Infertility has long been misunderstood as primarily a women’s health concern. However, research shows that male infertility is just as prevalent, contributing to nearly 50 percent of all infertility cases. Despite this, public perception often places the burden solely on women, leaving many men unaware of their reproductive health risks.
Dr. Minoos Hosseinzadeh, founder and medical director of the Fertility Institute of San Diego, explains, “Fertility is a shared responsibility between partners. Both men and women can face reproductive challenges, and proper evaluation of both individuals is crucial for successful conception.”
Defining Infertility: A Shared Challenge
Infertility is defined as the inability to conceive after 12 months of regular, unprotected intercourse (or six months for women over 35). Both male infertility and female infertility can result from a wide range of medical, genetic, and lifestyle factors.
While many assume that reproductive difficulties stem primarily from female issues, studies indicate that infertility cases are one-third due to female factors, one-third due to male factors, and one-third caused by a combination of both or unexplained factors.
How Infertility Affects Men and Women
Female Infertility
A woman’s reproductive health depends on egg quality, ovulation, fallopian tube function, and hormonal balance. Several conditions can impact female fertility, including:
- Polycystic ovary syndrome (PCOS): A hormonal disorder that disrupts ovulation.
- Endometriosis: Uterine tissue growing outside the uterus, often leading to inflammation and scarring.
- Diminished ovarian reserve: A reduction in the number and quality of eggs, typically due to aging.
- Blocked fallopian tubes: Prevent sperm from reaching the egg, often caused by infections or past surgeries.
- Hormonal imbalances: Disruptions in estrogen, progesterone, or thyroid levels can hinder ovulation and implantation.
Dr. Hosseinzadeh notes, “Many women assume infertility is solely their issue, but in reality, testing both partners can uncover hidden factors that may be affecting conception.”
Male Infertility
Unlike female infertility, which is often linked to egg quality and ovulation, male infertility is typically associated with sperm quality and production. Key causes of male infertility include:
- Low sperm count (oligospermia): Fewer sperm than normal in semen.
- Poor sperm motility (asthenozoospermia): Reduced movement, preventing sperm from reaching the egg.
- Abnormal sperm shape (teratozoospermia): Morphological issues affecting fertilization.
- Varicocele: Enlarged veins in the scrotum that overheat the testicles and lower sperm production.
- Hormonal deficiencies: Testosterone and other hormones regulate sperm production.
Sperm health declines with age, and lifestyle factors such as smoking, excessive alcohol consumption, obesity, and exposure to toxins can further impact male fertility.
Dr. Hosseinzadeh emphasizes, “Semen analysis is a simple yet powerful diagnostic tool. Many couples struggle for years before realizing male fertility factors play a role.”
Risk Factors Affecting Fertility in Men and Women
- Age: Women experience a decline in egg quality and ovarian reserve after 35, while men see reduced sperm motility and increased DNA fragmentation after 50.
- Lifestyle Choices: Smoking, excessive alcohol intake, drug use, and poor diet negatively impact fertility in both sexes.
- Environmental Toxins: Exposure to pesticides, heavy metals, and endocrine-disrupting chemicals can damage reproductive cells.
- Medical Conditions: Diabetes, autoimmune diseases, and sexually transmitted infections (STIs) can impair fertility.
- Obesity: Excess weight affects hormone levels, leading to ovulation issues in women and lower testosterone in men.
Testing and Diagnosis: A Comprehensive Approach
Fertility evaluation should include both partners to pinpoint underlying causes. Diagnostic tests include:
Female Infertility Testing
- Ovarian reserve testing: Measures levels of anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) to assess egg counts.
- Ultrasound and hysterosalpingogram (HSG): Detects ovarian cysts, fibroids, and blocked fallopian tubes.
- Hormone testing: Evaluates estrogen, progesterone, and thyroid function.
Male Infertility Testing
- Semen analysis: Examines sperm count, motility, and morphology.
- Hormone testing: Checks testosterone and luteinizing hormone (LH) levels.
- Genetic testing: Identifies hereditary issues affecting sperm production.
Dr. Hosseinzadeh states, “It’s essential that both partners undergo testing to develop a treatment plan that gives the highest chance of success.”
Treatment Options for Male and Female Infertility
Medical and Assisted Reproductive Treatments
- Ovulation induction: Medications like Clomid or Letrozole stimulate ovulation in women with irregular cycles.
- Intrauterine insemination (IUI): Sperm is placed directly in the uterus to enhance chances of fertilization.
- In vitro fertilization (IVF): Eggs are retrieved, fertilized in a lab, and implanted in the uterus.
- Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg, commonly used for male infertility cases with low sperm count or motility.
- Sperm or egg donation: Recommended when egg or sperm quality is too poor for conception.
- Surgical treatments: Procedures to remove fibroids, correct varicoceles, or clear blocked fallopian tubes.
Lifestyle Modifications to Improve Fertility
- Maintaining a balanced diet rich in antioxidants, vitamins, and essential minerals
- Exercising regularly while avoiding excessive strenuous workouts
- Reducing stress through meditation, acupuncture, or therapy
- Eliminating smoking, excessive caffeine, and alcohol consumption
- Using fertility-friendly lubricants and tracking ovulation for optimal timing
