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Why a Male Fertility Evaluation Could Benefit His Overall Health

October 9, 2013

Infertility is often a symptom of an underlying health condition. For women, conditions like PCOS or Hypothalamic Amenorrhea result in anovulation and could be indicative of endocrine system hormone imbalances. Sometimes balancing diet and exercise can restore a woman’s menstrual cycle.

As it turns out, this concept also applies to men. Male factor infertility is responsible for about half of all infertility cases, and as many as 40% of infertility cases are the combined result of both male factor and female factor infertility. It is important for men and couples to be educated on male factor infertility and to seek an evaluation to rule out hormone imbalances resulting from poor diet and lack of exercise, cancers, or other underlying health conditions which manifest through poor sperm quality or quantity.

Natan Bar-Chama, M.D., a Urologist and Director of Male Reproductive Health at Reproductive Medicine Associates of New York says that although the technology is available, and certainly successful in helping patients to conceive, the bigger concern is that the underlying cause of infertility could be an indication of a serious health complication. “It is important for people and couples to be educated about fertility, ask questions, and address health concerns,” he advises. In doing so, patients will understand the link between overall health and fertility, will receive treatment, and may even be able to avoid more advanced or invasive reproductive techniques.

When it comes to male fertility and health, Dr. Bar-Chama believes there are three imperative questions to ask during an evaluation:

  1. Does the male have underlying (potentially life threatening) health conditions like cancer? The prevalence of testicular cancer is higher in men with infertility and is the most common cancer found in young men. Testicular cancer impacts sperm production, therefore it is manifested in low sperm count. Similarly, a prolactinoma, or tumor on the brain could produce low levels of testosterone which presents as infertility.

  2. Does the man have a history of genetic disease? Low sperm count could also be the result of a genetic disease. It is important for men to get the diagnosis and to seek appropriate treatment. An educated couple can also make decisions about family building should their future child be at risk of inheriting sex-linked genetic disease.

  3. What is the man’s testosterone saying about his health? Testosterone, produced in the testes, is critical for sperm production and normal male physiology. Low testosterone affects cardiovascular health, risk of diabetes, metabolism, bone density, and mental health. Making a diagnosis at the age of 20 or 30 can help a man to be treated earlier in life and suffer a less significant impact on his fertility.

Once these three concerns have been ruled out or treated, and if sperm quality or quantity remains suboptimal, treatments are available to help the couple conceive. Varicoceles which impair sperm production and ejaculation can be repaired, sperm can be retrieved from testicular tissue, infections can be treated, and procedures like ICSI can ensure egg fertilization with one healthy sperm. “The technology is so good, that very often as long as we have some sperm, we can do IVF. However, most couples want to conceive in the most natural manner and avoid assisted reproductive technologies (ART) if they can,” he says.

Dr. Bar-Chama strongly urges couples to seek an evaluation by a comprehensive care team to rule out or treat underlying health conditions rather than utilizing advanced reproductive technologies without exploring the cause of infertility. He tells patients: “It doesn’t stop with a semen analysis. That is the first step, but if results come back abnormal (aside from normal fluctuations), it is imperative to evaluate why the results are abnormal rather than jumping to IVF with ICSI. Doing so without understanding the cause is potentially detrimental to the male patient or even life threatening.”


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