, there’s doctors who can help. It's recommended to seek medical care after a year of trying to conceive if: your partner is over 35 or under 35 and have been trying for 1 year, if you are experiencing a low sexual drive, have a previous groin, testicle or scrotum surgery, have pain in those aforementioned areas, or if you have a history of prostate, testicle or other sexual problems.

When seeking medical care, it’s always a good idea to start with your general practitioner. If possible, try to get an appointment with an andrologist. Andrologists are urologists who have completed additional training in male fertility. It is recommended to forgo ejaculation 2-5 days before your appointment (which includes masturbation!) in case your doctor wants to check your sperm during this appointment. Additionally, bring your medical records and your partner. It’s important to know your history, and have social support around while navigating this tricky time. 

There are also at home sperm count tests, but there are still gaps in scientific literature to understand their complete efficacy. While these at-home tests can be useful for understanding the amount of sperm produced, doctors can help provide a bigger picture to fertility issues beyond sperm count, such as sperm motility and mobility and ultimately can assist with making a diagnosis for targeted infertility treatment. 

Treatments for Male Infertility

You have options! Some lifestyle recommendations are to have more, and consistent, sex about every 2-3 days. Additionally, it is recommended to stop smoking tobacco, decrease alcohol intake and to integrate regular exercise and a healthy diet into your daily life.

If lifestyle changes don’t yield results, you can also consider trying in vitro fertilization (IVF), where the egg is removed from the uterus and inseminated in a laboratory before being returned to the womb. If low sperm count is the culprit, one type of IVF to consider is intracytoplasmic sperm injection (ICSI). This technique allows for a single sperm to be directly inseminated into the egg before being placed in the womb.

If the reason for  male infertility is due to having very low levels of gonadotropin hormones, the hormone that produces sperm, hormonal therapy may be another option. Finally, your doctor may advise you to consider donor sperm.

Infertility is stressful, but getting to the root cause and making a plan with your partner and healthcare provider doesn’t need to be. Keep trying and stay positive — the family you are dreaming about is just around the corner.