Piecing Together the Infertility Puzzle
Couples With Infertility Problems Often Focus on a Woman's Biological Clock and Forget About the Male Contribution
Quality, Not Quantity
Counts greater than 20 million are considered to be normal.
Before a proud man with a count in the zillions alerts the media, he needs to keep in mind that even if the number is high, sperm quality is also a factor.
Every sample of semen has lots of sperm that are abnormal. If more than 85 percent of the sperm don't have heads, tails, or look funny in some way, it doesn't bode well fertility-wise.
In addition, if a sperm looks normal but is directionally challenged, the likelihood of finding its way down the fallopian-tube highway is limited.
Anything less than 25 percent to 40 percent forward motility reduces pregnancy rates. These are all factors doctors consider when running a semen analysis.
The Source of the Problem Sometimes Solvable, Sometimes Unexplained
There are four main causes of male infertility.
In roughly 10 percent to 20 percent of infertile men, an obstruction prevents sperm from traveling from the testis (where it is produced) to the urethra.
Roughly 30 percent to 40 percent of infertile men suffer low-sperm production as a result of testicular problems, resulting from infection, drugs, radiation or environmental toxins.
While hormone levels should be tested, they are rarely the problem.
Sometimes a low-sperm count is attributed to a varicocele -- dilated veins in the scrotum. Varicocele repair was at one time a routine procedure thought to enhance male fertility, but is now highly controversial.
Studies show that the improvement in semen quality after varicocele repair doesn't always translate to increased pregnancy rates and can use up precious time, especially when a woman's biological clock is ticking.
The remainder of infertility is unexplained.
