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Beyond Hot Tubs and Boxers
Genetic Links to Male Infertility
By Kelly Burgess
Infertility can be traced to the male in 30 to 50 percent of all cases. That's not a statistic that many are aware of, but it's true, says Dr. Mark Leondires, reproductive endocrinologist. Historically, other than being told to stay away from hot tubs and switch to boxer shorts, male infertility issues weren't given a lot of attention. Fortunately, this is changing as science begins to investigate the genetic link in male infertility.
When a couple seems to be experiencing infertility issues, there are some basic physiological conditions that should be evaluated before any more intensive testing is done. "One of the things I tell my patients is that there are three basic components to fertility," says Dr. Leondires. "These are regular ovulation, open fallopian tubes and a good sperm count. Since sperm is easily accessible, that should be done first."
Unfortunately, it doesn't always work that way. "Even in the medical community, there's what I call medical sexism," says Dr. Leondires. "I just saw a patient the other day who discovered the problem was with her husband only after she'd been through four cycles of Clomid."
In the male, in addition to a simple semen examination, diagnosing male factor infertility should include a thorough exam to rule out obvious physical defects of the reproductive system, as well as hormonal deficiencies. Once these factors are eliminated, the semen analysis can help the physician diagnose a host of possible problems that may be a factor in infertility.
"In examining a semen analysis, sperm count becomes just one component," says Dr. Mark Perloe, medical director of Georgia Reproductive Specialists. "A semen analysis is like a UPS tracking number; it can tell us if the sperm is likely to get to the egg. Unfortunately, if the outside of the box is damaged, there may be some damage inside. Sometimes, physicians will overlook the underlying information, such as the presence of immature cells and clues that there may be some infection or abnormality that's damaging the sperm."
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