Editor’s note: Dr. Jamin Brahmbhatt is a urologist and robotic surgeon with Orlando Health and an assistant professor at the University of Central Florida’s College of Medicine.
When opposite sex couples are trying and failing to get pregnant, the attention often focuses on the woman. That’s not always the case.
Several times a month, men come into my office to ask, “Could I really be the problem?”
Why are some men in denial? I think the possibility that the man could have fertility issues can be more than just a clinical concern. For men who associate their virility with their identity and self-worth, it could lead to a deep personal crisis.
While it’s easy for me to offer tests and treatments for infertility, it’s difficult to handle the emotional and physical challenges that may arise for my patient or the couple on their journey to parenthood. I’ve seen couples split up over the struggle to get pregnant.
Doctor Katarzyna Koziol injects sperm directly into an egg during in-vitro fertilization (IVF) procedure called Intracytoplasmic Sperm Injection (ICSI) at Novum clinic in Warsaw October 26, 2010. Bishops of Poland’s influential Roman Catholic Church have branded in-vitro fertilization (IVF) “the younger sister of eugenics” in a letter aimed at swaying lawmakers ahead of a parliamentary debate. REUTERS/Kacper Pempel (POLAND – Tags: HEALTH RELIGION) Kacper Pempel/Reuters
The recent Alabama state court ruling on what defines an embryo and access to assisted reproductive care has thrust fertility issues into the spotlight, often spotlighting them primarily as women’s concerns. That isn’t the case, which is why it’s crucial to broaden our focus and address male infertility. It also contributes to the challenges couples face and affects the people involved.
When to get treatment for male infertility
In the United States, about 1 in 8 couples have difficulties in getting pregnant or sustaining a pregnancy. Within this context, male infertility plays a significant role, contributing to around 40% of cases of infertility.
Couples are generally advised to seek fertility testing after one year of trying to conceive without success, based on the time it may take for healthy couples when the woman is under age 35. When the woman is over age 35, couples should seek help after just six months of trying. The latter is due to the decrease in fertility that can occur with age, making early intervention important. Even though the ages listed are dependent on the female partner, it’s essential both partners get tested during the fertility evaluation.
Moreover, if there are specific health concerns that might affect fertility, such as known genetic conditions, previous surgeries affecting the reproductive organs, previous cancers that required chemotherapy or chronic diseases such as diabetes, men should consult with a health care provider before beginning to try for a pregnancy. This proactive approach helps address any potential complications early in the process and sets the stage for a more informed and focused attempt at conception.
Laboratory Fertilization Of Eggs In IVF Treatment Stock Photo:Image ID: 155727377 Shutterstock
Clearing the air with facts
The first few minutes of my encounter with my male patients is clearing the air on what is fact and myth about their fertility. It’s about getting on the same page on what is online hype and what is real medicine. Here are the top points I clear up with my patient.
Men’s fertility naturally declines with age, affecting sperm quality and genetic integrity. This process is influenced by lifestyle choices such as smoking cigarettes or vaping, excessive alcohol use and obesity, which significantly reduce sperm quality and production. Health issues such as varicocele, infections and hormone imbalances also impair fertility, just as environmental factors such as heavy metals and excessive heat can damage sperm function. Stress, too, disrupts hormones necessary for sperm production.