Infertility is often viewed as a woman's problem. When a couple can't have children naturally, we've all heard someone describe it as "she can't have children."
But in 20 percent of couples who can't conceive, the man is the one who has fertility issues. And according to fertility expert Dr. Alex Shteynshlyuger, urologist at New York Urology Specialists, as couples wait longer to try to have children, infertility problems increase for both men and women. And common treatments for men, such as testosterone enhancement, can cause their own problems.
"While it may sound counterintuitive, supplemental testosterone can cause infertility problems and poor sperm quality in men by suppressing testicular testosterone production," he says.
Shteynshlyuger says Clomid, which is generally known for helping women ovulate, is showing promise in reversing low testosterone, but it may take several months for the change of treatment to show benefits. Shteynshlyuger also warns against using controlled substances, which can also be detrimental to sperm production and testosterone.
According to RESOLVE, the National Infertility Association's website, the red flags should go up if you're younger than 35 and a year of unprotected intercourse results in no pregnancy or if you're over 35 and haven't gotten pregnant after 6 months of unprotected intercourse. Testing of the male usually begins and ends with semen analysis, where the man brings in a sample of semen to be tested for a sperm count.
According to WebMD, sperm count can be affected by:
- Hormonal problems in the testicles or pituitary gland
- Testicular injury or failure
- Effects from cancer treatment
- Antibodies that attack sperm, which may develop after a vasectomy, infection or injury to the testicles
- Use of certain prescription medicines, marijuana or tobacco
- Structural problems, such as varicoceles, which are varicose veins in the scrotum; vasectomy; birth defects, such as an absence of a vas deferens; chromosomal problems or genetic issues; or retrograde ejaculation, which is when the semen is ejaculated into the bladder rather than out the penis.
As part of an infertile couple, I recommend one more step in the process of dealing with infertility: Seek emotional help. Few things will take a bigger toll on a relationship than not being able to have a child of your own. The pain may lessen, but it never goes away. We found a fantastic counselor who shared our faith and perspectives. He provided a lot of information and a sounding board to two people who really struggled. There's no one person to blame when conception doesn't happen in a relationship—and a good therapist can show you that you are in this together as a couple.
Your fertility specialist may be able to recommend a counselor, or check out RESOLVE to find an infertility support group made of people who have been through your situation. Also find our Your First Steps After an Infertility Diagnosis or check out our Fertility and Infertility pages for more guidance.