Men's Health

Men’s Health Questions Answered: Male Infertility

Dane P. Johnson, MD

Men’s health topics are important to discuss with a doctor, but for many men it is difficult to have these conversations with their health care provider. Discussing sex, prostate health and other men’s health conditions can be uncomfortable, but understanding these conditions and how they affect overall health is critically important for every man.

Dane Johnson, MD, Assistant Professor of Urologic Surgery at Washington University School of Medicine in St. Louis, specializes in men’s health. Johnson sees couples for male factor infertility, helping them achieve pregnancy through his urologic expertise. He encourages men to ask their questions and engage in honest conversations with their doctors. To help start this conversation, Johnson answers some of the questions regarding a sensitive, but important men’s health condition: male infertility.

What is male infertility?

Experiences with infertility can be complex and stressful. For couples who want to have a baby, dealing with infertility is very difficult.

Infertility affects about 20% of the population, and is defined by the inability to achieve pregnancy within 12 months of trying.

As a fellowship-trained urologist in male infertility, I often see couples in my fertility clinic who are experiencing a lot of stress from difficulties achieving pregnancy. Roughly half of couples I see presenting with infertility have some form of male factor.

What causes male infertility?

The first test couples should have at the fertility clinic is a semen analysis. This is a simple test that can quickly identify male factor infertility. Male infertility is diagnosed based on an abnormal semen analysis that demonstrates either low motility, low sperm count or abnormal sperm function. There can be multiple causes of male infertility that may be present on examination or through further laboratory workup.

These diagnoses can include scrotal varicoceles or low testosterone, as well as several other potentially correctable factors for male infertility.

Varicoceles are the number one identifiable cause for male infertility. They are abnormal, dilated veins in the scrotum that alter the temperature of the testicle and disrupt sperm production. These can be corrected surgically, with a small incision on the groin that allows us to identify and remove the dilated veins, and reestablish normal temperature in the testicle and therefore improve sperm production.

What other infertility treatments are available?

In addition to seeing men with male infertility, I work in close collaboration with experts at the Fertility and Reproductive Medicine Center to address factors for female infertility. The specialists at the Fertility and Reproductive Medicine Center understand the challenges of infertility and are here to help with their expertise in reproductive endocrinology.

As a team, we work to identify any and all infertility factors affecting a couple, in the hopes of achieving a successful pregnancy.

Thank you for being our patient at Washington University School of Medicine in St. Louis. Urologic problems can be very complex and difficult to discuss. We appreciate your openness and willingness to trust in our expertise. We will do everything we can to take care of you and aim for the best outcome.