by Tenebris

Created on: July 02, 2008   Last Updated: August 24, 2008

Until very recently in medical history, inability of a couple to conceive has been seen almost exclusively as a woman's problem, and thus by far the largest percentage of infertility research has focused on treatment of female infertility. However, as infertility becomes a growing concern in the western world, medical attitudes have shifted. Today, in treating a woman who has been unable to conceive, both members of the couple are examined. In roughly two-thirds of the cases which do not involve female menopause, the reason for the infertility can be traced at least partly to the man, while over a third of non-menopausal infertility cases are due to male infertility alone.*

Primary causes for male infertility fall into three general categories: poor sperm motility, poor sperm quality, or very low numbers or altogether absent sperm in the ejaculate. Secondary (underlying) causes include physical blockage of the vas deferens, endocrine irregularities, sexually-transmitted diseases (STDs), congenital disorders, and coital issues. Some lifestyle patterns, such as smoking, high caffeine intake, or increased heat to the testes, have also been correlated with such infertility factors as lowered sperm count and motility. Diagnosis is based primarily on medical history, physical examination, bloodwork, and semen analysis. Specifics in the medical history may suggest additional invasive or non-invasive diagnostic imaging. Within our current knowledge and diagnostic ability, up to half of all infertility in both men and women cannot be linked to a specific cause.

Treatment is tied to secondary cause. However, where the underlying condition cannot be corrected, treatment also depends upon whether otherwise healthy sperm are blocked from leaving the man's body, whether the sperm count or motility makes it unlikely that otherwise healthy sperm will successfully reach and fertilise the egg, or whether there is an abnormality within the sperm themselves. Some lifestyle changes may also be recommended to improve future chances of conception, though it is important to note that there is no clear cause-effect relationship here. For example, higher physical fitness has been tied to a higher sperm count, but fitness also correlates with decreased stress: and decreased stress also correlates with a higher sperm count. Either way, improving fitness can't hurt.

Even where the couple's inability to conceive is due to male infertility alone, infertility treatment may still require both

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