It's common but new treatments are bringing help - Most Americans still think of infertility as a women's health issue, but the numbers show that male factor infertility is almost as common.
"It is an unfortunate yet common myth that infertility is a female problem," says Bar-Chama. "In reality, 40% of infertility cases are due to a female factor, 30%-40% due to a male factor and the rest is a combination of the two." Doctors estimate 2.5 million American men could have male factor infertility. About one out of five American couples suffer from infertility.
"Infertility is defined as a couple unsuccessfully trying to conceive after 12 months of unprotected intercourse," says Bar-Chama. "However that does not mean that a couple at high risk for infertility who are anxious should wait a whole year to be initially evaluated."
Fertility declines with age for both men and more so for women, and Bar-Chama recommends that both men and women of advancing age be evaluated early in their attempt to conceive.
Infertility is even more common in men with certain risk factors. "Men are more likely to have fertility problems if they have a history of scrotal or inguinal surgery, undescended testicles or endocrine disorders such as low testosterone and STDs," says Bar-Chama. "Another risk factor is toxin exposures, whether as the result of behavioral choices or chemotherapy received for cancer."
Smoking cigarettes, excessive drinking, being overweight and using anabolic steroids are all factors that decrease fertility.
Male infertility can also have a genetic cause, such as the presence of additional chromosomes or the deletion of important genes responsible for sperm production. Chronic conditions that can contribute to male infertility include dilated veins within the scrotum, called varicoceles, that disrupt the sensitive temperature-dependent process of sperm production.
With today's technological advances, even in the most severe cases where the semen analysis reveals no sperm at all, "we are able to perform complex microsurgical procedures to either relieve blockages or retrieve and successfully utilize sperm directly isolated from within the testicle," says Bar-Chama.
Signs and symptoms
For most men, there are no red flags for infertility until they begin trying to start a family. "If you're trying to conceive and are not successful, it is important to undergo an evaluation of both partners," says Bar-Chama. "It can potentially save you an unnecessary delay in the process and significant emotional pain."
For men, the initial fertility evaluation is simple and noninvasive and is comprised of a physical exam, semen analysis and blood work.
"If the sperm count is low, it is important to figure out why so that reversible conditions can be identified and treated and potentially life-threatening conditions such as testicular cancer can be diagnosed and treated early," says Bar-Chama. "Our goal is optimize the male's fertility potential."
Traditional treatment
The past decade has seen remarkable advances in infertility treatments, which can range from medication to new microsurgery techniques and advanced assisted reproductive technologies.
"Our goal is to optimize the fertility status of the male to achieve the pregnancy in the most natural way," says Bar-Chama. "We want to work with men to see what's curable and what's not curable, and for the most difficult cases we can offer the most advanced micro-surgical and reproductive technologies."
For some patients, the first step is making lifestyle changes like quitting smoking or losing weight. "For others, we can diagnose chronic conditions, including hormonal problems like low testosterone," says Bar-Chama. "We can also evaluate for genetic causes, which can call for advanced or alternative options, such as microsurgical extraction of testicular sperm, adoption or donor sperm."
Microsurgery opens up a wealth or surgical options, including minimally invasive correction of a varicocele and vasectomy reversals. "For men with no sperm in the ejaculate, we can use microsurgical techniques to extract testicular sperm," says Bar-Chama. "Then we coordinate with the harvesting of the women's eggs so that the sperm are injected directly into the female egg, using an
advanced procedure called ICSI" — intracytoplasmic sperm injection.
Research breakthroughs
Advances in treating infertility have improved radically in the past decade, and they continue to evolve.
"Some of the most promising research is focused on isolating, growing and differentiating those stem cells located in the testicle that develop into mature sperm," says Bar-Chama. "These cells have remarkable potential for differentiating into neural, cardiac and muscle cells as well as the future promise of repopulating a sterile testis, for instance after chemotherapy."
Questions for your doctor
One of the first questions about infertility a couple should ask is, "Is it in the male?" Unfortunately, some women go through many invasive tests when a basic noninvasive evaluation would show that the man is the cause. The next question is, "Why do I have male infertility, and are there medical and surgical options to improve my fertility?" Medical advances have enabled many difficult male-infertility couples to become parents.
"Practicing in a male infertility program is truly rewarding," says Bar-Chama. "It's a true privilege to participate in the joy and fulfillment of infertile couples who are successfully treated."
What you can do
Get informed.
