Male
Factor Infertility
Aaron
Spitz, MD
Center for Male Reproductive Medicine
24301 Paseo de Valencia
Laguna Hills, CA 92653
One
of the least discussed men's health issues is male
infertility. Most men are surprised to learn that
infertility strikes men just as frequently as it strikes
women and it strikes often. Unfortunately, there is
a common misconception that infertility is usually the
woman's problem.
Male
infertility is not just a sperm problem; it may
be a HEALTH problem: Most men in infertile couples consider
themselves"young and healthy," and they are
unlikely to be under the supervision of any other physicians
for regular care. Occasionally, abnormalities in a semen
analysis may be the first presenting signs of an underlying
serious or life threatening disease such as testis cancer.
Some conditions that initially cause poor quality semen
can later cause erectile dysfunction and loss of bone
and muscle mass.
The
male evaluation:
Men in infertile couples with possible "male factor"
infertility should ideally receive care from an urologist
who is specialty trained in male reproductive medicine
and surgery. The causes of male infertility are many
and varied. The most common cause is a varicocele, which
is a collection of varicose veins in the scrotum. The
abnormal circulation in these veins causes a harmful
elevation in the temperature of the testicle.
Blockages
may occur at various locations along the pathway that
the sperm travels. Infection or trauma can scar and
block the epididymis. Hernia surgery, previous vasectomy,
and cystic fibrosis can block the vas deferens. The
prostate may have a cyst or stone, which blocks sperm
from entering the urethra during ejaculation. In the
most severe cases of male infertility, a genetic defect,
a toxin, or an unidentified cause may result in no sperm
being produced in the ejaculate. All of these causes
are reversible or treatable with outpatient minimally
invasive surgery or microsurgery.
Non-surgical therapy is aimed at restoring proper hormone
balance, supplementing important amino acids such as
carnitine and L-carnitine, and using anti-oxidants to
combat free radicals, which are derived from toxins.
Steroids play a role in treating anti-sperm antibodies.
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