The Male Side of Infertility

For instance, few men know that supplements containing male hormones such as anabolic steroids can reduce sperm production. The same is true with supplemental testosterone. Although you might think these compounds would increase sperm production, the opposite occurs. Basically, the body thinks it has enough male hormones from the supplements, so it stops making its own hormones, affecting sperm production.

Dr. O'Brien also searches for physical clues for the infertility, including abdominal, scrotal or perineal scars. Such surgeries can affect a man's ability to have an erection and/or orgasm—both of which affect fertility. Another common cause of male infertility is varicocele, in which the veins wrapped around the spermatic cord are numerous and dilate too much, increasing temperature in the scrotum and reducing fertility. Minor surgery can transect the vessels with dramatic results, says Dr. O'Brien.

She also asks if the man or his partner has ever had a sexually transmitted disease. Chlamydia, for instance, can cause blockages and other reproductive problems.

In evaluating sperm, she looks for four things: volume, concentration within the semen (too little semen could signify an ejaculation problem), how well the sperm move (motility) and how healthy they look (morphology). Just because one sperm sample is abnormal, she cautions, doesn't mean you have a problem. She requires another three months later, because something as mundane as the flu or a high fever can interfere with sperm production.