Conversations around fertility often center on women, but infertility is also a significant issue for men. A urologist from Baylor College of Medicine discusses the factors affecting male fertility.
“With fertility, you can’t finger point. It’s not a male or female problem as much as it needs to be considered a couple’s problem,” said Dr. Larry Lipshultz, professor in the Scott Department of Urology and member of the Dan L Duncan Comprehensive Cancer Center at Baylor. “Both partners need equal evaluation, not just the woman, which is usually where the focus is placed.”
Infertility in men does not present symptoms unless there has been an accident involving the testicles or specific surgeries. The primary sign of infertility is the inability to impregnate someone, which can be determined through a fertility test.
A gradual decrease in fertility occurs in men typically over the age of 50. Unlike menopause in women, this decrease does not result in immediate infertility but rather subfertility, indicating a delay in conceiving.
According to Lipshultz, anything beneficial for overall health positively impacts sperm production while detrimental factors negatively affect it. Although no specific vitamins are required to influence fertility significantly, antioxidants are helpful. Obesity adversely affects sperm production; hence specialists might recommend weight loss programs to improve hormone production.
“The issue with obesity is that fat metabolizes testosterone to estrogen, which is bad for sperm production,” he said. “Generally, trying to maintain a good bodyweight through exercise and proper diet is going to be helpful.”
While testosterone is necessary for sperm production, external testosterone intake can inhibit hormones that stimulate sperm production. Specialists can guide safe ways to take testosterone without harming sperm production.
Avoiding direct heat exposure to testicles from sources like hot tubs or cell phones in pockets is advisable; however, environmental heat does not impact fertility significantly. Chemotherapy, radiotherapy, and new drugs called biologics can also detrimentally affect sperm production.
Men facing fertility issues have higher risks of comorbid conditions including cancer and increased mortality rates.
“If you’re in the reproductive age group and you have some type of problem that requires medication, check with your physician that this is not going to hurt your sperm production," Lipshultz advised. "If you are in a situation that this is going to be permanent, make sure you bank your sperm."
A semen analysis can determine if one has an adequate number of properly moving sperms and assess their functional normality regarding fertilization capability. At-home tests are available but may provide misleading results.
For males experiencing infertility who wish to reproduce, consulting a urologic specialist focused on male reproductive health is recommended.
“Men need to take better care of themselves," Lipshultz emphasized. "Women have a doctor from their teenage years for menstrual health, birth control and more,” he noted. “Men often don’t regularly see a physician and by the time we see them for urologic problems or reproductive issues or men’s health in general it may be too late.”
