Infertility in Men: Signs, Causes, Symptoms
A relationship is a partnership, especially when trying to conceive a child. Couples that are unable to conceive after one year of trying should be given a fertility diagnosis and seek advice from a health care professional, six months of trying for couples over 35. Infertility is typically thought of as a challenge that women face – this point of view is outdated and wrong. Of the 1 in 7 heterosexual couples struggling to conceive, 30-50% of those issues are due to male factors, and this trend is rising. Male fertility has declined 50% in the past 40 years, leaving men half as fertile as their grandfathers were. It’s time we include men in the conversation!
Many men do not recognize infertility signs and symptoms unless they’re checked in for a medical issue or they are unable to fertilize an egg.
Signs and symptoms of infertility in men:
- Changes in hair growth
- Low sperm count
- Signs of chromosomal abnormalities
- Lumps or swelling of the testicles and surrounding areas
- Pain in the testicles and surrounding areas
- Testicles are hard and shriveled up
- Loss of ability to smell
- Lower sex drive, erectile dysfunction, premature ejaculation, and other sexual function issues
1. Dry Orgasms
Have you ever had an orgasm, but didn’t ejaculate any semen? Or only had a trace amount of sperm? According to the National Institute of Health, a normal amount of semen produced after ejaculation should range from 1.5ml all the way up to 5ml — 5ml is just over one teaspoon.
Dry orgasms, can go away on their own, or last permanently, depending on the cause behind them. Having dry orgasms is not usually considered as a serious health issue; Nonetheless, it can seriously affect your chances of conceiving.
2. Semen Color and Texture
You can learn a lot about your fertile state by looking at the final product, semen quality. Your semen is a mixture of minerals, vitamins, and proteins that contain sperm, all of these make up the look and texture of your semen.
Normally, semen is cloudy-white or grey, with a jelly-like texture. Semen can also be yellowish, especially when ejaculations are infrequent. A semen analysis can also warn you of possible health conditions that could possibly contribute to infertility.
Urine that is cloudy could be a sign of a condition known as Retrograde ejaculation. This condition causes your semen to go into the bladder instead of exiting the penis. A sign of this is cloudy urine after a recent orgasm.
Yellow Semen Signs
Jaundice: Aside from infrequent ejaculation and urination, yellow semen can be the result of jaundice. People with jaundice may notice that the whites of their eyes are yellow.
Change in Diet: Consuming food products with yellow dye: processed pastries, flavored popsicles, sugary cereals, etc. can tint the color of your semen, possibly causing a false alarm.
Leukocytospermia: A high number of white blood cells in your semen can make it appear yellow. This condition is called Leukocytospermia. This condition can lower sperm quality, therefore leading to a lower fertility rate.
Semen with Urine: When you ejaculate, your semen travels through your urethra and exits the tip of your penis. Both urine and semen travel through the same tube(urethra), this makes it possible for your urine to give your semen a slight yellow tinge.
Brown Pink or Red Semen (Hematospermia)
The pink or red color in the semen is a sign of fresh blood. Semen that is dark-brown or orange is a sign of stale blood. Bloody semen can be a sign of health issues that can affect fertility: Prostate infections, rough sex/masturbation. In rare cases, it could be a sign of cancer in the testicles, prostate or urethra, which is treatable in most cases.
3. Smell Semen
A normal semen sample should smell like bleach or chlorine. Your semen is built up of alkaline substances, which makes it above 7(neutral) on the pH scale. The pH scale ranges from 0-14, with 0 being most acidic and 14 being extremely basic. Semen needs to be basic to help protect sperm cells on their way to the fallopian tubes because the vagina is acidic.
A sign of a fertility issue is foul-smelling semen. Semen that smells fishy, or rotten can be a sign of an STI or underlying bacterial infection. However, the smell of your semen can be affected by drinking caffeine or alcohol and eating garlic, meat, and other foods. Try limiting these from your diet to check if the smell goes back to normal after a few days. If the smell remains, it could be due to an underlying health issue.
Learning more about the causes of male fertility problems can help couples trying to conceive. One of the first things you should consider is sperm quality.
