The Male Side of Infertility

Say the word 'infertility,' and you're likely to think of blocked tubes, infections, hormonal abnormalities and sub-par eggs. In other words, women's fertility issues. But if you replace "egg" with "sperm," you could just as easily be talking about a man. In fact, half of all infertility results from male reproductive problems.

Yet we often don't hear much about problems on the man's side. "These men are often young," says Jeanne O'Brien, MD, an associate professor of urology and male infertility at the University of Rochester Medical Center in New York. "There's often a stigma associated with being unable to reproduce, and many men this age don't like to go to doctors and avoid it if they can."

That's a shame, because in many instances, Dr. O'Brien says, the cause of the infertility can be identified and corrected.

Male infertility, or "subfertility," as it's often called, affects about one in 20 men. It can result from numerous causes, ranging from the mechanical—undescended testicles, dilated veins and blocked tubes—to the hormonal—problems with sperm production.

The first step is a complete evaluation. Dr. O'Brien prefers to see patients with their partners. Not only are men more comfortable with their partner in the examining room, she says, but the woman often knows more about his health history than he does.

During that evaluation, Dr. O'Brien plays detective, searching for clues as to what might be wrong. Sometimes the answer is obvious—to her, at least.