Couple having discussion with doctor in IVF clinic sitting at desk 1500 x 1000

Infertility is a sensitive issue. Most people believe it affects only a minor part of the population. However, multiple studies have shown that between 15 and 20 percent of people in the reproductive age suffer from some degree of infertility. If we dissect the statistics further, it comes to light that female factor infertility is the culprit in only 40 percent of the cases. The surprise here is that male factor infertility is to blame in roughly 30 to 40 percent cases.

People find that surprising because the problem of infertility or childlessness is traditionally laid at the door of the female partner in a couple. However, among couples that come in for IVF or surrogacy treatment in my practice, the male partner is as likely to suffer from infertility and be responsible for a couple’s childlessness as the female.

At the same time, diagnosing male factor infertility is a lot harder than diagnosing female infertility as the latter offers more observable and visible set of symptoms compared to the former because of its impact on menstruation. Conditions like polycystic ovary syndrome (PCOS) or endometriosis play havoc with their ovulation cycle. A disturbance of the ovulation cycle is instantly recognizable as it causes noticeable changes in a woman’s menstruation cycle. The symptoms for males as such are a lot less visible and therefore, rarely draw discussion when a couple is not able to conceive a child through regular sexual intercourse. There are, however, some signs that may suggest male infertility is the problem.

 

Five possible signs of male infertility

1. Trouble with ejaculation and orgasms

The medical term for this is “ejaculation disorder.” It is an important sign that a male infertility factor could be lurking somewhere. The base issue is that ejaculation is not normal, for example, the volume of the ejaculate is too low, it takes place only rarely, or is hampered by erectile dysfunction.

Disorders related to ejaculation are many different causes. For one, there is the phenomenon of retrograde ejaculation in which the semen actually retreats into the bladder instead of being ejaculated. Other causes include certain types of medications such as antipsychotics, neurologic conditions, and problems related to the spinal cord. If you suffer from any of these conditions and are not able to conceive a child with your partner, you should get checked by your physician or a fertility specialist.

2. Varicocele of the testes

A varicocele is when the veins in your testicle swell which obstructs necessary drainage and lowers your sperm count. The condition affects around 10-15% of reproductive age men.  Although it’s exact cause is a matter of debate, signs of a varicocele include swelling of the testicle(s), a dull pain, lumps, and observably large inflamed veins.The bad news is that a varicocele can seriously affect your capability to impregnate your partner. The good news is it can be corrected easily with surgery in most cases. Routinely check your testicles for any kind of swelling or lumps. If you find anything out of the normal, get it checked out by a medical professional.

3. Low sperm count

Lack of enough sperm to travel up the vagina and fertilize eggs is one of the more common causes of male infertility. Scientifically known as oligospermia, it denotes a male whose sperm count falls below 15 million sperm per milliliter of semen. Now that may sound a lot but remember that in a normal healthy and fertile male, the sperm count is between 20 million to 150 million sperm per milliliter of semen.

Related story: Sperm Counts in the Privacy of Your Home

A low sperm count is also one of those infertility causes that has no visible symptoms. It can only be confirmed by a diagnostic test where your sperm is sent to the lab for a complete semen analysis. Some of the common causes of a low sperm count include infections in the testes, environmental exposure to toxic materials, an imbalance in the hormone levels, stress, obesity, excessive smoking and alcohol consumption, and STDs.

4. Smaller than normal testicles

Males born with Klinefelter’s Syndrome (KS) is also called 47,XXY or XXY because they have one or more additional X chromosomes. The primary result of KS is smaller than normal testicles, which limits their ability to produce enough testosterone levels for puberty to begin. Other signs of Klinefelter’s syndrome include negligible facial hair, excess fat in the area around the breast and thin or disproportionate bodies.

5. Decreased libido & other hormonal problems

In popular culture, men are portrayed as more desirous of sex than women. While that depiction is certainly overblown, there is also the fact that men produce a greater amount of testosterone, the hormone most closely related to the libido or sex drive. That is why if you or your partner perceives a change in your sexual drive that is unrelated to external events (like excess stress resulting from increased work hours or a tragic episode in your life), it should warrant greater scrutiny. For one, it hints at the possibility of lower than normal levels of testosterone being secreted in the man’s body, which is a possible cause of an underlying infertility problem.

The inability to maintain an erection for the duration of the sexual intercourse (erectile dysfunction), having problems ejaculating (premature or delayed ejaculation) or ejaculating only small amounts of fluid are also signs of a larger infertility problem.

Abnormalities related to the other hormonal systems like the pituitary, hypothalamus, adrenal and thyroid glands also have the ability to influence male fertility. Some symptoms of these types of problems include unexplained weight gain, a decreased amount of facial and body hair, and gynecomastia (abnormal breast growth in males).

 

For the sake of fertility, do not ignore these sign

Although a stereotype, there is no denying that men usually do not acknowledge issues about their fertility. That may lead to ignoring signs and symptoms like the ones described above. Issues may not be attended to until and unless there is some sort of pain or discomfort. That makes all the more important why sexual problems, no matter how supposedly small or irrelevant, should be addressed as soon as they manifest.

While this article has discussed some of the more prominent signs of male factor infertility, there may be others that negatively impact your ability to reproduce. That said, a visit to a fertility specialist not only helps you learn what the exact problem is but also puts you on the right treatment protocol.

Pranay Shah MD
Dr. Pranay Shah is one of India’s leading names in the area of infertility treatments. An M.S. holder in Obstetrics & Gynecology, Dr. Shah is also a USA Cleveland Clinic certified ART specialist and has to his credit hundreds of successful IVF cases. In his spare time, Dr. Shah loves to drive and explore places and nurtures an abiding love for Scandinavian crime fiction.

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