Fertility is an Equal-Opportunity Issue for Couples

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man and woman sit next to each other on examining table holding hands as a doctor sees them and takes their information on a clipboard

Trouble conceiving is often thought of as a “woman’s problem,” but male fertility issues can affect up to half of all couples struggling to get pregnant. Fortunately, testing for fertility problems in men is easy and non-invasive.

“Even under normal circumstances, it can take up to a year for a couple to achieve a pregnancy,” says Puneet Masson, MD, Director of the Male Reproductive Medicine and Surgery at Penn Fertility Care. “However, 15 percent of couples will still not be able to conceive even after a year of trying.”

“Some patients may be reluctant to undergo evaluation once they realize they may have infertility issues, especially the men,” he continues. “But I tell them that this is a medical condition just like anything else, and that the first step toward successful treatment is a proper diagnosis.”

Dr. Masson specializes in male reproductive medicine and surgery at Penn Medicine Cherry Hill, Radnor and Philadelphia, where he helps couples improve their chances of conceiving naturally and works to pinpoint causes of infertility when possible. He says that men may be at an increased risk of fertility issues if they have a history of smoking, excessive drug or alcohol use, injury to the reproductive organs, or exposure to environmental toxins such as lead and pesticides.

Causes of Fertility Problems

“Many things can contribute to fertility problems, and in some cases, there may be several causes or no identifiable cause,” he explains. “The most common male fertility issues are related to the concentration and quality of sperm.”

For instance, sperm may be malformed, few in number, or unable to move quickly enough. Semen thickness may also restrict sperm motility. Other times, physical problems prevent otherwise healthy sperm from reaching the egg. Common issues include:

  • Masses and cysts in the testicles
  • Physical damage caused by cancer treatment or sexually-transmitted diseases
  • Undescended testicles
  • Blocked tubes or enlarged veins inside the male reproductive organs

To get to the root of the problem, doctors will review a patient’s full medical history and perform a physical exam and semen analysis. Some patients may also require a blood test, ultrasound or genetic screening, Dr. Masson adds.

Treatment options for male fertility issues vary depending on the problem.

“Treatment may include medication, lifestyle modifications or procedures to correct a physical abnormality,” Dr. Masson says. “For some couples, a combination of these things may help, or we may turn to in-utero insemination or in vitro fertilization.”

In some cases, the issue may not be physical.

“Sometimes we find that the issue is tied to intimacy or sexual functioning,” he says. “For instance, couples may not be engaging in sexual relations secondary to erectile dysfunction, pain with intercourse, or orgasmic/ejaculatory dysfunction; these concerns must be addressed.”

Dr. Masson also sees men who are interested in future paternity after having had a vasectomy. “Reversals are most effective if done within 10 years of the vasectomy,” he says. “After that it’s more challenging, but it’s still possible. We also offer surgical sperm extraction, which must be coupled with IVF.”

While there are many medical practices in New Jersey that specialize in female fertility issues, there are not as many options for men. Dr. Masson’s presence in Cherry Hill is changing that.

“If a couple has not successfully gotten pregnant in a year, they should come in for evaluation,” he says. “There is no reason to be embarrassed. In some cases, the problem is easily correctable.”

Fertility After Cancer

Many young men diagnosed with cancer wonder whether they will be able to have children after surviving the disease.

“Certain cancers and treatment options can negatively impact reproduction,” Dr. Masson says. “The Fertility Preservation Program at Penn Fertility Care offers men and women options to preserve their fertility.”

After discussing the patient’s reproductive goals, Penn physicians may recommend cryopreserving sperm for future use.

“We may recommend against this if the semen quality is poor or if the patient is on a treatment protocol that won’t allow it,” Dr. Masson says. “But for the right patients, having this option to preserve fertility is a great comfort. It provides hope.”

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