Male factors are the sole cause of infertility in 20-30 percent of infertile couples and are a contributing factor in another 20-30 percent of couples, thus affecting about half of infertile couples. When a male factor is suspected the workup should begin with a thorough history, which can often uncover the source of the problem without having to go through unnecessary testing and treatment.
The major causes of male infertility include medical causes, genetic abnormalities, environmental causes and lifestyle factors, all of which should be asked about by our physician. Medical causes that should be investigated include problems with sexual intercourse, ejaculation problems, and hormonal irregularities. A history of being born with undescended testicles, of a childhood mumps infection and of testicular injury or cancer should also be asked about. A history of chemotherapy treatment may be another cause testicular dysfunction that is important to mention to your doctor.
In terms of genetic causes you will be asked about a history of similar problems in the family, which can suggest chromosomal abnormalities as a cause of infertility. Another genetic disorder affecting fertility is cystic fibrosis. About 98% of men with the CF mutation have congenital absence of the vas deferens, thus blocking the transport of sperm. This problem can be circumvented vial the TESA procedure through which sperm are retrieved directly from the testicles.
Environmental exposures that can be detrimental to fertility and thus must be asked about include exposure to radiation from radiation therapy or x-rays; overheating of the testicles from excessive hot tubs use or from laptop use; and exposure to industrial chemical. Some lifestyle factors that may contribute to infertility include tobacco use, use of anabolic steroids and excessive exercise.
If any of the above mentioned factors relate to you, sharing it with your physician can point him to the right diagnosis thus sparing you unnecessary evaluations and treatments and shortening your infertility journey.