Male factor: up to 50% of a couple’s fertility problem

Infertility is defined as a couple’s inability to conceive after 12 months of regularly unprotected intercourse and affects nearly 1 in 6 (15%) of couples in Canada. Male factor – an aspect related to the male partner – can contribute to a couple’s fertility problem in up to 50% of cases. Therefore, it is crucial both couples are evaluated during the work-up for infertility.

The most common test to evaluate the male is a semen analysis. A semen analysis is able to identify whether a male produces sperm, the concentration of sperm, their shape and how well they move. A semen analysis is a very powerful tool in the evaluation of male infertility but has its limitations. Although higher values are able to predict fertility, values below the normal reference range do not mean a male is “infertile”. Furthermore, males with normal reference ranges could also be “infertile”. Therefore, it is crucial for a male to be seen by a Urologist, especially a Urologist with sub-speciality training in male infertility to identify whether there could be a correctable male factor.

Investigations of the male typically include the following: 2 semen analysis, blood work, history and physical examination. Further investigations may be needed depending on the results of the semen analysis and blood work. Common causes of male factor infertility include: varicoceles (i.e. dilated veins within the scrotum), hormonal imbalances (i.e. low testosterone), medications, sexually transmitted infections, etc…

The evaluation of the male partner serves to ensure a male component is not contributing to the couple’s inability to conceive. Furthermore, investigations and treatments seek to identify potentially correctable causes to assist the couple in conceiving naturally or maximizing their chances to conceive with assisted reproductive technologies.