Male Infertility When couples are having difficulty conceiving, oftentimes the medical focus is on the female. But what many might be surprised to learn, is that males play a significant role in infertility issues. In fact, of the more than three million infertile couples in the United States, physicians estimate that male infertility may be a contributor nearly 50 percent of the time. As with women, the causes of infertility in men are varied, and include genetic, infectious, congenital, diopathic and lifestyle issues. Researchers believe that one major culprit in male infertility is a varicocele, an enlargement of veins inside the scrotum that drain the testicles. As many as 15 percent of all men are believed to have varicoceles, but up to 40 percent of infertile men have them. And, in secondary infertility cases—those couples that successfully conceived one child with no problems, but are unable to do so again—more than 70 percent of men are believed to have a varicocele. Physicians are not entirely sure why these enlargements cause infertility, though they suspect that the enlarged veins cause a rise in temperature in the immediate region, leading to decreased sperm production, and damaging sperm’s speed and shape. Diagnosis is completed through a physical exam, and microscopic surgery is the prescribed treatment. A specialized surgical microscope, which magnifies vision 15 to 20 times, is used to perform this procedure. Seventy percent of men see an increase in sperm production as soon as three months after the procedure, and sperm counts can continue to rise for another seven months. Although other causes of male infertility include congenital defects and disease, physicians don’t know what causes up to 30 percent of all male infertility. Still, a variety of treatment options with good success rates are available for many of these conditions. For example, vasectomy reversals have great outcomes, with up to 95 percent of men producing sperm in a quantity acceptable to conceive naturally, or to be used in conjunction with another procedure, such as artificial insemination. It takes a trained male infertility expert to diagnose and treat male-related infertility issues. Look for someone with fellowship training in the area, with specialized attention to endocrinology research and surgical techniques. In addition, it’s helpful if the specialist is affiliated with a fertility and reproductive center because often, female and male issues “work together” to cause problems. In this way, a team of doctors can work together to solve the problem quickly. Learn more about male infertility.