Every couple looking to conceive should have a clear understanding of the basics of male infertility, and physicians may be surprised to learn that a lot of past information has changed. “The old guideline was that if you have gone for twelve months of trying without success then you should see a physician,” says Dr. Chris Schrepferman, a Louisville urologist. “That guideline has been revised to six months.” He notes that the focus has also shifted from the female to the male. “Traditional mode ten years ago was the female patient would get a pretty extensive evaluation and maybe start hormone therapy before the male patient would even have a sperm test done.”
Now, couples should be aware that men are often evaluated first. “Semen analysis is about 125 dollars and can save the female partner a whole lot of workup and cost if it is addressed early in the process,” says Schrepferman. “The presence of veins around the Varicocele is the most common cause of infertility in the male and is easily correctible.”
He also warns against a common error in treating male infertility: prescribed testosterone therapy. “The classic story I get is a patient who can’t conceive will see a non-fertility specialist or a non-urologist and get their testosterone checked. If it is on the low side, the physician will give them testosterone.” Whereas the common belief is that increasing testosterone levels will make sperm bigger and stronger, often the opposite will happen and sperm production stops completely.
There are many things men can do to prevent infertility and physicians should counsel their patients to maintain a healthy weight, not smoke cigarettes nor use marijuana. Schrepferman also notes the importance of staying active: “Regular exercise keeps the testosterone level and metabolic rate high which is good for fertility.” Environmental exposures like pesticides and insecticides can impact sperm production as well.
By being proactive and seeing a qualified infertility specialist, men can make things easier on themselves. “The typical visit is about thirty to forty-five minutes. The doctor goes through an extensive list of questions about exposures and history, and does an exam of the testicles,” says Schrepferman. It is helpful if the female partner comes with them if possible.
The urologist encourages men to have hope. He reminds us, “It is important to emphasize that even if a patient has a 0 sperm count and believes there is no chance that they could ever have children, that is rarely true and there are many ways to have children.” Modern technologies can help, sometimes finding even a handful of viable sperm inside the testicle of someone with a 0 sperm count.
Physicians are urged to refer patients with fertility problems to a specialist, since the earlier they seek help, the sooner a problem can be treated.
By Jamie Lober, Staff Writer