Male Infertility

Although traditionally considered a woman's problem, male infertility is more common than you may think. About 13 out of 100 couples suffer from infertility, and in 40 percent of those cases, the problem is with the man. Often this is due to problems with his sperm delivery or sperm production.

Common Causes of Male Infertility

If you’ve experienced difficulty conceiving after consistent, unprotected sex for over a year, male infertility may be the cause. There are three basic categories of male reproductive issues:

Pre-testicular Issues

Rather than specific irregularities in the genitals, pre-testicular issues include more systemic and hormonal causes of male infertility. If a man's general health is compromised, his reproductive system may not be operating optimally. Pre-testicular causes of male infertility include:

  • Obesity
  • Psychological stress
  • Unhealthy diet
  • Aging
  • Decrease in the sperm-stimulating hormones LH and FSH
  • Hypogonadism, or low testosterone, is also a pre-testicular cause of male infertility, and is often related to other general health factors

Testicular Conditions

The most common causes of male infertility are problems with the production and maturation of sperm. Because sperm are produced in the testes, any defects or disorders in the testes (abnormal shapes or low numbers) are likely to result in your inability to conceive. Testicular conditions can be hereditary or can occur as the result of trauma or prolonged exposure to heat or chemicals. Common testicular issues include:

  • Chromosomal disorders
  • Testicular trauma
  • Conditions related to aging
  • Excessive heat or friction
  • Infection
  • Testicular cancer (and related treatments)
  • Exposure to harsh chemicals or pesticides
  • Prior malaria or mumps, which can affect the testes
  • Low sperm production
  • Abnormal sperm shape

Post-testicular Conditions

Post-testicular conditions are ones that affect the ability of the sperm to travel from the tip of the penis to the ejaculate. This means your sperm could be perfectly healthy, but for some reason they cannot reach your partner. Post-testicular causes of male infertility include:

  • Prior vasectomy
  • An improperly positioned penile opening, also called hypospadias
  • Aspermia (lack of ejaculate)
  • Complications from hernia surgery
  • Retrograde ejaculation
  • Erectile dysfunction
  • Epididymis or ejaculatory duct obstructions
  • A missing or blocked vas deferens, which often occurs as a result of mutations in the cystic fibrosis gene

Diagnosing Male Infertility

If you may be suffering from male factor infertility, Dr. Hsieh can diagnose your condition. During your initial consultation, he will conduct a comprehensive exam and discuss your medical history and any concerns you may have. Should additional diagnostics be needed, you may undergo tests such as semen analysis, hormone testing, genetic analysis or ultrasonic imaging. Based on the information gathered during this process, Dr. Hsieh will arrive at your recommended treatment plan.


Your Treatment Options

Once the likely cause(s) of your infertility are identified, Dr. Hsieh will recommend an appropriate treatment plan, which may include:

  • Injectable or subcutaneous (administered beneath the skin) stimulatory hormones (e.g. HCG)
  • Pharmaceutical drugs such as bromocriptine, kallikreins or phosphodiesterase inhibitors
  • Herbal medications such as carnitine or zinc
  • Nutritional supplements, particularly antioxidants
  • ICSI (Intracytoplasmic Sperm Injection), a technique used during IVF (in vitro fertilization) in which sperm is injected directly into your partner’s (or a donor’s) egg
  • If you have previously undergone a vasectomy, a vasectomy reversal may be recommended

Dr. Hsieh will work with you to create a customized treatment plan based on your needs, preferences and budget. A number of non-surgical treatment options are available including simple oral health supplements that may help to improve your condition.