Infertility is often seen as an issue that primarily affects women, but that isn’t indicative of the larger statistical reality. In fact, about 7% of men deal with infertility, and in about 30% of cases where couples struggle to conceive, the issue is male-factor infertility.
We recently spoke with Dr. Jesse Ory, a male infertility specialist and Assistant Professor at Dalhousie University. Here’s what we learned about male infertility:
It’s common:
Infertility affects one in every six couples trying to conceive. About half the time (when a reason can be found), a male factor is the contributing cause. While it can feel uncomfortable to talk about infertility and seek guidance on how this plays out in one’s journey to conception, it is a common health issue for both men and women.
It’s treatable
In an article for Healthline, Dr. Aimee Eyvazzadeh says that male infertility is often more treatable than female infertility.
Dr. Ory tell us the treatment options for male infertility include the following:
- Lifestyle changes, including weight management, stopping (or cutting back on) cannabis use, and adjusting the timing of sex. These changes can improve sperm count and increase chances of pregnancy.
- Medications that will boost a man’s natural testosterone levels, which can in turn heighten sperm count. These medications include clomiphene citrate, or HCG. (It’s worth noting that using testosterone itself will cause infertility).
- Surgeries depend on the person, and range from surgical repair for men with varicoceles, to more detailed microscopic procedures (like microTESE) for men with more severe forms of infertility.
The risk factors
Dr. Ory says that there are many things that can negatively impact male fertility.
“Common ones include a history of steroid use, cannabis use, prior STIs or exposure to heat. Other risk factors can include having received chemotherapy in the past, having an undescended testicle, or having a varicocele (an enlargement of the veins within the scrotum),” he says.
Checking in with a male infertility specialist to form a plan is the best way to mitigate these risk factors. Some are relatively easy to reverse (cannabis use, for example), while others, like chemotherapy, are not reversible. The best option for men going through chemotherapy is to freeze their sperm, which can quickly be arranged before cancer treatment.
The stigma
Dr. Ory says it’s very important that both men and women get tested at the outset of any struggle to conceive.
“Historically, the focus on fertility has (unfairly) been on women,” he says. “Because of this, women often feel pressure to initiate the workup either with their family doctor or gynecologist.”
In many cases, this means men will wait to be tested. However, focusing primarily on the female partner will only delay finding a solution.
In the previously referenced Healthline article, Dr. Eyvazzadeh says that gender stereotypes can play a role in whether men feel comfortable seeking help in this area. Fortunately, a shift in the conversation seems to be occurring because of positive representation in media, including on podcasts.
Dr. Ory tells us that the total workup for men is much less invasive than it is for women. It usually includes some simple bloodwork and a semen test.
The semen test can also easily be done at home, if nerves are a factor!
The most important thing is to recognize that help is available and to seek it out.
“Even meeting with a fertility specialist, virtually or in person, to have a conversation can be very eye opening to risk factors and things that can be improved,” Dr. Ory says.