Low Sperm Motility: Sperm motility refers to your sperm’s ability to swim through the vagina after ejaculating. According to the Journal of Human Reproductive Sciences, In order for sperm to pass through the cervix, and fertilize an egg, sperm need to have motility of at least 25 micrometers per second to be fertile.
Research from The American Society for Reproductive Medicine shows a strong positive relationship between the number of motile sperm and increased fertility rates. Researchers tracked family sizes across generations and came to the result that for each additional child in a family, the number of motile sperm cells increases by about 1.8 million.
Sperm Count: Low sperm count is the number one leading cause of correctable infertility in men. The chance of conceiving is strongly tied to your sperm count. In some cases, men have no sperm in their semen, this condition is known as azoospermia. A sperm count lower than 15 million per ejaculate is considered low.
Sperm count and motility can be tracked using a semen analysis, which can be done in a fertility clinic or at home. Legacy has created an easy and affordable solution that allows men to test their sperm from the comfort of their own home. Clients receive a clinic-level analysis that assesses over 50 different data points and provides men with personalized lifestyle recommendations for sperm health improvement. Legacy clients can then choose to cryogenically preserve their youngest and healthiest sample.
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Hormone Imbalances: Infertility can stem from hormonal problems affecting different hormonal glands in the body: hypothalamus, thyroid, adrenal, etc. For instance, lower testosterone levels result in lower sperm production, erectile dysfunction, abnormal sperm, and a lower sex drive.
Certain hormone-based medications that can cause infertility in men include:
- Chemotherapy medications
- Certain Antifungal or ulcer drugs
- Testosterone Replacement therapy
- Anabolic steroid use
Immune Disorder: Sometimes the immune system can accidentally target healthy sperm cells, leading to a lower sperm count. These are known as anti-sperm antibodies.
Cancer and Tumors: Cancers affect the tissues and organs of the male reproductive tract. Cancer treatments are vital to your well-being, albeit they can still affect fertility.
Sexual Transmitted Infections: Sexually transmitted infections(STIs) are one of the leading causes of infertility in the world. Adults that are sexually active should get screened for STIs at least annually. Sexually transmitted infections like chlamydia and gonorrhea are preventable as well. STIs can cause Infertility by inflammation of the testicles, and some infections can also lead to permanent damage to the testicles and epididymis. Fortunately, most of the time, sperm cells can still be retrieved.
Undescended Testicles(cryptorchidism): This term isn’t to be mistaken with the idiom “balls dropping”, which refers to men undergoing puberty. In some men, undescended testicles happen when the testicle(s) fails to descend into the sac while the fetus is developing. Men with this condition are more likely to experience male infertility.
✔️ Medically Reviewed by Dr Roohi Jeelani, MD, FACOG and Lauren Grimm, MA
Dr Roohi Jeelani is Director of Research and Education at Vios Fertility Institute in Chicago, Illinois. Dr Jeelani earned her medical degree from Ross University School of Medicine in Portsmouth, Dominica. She then completed a residency in Obstetrics and Gynecology and a fellowship in Reproductive Endocrinology and Infertility at Wayne State University, Detroit Medical Center, where she was awarded a Women’s Reproductive Health NIH K12 Research Grant. She is board certified in Obstetrics and Gynecology. Dr Jeelani has authored numerous articles and abstracts in peer-reviewed journals, and presented her research at national and international scientific meetings. A Fellow of the American College of Obstetrics and Gynecology, Dr Jeelani is a member of the American Medical Association, the American Society of Reproductive Medicine, and the American Association of Gynecologic Laparoscopists.
Lauren Grimm is Research Coordinator at Vios Fertility Institute in Chicago, Illinois. Lauren earned her bachelor’s degree from Loyola University Chicago, where she also completed her masters in Medical Sciences. Lauren has worked alongside Dr. Jeelani for the last 3 years, authoring a number of abstracts and articles in peer-reviewed journals, and presented her research at national and international scientific conferences. Lauren will be continuing her education this fall at Rush University Medical College in Chicago, IL as an MD candidate.
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