Seven million couples suffer from infertility in the United States.
This means that approximately 15% of couples have difficulty conceiving within the first year of their family planning. While most of the focus surrounding infertility is based on female causes of infertility, up to 50% of infertility cases are linked to male causes.
Male infertility is caused by a variety of factors. These include structural or genetic abnormalities, hormone disturbances, as well as certain medical conditions. Lifestyle choices and environmental exposures are also contributors and many times is a silent cause of infertility. The male partner cannot be overlooked in the work up for a couple having difficulties conceiving. Most women have consistent access to women’s health and because of this, infertility evaluation and treatment has been focused only on the female causes. It is extremely important that the male partner in an infertile couple undergoes a thorough evaluation with a Male Fertility Specialist. These are urologists who have spent additional training in the diagnosis and treatment of male infertility.
In the event that couples have difficulties achieving a pregnancy after one year they should seek fertility evaluation. Couples of advanced age or those that have concerns about conception should not delay in the evaluation.
Dr. Avila invites the patient’s partner to accompany them during the office visit. The evaluation of the male partner includes a thorough history and physical exam. During the history, the patient is asked in-depth questions that relate to his health as well as his impaired fertility. He will also perform a physical exam, which may identify structural abnormalities. Since women contribute up to 50% of fertility problems, Dr. Avila will ask for a reproductive and health history from the female partner as well.
Dr. Avila’s Goals For Evaluation
Dr Avila has the couple’s wishes to conceive a child in mind while going through his goals in his evaluation for an infertile male.
- To identify and correct reversible causes of impaired male fertility
- To identify significant medical conditions that may cause impaired male fertility
- To identify possible genetic causes that may be passed on to the unborn child
- To identify irreversible causes of impaired male fertility, which should be managed by IVF, IUI or adoption
The semen analysis is the cornerstone of the diagnostic evaluation of the male partner. It is the most reliable indicator of male fertility; it provides information on whether there is an obstruction of the flow of sperm; and it gives Dr. Avila the ability to evaluate the quality of sperm and the body’s ability to make sufficient amounts of sperm. Factors that are considered in the semen analysis are volume, concentration, motility, direction of movement, morphology and pH.
Proper signaling between the testicle and the pituitary gland near the brain is crucial for proper fertility. Other factors such as thyroid disease, excess cortisol, and elevated prolactin levels can have an affect on male fertility. Dr. Avila may evaluate these hormones and others to thoroughly determine your reproductive potential.
Genetic abnormalities account for a small percentage of difficulties with male fertility. These abnormalities are more common when the semen analysis exhibits low or no sperm counts, or when Dr. Avila identifies atypical findings on your physical exam. In these situations, genetic testing may be warranted.
Depending on what Dr. Avila discovers during his evaluation, he may order additional testing such as an ultrasound, a CT scan, MRI, or further specialized testing of sperm.