The Unspoken Truths about Male Infertility

What is The Grapevine? A weekly newsletter that shares clinician-approved fertility insights in an easy-to-understand way.

Today’s topic is the unspoken truth about male infertility. When people discuss “fertility”, it almost always refers to a woman’s reproductive system and the things that can go “wrong” that contribute to infertility. But did you know 40-50% of the time, male hormone and sperm imbalances are the culprit for fertility issues. Let’s get into it and better understand why this happens and how it could impact future conception planning.

Fertility — why do we only think of women? Fertility is basically the ability to conceive and induce a pregnancy. Fertility is not limited to just a woman’s body or just a man’s body, but is impacted by both individual characteristics and the joint compatibility of both egg and sperm cells. Often, women have been the targets of infertility blame for centuries, likely because of the perceived solo responsibility for carrying a pregnancy. But wait until we tell you - only a third of infertility is caused by factors related to a woman’s hormones or health. Another third is related to a man’s hormones and health. The last third is either a combined complication or an unknown cause. This means that 40% of the time on average, “the male partner is either the sole cause or a contributing cause of infertility”. Insert mind blowing emoji.

You mean MEN have fertility problems, too? Yes! Men have hormones and reproductive cells too (also known as sperm). They also can have hormone imbalances, abnormalities, or health complications that can lead to infertility. We just don’t talk about it much. Cue the patriarchy.

Wait, I don’t know the first thing about male fertility. What are the basics? You probably know what sperm are, but what about seminal fluid, prostate, or the tubes that carry sperm? Here are the basics: sperm are developed in the testicles, the prostate gland and the seminal vesicles in the bladder help create seminal fluid that help transport the sperm, and the urethra is the transport tube in the penis through which sperm travels during ejaculation. If you want more details or are a visual person, the Mayo Clinic has more good info and a graphic that helps!

Ok so what are the things that go wrong? Generally male infertility is caused by either sperm transportation or sperm formation. Let’s break them down.

Sperm transportation includes issues like erectile dysfunction, tube blockage, and sperm motility (movement). These cause between 10-20% of male infertility issues.

Sperm formation involves the development of sperm, the shape, and the amount of sperm created. This could be caused by health issues, like diabetes, chromosomal abnormalities, thyroid disorders, or varicocele (enlargement of veins in the scrotum that increase the temperature, damaging sperm). 

Male infertility can also be impacted by lifestyle factors, including obesity and smoking, environmental exposures, including pesticide use, and age-related factors (Did you know men also have a biological clock? Sperm quality and quantity decrease with age!).

What does male fertility testing look like? We talked a few weeks ago about our favorite fertility test recommendations (Found here if you missed it!). Fertility testing for men also exists, but looks a little different and usually at-home test kits aren’t sufficient. Men seeking fertility treatment would typically have an evaluation by a urologist, provide a semen sample for testing, and potentially have hormone testing done. Hormone tests look at their levels of testosterone, estradiol, follicle stimulating hormone, and luteinizing hormone. (Do some of these sound familiar? Yup, men and women do indeed have the same hormones, just different levels!)

So men struggle with infertility too. What can they do about it? Treatment for male infertility can involve many different avenues, similarly to female infertility. Well established treatments can involve hormone replacement therapy, other medications, or surgery to treat a hormone imbalance, infection, swelling, or structural blockage or abnormality. However, treatment for issues like poor sperm motility or low sperm density are still being explored, but medication therapies do exist. Reproductive technology advances allow for the retrieval of sperm for sperm freezing, IVF, intrauterine insemination (IUI), and other technologies that can facilitate inducing a pregnancy.

So what’s the TL;DR? Girls, you are not alone and you are not to blame for all that goes wrong when trying to get pregnant. Infertility is a struggle for all genders, bodies, and humans. If you and your partner are planning for a family and may be concerned, or just curious, about fertility issues, it is important for both men and women to get evaluated! Male infertility can be linked to the sperm, the semen, the transport, or the execution, so we always recommend discussing these potential issues with your provider.

Editor’s Pick: If you’re planning for pregnancy and need a boost “getting it on” or even if you’re a solo gal riding out a dry season, we have some fun toys to help spur things along. 

• The Verge Couple Vibrator. The Verge is a two for one deal - stimulation for you and a partner, if you want. The Verge is worn over the penis and testicles, providing pressure and vibration. It can be worn with the stimulating tip facing down for extra sensation on the perineum or worn up to stimulate a partner during sex.

• Volta Clit Vibrator: This is a real powerhouse. Offering flicking, fluttering, tapping sensations along with hefty vibration, the Volta Clit Vibrator claims to be both man’s and woman’s best friend. Use it for her or for him here, there, and everywhere and see where the night takes you.

Upcoming Newsletter Editions:

• “5 Ways to Increase Your Fertility”

• “Our Recommended Prenatal Vitamins”

• “Myth Busters: Fertility Edition”

Make sure to not miss future editions by subscribing to The Grapevine now!

Quick note: We acknowledge that not everyone assigned male at birth or born with testes identifies as a man, so in this newsletter the terms “man/men” include all persons born with testes. This newsletter was written with those assigned male at birth and those born with testes in mind, but we also think this is important reading for those who identify with any gender, especially partners and friends. If you have questions or suggestions on how we can be more inclusive, we would love to hear them.

*The information provided is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or any other qualified healthcare provider with questions you may have regarding a medical condition or treatment.