MALE INFERTILITY

Almost half of all fertility problems originate with the male partner. There are many causes and treatments. Infertility may be the first sign of a serious illness.

During the initial visit, Dr. Sokol takes a detailed history to uncover symptoms of hormone imbalance or toxic exposures that might interfere with fertility. She performs a physical exam to find any anatomic abnormalities, signs of hormone deficiency or other medical conditions. A semen analysis is done to evaluate the sperm count, motility (movement) and the morphology (appearance). Hormone testing may be requested. Treatment options include life style changes, hormone therapy, surgery, and assisted reproductive techniques.

CHEMICALS , DRUGS, AND LIFESTYLE HABITS THAT INTERFERE WITH HORMONES AND SPERM

Chemicals: Many chemicals may be harmful to sperm production or function because they interfere with the hormones controlling the production of testosterone and/or sperm. Men can be exposed to heavy metals, pesticides, and industrial chemicals such as phthalates and PCBs in the environment or at work.

Drugs: Certain prescription drugs and many recreational drugs can cause male infertility. Cancer treatments such as radiation and chemotherapy often harm sperm.

Lifestyle habits: Obesity, the use of hot-tubs and saunas, and heavy drinking have all been associated with infertility.

LOW TESTOSTERONE

Birth Defects and Delayed Puberty: Some boys are born with a congenital (Kallmann’s Syndrome) or chromosome abnormality (Klinefelter’s Syndrome) that prevents them from producing normal amounts of the male hormone, testosterone. They are unable to go through puberty normally and do not have normal fertility as an adult. These boys may have behavioral and educational difficulties. It is important to diagnose these problems before the boys are teenagers to provide them with the best treatment possible.

Medical Conditions: The onset of low testosterone levels can also occur after puberty and may be caused by brain tumors, drugs, or other medical problems that interfere with the ability of the testes to make testosterone. A careful evaluation will uncover the cause of the problem and lead to the best treatments for these patients.

“Male Menopause”: There is an increased interest in aging as a cause of low testosterone. This is a controversial topic, but most doctors specializing in the field of male reproduction agree that men who are concerned that their testosterone levels are low should undergo a careful evaluation by a specialist. Because very few men meet the criteria recommended by the major medical societies for the diagnosis of low testosterone, it is important to not start a man on medications unless the evaluation clearly indicates that he needs testosterone.

Diagnosis and Treatment: To make the correct diagnosis, Dr. Sokol takes a detailed history and performs a physical exam, looking for symptoms and signs of low testosterone. Hormone testing is done in a specialty lab. Other tests may be ordered. Dr. Sokol then prescribes the type and dose of testosterone medication which will be best for the patient.