Infertility can be a challenging and emotional time for people trying to grow their family. While primary infertility—when a couple has never conceived—is often discussed, secondary infertility can be just as difficult to navigate. Secondary male infertility means that issues with the father’s reproductive health can prevent conception after already naturally conceiving and having a child.
Pinpointing the Cause
Secondary infertility affects about 11% of couples in the United States, with about one-third of all cases being male factor infertility.
Even after successfully conceiving before, various factors can change over time and impact a man’s fertility, including:
- Being 40 years or older
- Low sperm count or reduced semen quality
- Reduced testosterone levels
- Testicular varicocele, a condition where the veins in the scrotum become enlarged
- Ejaculatory disorders
- Prostate enlargement or removal
- Medical conditions such as hypertension and diabetes
- Taking medications that affect sperm production
- Genetic conditions
- Lifestyle factors such as weight gain, alcohol consumption, or smoking
“Poor diets with high saturated fat, sugars, and sodium can contribute to obesity, which can affect reproductive hormone levels such as estrogen and testosterone,” says Laura Claflin, DPN, APRN, a nurse practitioner in Men’s Health Services at University of Utah Health. “Moderate physical activity and a well-balanced diet can help regulate sperm production and improve hormone levels.”
Diagnosis and Treatment
Both partners can undergo diagnostic tests after trying to conceive for a year if the female partner is under 35 or for six months if she is older than 35.
To diagnose male factor infertility, men will likely have:
- A thorough physical exam. Reviewing a patient’s medical history and discussing lifestyle factors can help determine if there is an underlying medical reason for infertility or changes they could make to their lifestyle to increase conception chances.
- Semen analysis. A sperm count and analysis can determine the quality and quantity of the sperm.
- Hormonal testing. Checking testosterone levels might point to sperm production problems.
- Genetic testing. A blood test can rule out certain genetic factors, such as chromosomal conditions, that can contribute to male infertility.
- Structural examinations. Additional tests like a scrotal ultrasound or transrectal ultrasound can help identify any structural issues.
Treatment options for male infertility will vary based on the underlying causes, but include:
- Lifestyle changes. Before or in tandem with other medical interventions, you can make positive health changes that can enhance fertility, such as improving your diet, exercising, reducing alcohol consumption, quitting smoking, and avoiding exposure to harmful toxins.
- Hormone treatments. If testosterone or other hormones are not in an ideal range, certain medications or hormone replacement might be recommended.
- Surgical interventions. Certain procedures can address any physical abnormalities, such as varicocele repair or correcting an obstructed vas deferens.
- Assisted Reproductive Technologies (ART). A few different types of treatment are common for couples experiencing infertility, including:
- In vitro fertilization (IVF). An egg is fertilized with sperm in a lab, and an embryo is then implanted into the uterus.
- Intrauterine insemination (IUI). Sperm is placed directly into the uterus.
- Intracytoplasmic sperm injection (ISCI). This type of IVF is used when sperm quality is poor. Live sperm is injected directly into an egg to fertilize it.
“Whatever the cause of your male factor infertility, your team will help you understand all your options for treatment, while also considering you and your partner’s specific goals,” Claflin says.
Navigating Your Journey
Experiencing secondary infertility when trying to grow your family can be confusing and frustrating. Don’t be afraid to seek out emotional support from health care professionals or support groups.
“One important way couples can support one another through struggles with infertility is to work together as a team,” Claflin says. “Communicating with each other and taking time off when needed is important. Counseling and support groups are great resources to learn how to communicate and support one another while making the experience less isolating.”
Understanding the causes of secondary male infertility and your treatment options can provide hope. With the right support and intervention, many couples struggling with infertility go on to successfully grow their families.