The American Fertility Association (theafa.org/), a patient advocacy group, has excellent information on getting pregnant, infertility and finding a local fertility professional. The Society for the Study of Male Reproduction (http://www.ssmr.org) is a good place to identify male infertility specialists in your area. ( nydailynews.com)
"It is an unfortunate yet common myth that infertility is a female problem," says Bar-Chama. "In reality, 40% of infertility cases are due to a female factor, 30%-40% due to a male factor and the rest is a combination of the two." Doctors estimate 2.5 million American men could have male factor infertility. About one out of five American couples suffer from infertility.
"Infertility is defined as a couple unsuccessfully trying to conceive after 12 months of unprotected intercourse," says Bar-Chama. "However that does not mean that a couple at high risk for infertility who are anxious should wait a whole year to be initially evaluated."
Fertility declines with age for both men and more so for women, and Bar-Chama recommends that both men and women of advancing age be evaluated early in their attempt to conceive.
Infertility is even more common in men with certain risk factors. "Men are more likely to have fertility problems if they have a history of scrotal or inguinal surgery, undescended testicles or endocrine disorders such as low testosterone and STDs," says Bar-Chama. "Another risk factor is toxin exposures, whether as the result of behavioral choices or chemotherapy received for cancer."
Smoking cigarettes, excessive drinking, being overweight and using anabolic steroids are all factors that decrease fertility.
Male infertility can also have a genetic cause, such as the presence of additional chromosomes or the deletion of important genes responsible for sperm production. Chronic conditions that can contribute to male infertility include dilated veins within the scrotum, called varicoceles, that disrupt the sensitive temperature-dependent process of sperm production.
With today's technological advances, even in the most severe cases where the semen analysis reveals no sperm at all, "we are able to perform complex microsurgical procedures to either relieve blockages or retrieve and successfully utilize sperm directly isolated from within the testicle," says Bar-Chama.
Signs and symptoms
For most men, there are no red flags for infertility until they begin trying to start a family. "If you're trying to conceive and are not successful, it is important to undergo an evaluation of both partners," says Bar-Chama. "It can potentially save you an unnecessary delay in the process and significant emotional pain."
For men, the initial fertility evaluation is simple and noninvasive and is comprised of a physical exam, semen analysis and blood work.
"If the sperm count is low, it is important to figure out why so that reversible conditions can be identified and treated and potentially life-threatening conditions such as testicular cancer can be diagnosed and treated early," says Bar-Chama. "Our goal is optimize the male's fertility potential."
Traditional treatment
The past decade has seen remarkable advances in infertility treatments, which can range from medication to new microsurgery techniques and advanced assisted reproductive technologies.
"Our goal is to optimize the fertility status of the male to achieve the pregnancy in the most natural way," says Bar-Chama. "We want to work with men to see what's curable and what's not curable, and for the most difficult cases we can offer the most advanced micro-surgical and reproductive technologies."
For some patients, the first step is making lifestyle changes like quitting smoking or losing weight. "For others, we can diagnose chronic conditions, including hormonal problems like low testosterone," says Bar-Chama. "We can also evaluate for genetic causes, which can call for advanced or alternative options, such as microsurgical extraction of testicular sperm, adoption or donor sperm."
Microsurgery opens up a wealth or surgical options, including minimally invasive correction of a varicocele and vasectomy reversals. "For men with no sperm in the ejaculate, we can use microsurgical techniques to extract testicular sperm," says Bar-Chama. "Then we coordinate with the harvesting of the women's eggs so that the sperm are injected directly into the female egg, using an
advanced procedure called ICSI" — intracytoplasmic sperm injection.
Research breakthroughs
Advances in treating infertility have improved radically in the past decade, and they continue to evolve.
"Some of the most promising research is focused on isolating, growing and differentiating those stem cells located in the testicle that develop into mature sperm," says Bar-Chama. "These cells have remarkable potential for differentiating into neural, cardiac and muscle cells as well as the future promise of repopulating a sterile testis, for instance after chemotherapy."
Questions for your doctor
One of the first questions about infertility a couple should ask is, "Is it in the male?" Unfortunately, some women go through many invasive tests when a basic noninvasive evaluation would show that the man is the cause. The next question is, "Why do I have male infertility, and are there medical and surgical options to improve my fertility?" Medical advances have enabled many difficult male-infertility couples to become parents.
"Practicing in a male infertility program is truly rewarding," says Bar-Chama. "It's a true privilege to participate in the joy and fulfillment of infertile couples who are successfully treated."
What you can do
Get informed.
The American Fertility Association (theafa.org/), a patient advocacy group, has excellent information on getting pregnant, infertility and finding a local fertility professional. The Society for the Study of Male Reproduction (http://www.ssmr.org) is a good place to identify male infertility specialists in your area. ( nydailynews.com)
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