Balls in Your Court: Male Fertility Red Flags

Think infertility is just a female issue? Think again. In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols serves up some tough love (and solid science) about male fertility. From hormonal red flags and testicular trauma to lifestyle choices and personal history, this episode breaks down when men should consider that they might be the reason pregnancy isn’t happening.

Whether you’ve been “lucky” to avoid pregnancy in every relationship or just assumed things were working fine because, well, you feel fine — it’s time to check the scoreboard.

No blame. Just facts, awareness, and a gentle reminder: sometimes the strongest move a man can make… is handing over a cup.

Thanks for tuning in to another episode of 'Taco Bout Fertility Tuesday' with Dr. Mark Amols. If you found this episode insightful, please share it with friends and family who might benefit from our discussion. Remember, your feedback is invaluable to us – leave us a review on Apple Podcasts, Spotify, or your preferred listening platform.

Stay connected with us for updates and fertility tips – follow us on Facebook. For more resources and information, visit our website at www.NewDirectionFertility.com.

Have a question or a topic you'd like us to cover? We'd love to hear from you! Reach out to us at TBFT@NewDirectionFertility.com.

Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.

Transcript

0:01

Today we talk about a topic many guys avoid. How to know if you might be the reason you and your partner aren't getting pregnant. I'm, Dr. Mark Amols, and this is Taco about fertility Tuesday. Today we're going to tackle a topic a lot of guys dodge like it's a group text about brunchs. Male infertility. If you and your partner have been trying to conceive and it's just not happening, it might be time to ask, is it me? Well, this episode is for the men out there or the partners of men who want to understand when it's time to consider that the issue might not be her, it might be you. What? Fertility isn't just a female problem. Male factor. Infertility accounts for nearly a, third of all infertility cases and plays a role in, in up to half of the fertility cases. So grab your ego, set it gently to the side, and let's break this down. I can tell you, even myself, I fell into this trap. I thought, hey, everything's working right? I can get erections. I have no problems having intercourse, and I feel pretty manly, so it can't be me. That's what I thought. But when I look back now and I look at my life, I realize, wow, there were signs that there could have been a problem, and I never thought about it. And so when we had infertility and I found out was me, it was a bit of a shock. If I would have just went and checked years before, we could have six years earlier, known there was a problem and maybe started fixing it, potentially the sperm could have been better. And so this episode is to help other guys realize there's nothing demasculating about trying to find out if it might be you two. You may prevent your wife, your partner from going through multiple testings, invasive testings, treatments, even surgery by just doing a simple test. That can help us find out a lot of information. So if you're ready for some tough love, let's get to it. One of the first things you should ask yourself is, do you have a, medical history that raises eyebrows? For example, if you are someone who had undescended testicles as a child, even if it was repaired, there might be an issue if you ever had testicular trauma, such as torsion or surgery, or maybe you're a skateboarder and unfortunately you fell on the handrail when skateboarding, it could potentially be you. If you had mumps after puberty. Mumps can destroy sperm production, but also other things that you May not be thinking about, for example, if you notice that the testic feel a little weird, maybe it feels like there's a bag of worms in theestinal. And yes, men are checking down there. I can assure you if you notice something different, there could be something wrong. But even medical conditions that don't even affect the testles, such as diabetes. If you have diabetes, you could have retrograde ejaculation or even just being obese. Sometimes being obese can lead to high estrogen levels that can then cause your testosterone levels to drop, which can then lead to low sperm count. Now the next category to be looking at are going to be hormonal warning signs. So at these things that are basically causing your testosterone levels to go down. So this going to be like a low libido. Now keep in mind not every guy wants to have intercourse every minute of the day. So it's still normal to maybe not have that high of a libido for some people. But still you know what your normal is. And so if it's changing or if you knowice your partner's will be those is changing, you may want to look into that. The same thing goes for energy. When men have low testosterone levels, they start becoming more fatigued, they have lower energy. And so this would be a reason that could be pointing towards a sperm issue. Another area that men don't like to discuss is erectile dysfunction. Now there are many reasons that you can have a erectile dysfunction. Sometimes it can even be psychological. But for some reason, if you're not able to get erections or you're really struggling to get erections or maintain erections through the whole active intercourse, then you may have lower testosterone levels which can be affecting things. Another sign, although this is more mechanical but can be affected, is if you notice that there is very little ejaculate. Now you may not notice this as their partner, but men do notice how much they are able to ejaculate. If they notice it's very little, like a few drops, then you could have retrograde ejaculation where the sperm is actually going backwards into the bladder versus being ejaculated out. Now the next category I going to be talking about is history. This is where I was talking about myself, you know, with my partner. We were together for many, many years and never got pregnant. And we just thought we were really good at preventing pregnancy. In reality we had problems. And that's something you should be thinking about. If you've been in long term relationships and you weren't using protection and they weren't using protections. But somehow you escaped having a pregnancy. You need to be asking yourself, could you be the problem? Especially if you've been multiple prior relationships and none of those women ended up having pregnancies with you, but then ended up having pregnancies in another relationship. One area that I see a lot of men not think about is using steroids. Now, yes, if you use testosterone, you are going to reduce your sperm count and cause infertility. But I'm not even talking about that. I'm talking about why did you have to go on testosterone? If you had to go on testosterone because you were fatigued or because you were having erectile dysfunction, or someone told you your testosterone was low, then that means you might have a problem because your testosterone level is low, which is why you got on the testosterone. Even if you're off it now, the question is, why did you have to go on it? It's one of the questions I ask patients when they tell me they used to take testosterone. I asked why. Now, if they were doing it because they're a bodybuilder, okay, that makes sense. They're doing it for anabolic steroids so they can get bigger. But if they're doing it for any other reason, it has to do with libido or signs of low testosterone, then that tells me there may be an issue. The last part'going to be family history. Do you have a family history of male factor inferttilility in your family? It can be passed along. For example, my kids, there's a very high chance my sons may have sperm issues since I had a sperm issue. But there are other things too that run in families that can point to potential problems. For example, cystic fibrosis carrier status. There are some men out there who are a cystic fibrosis carrier, and that leads to a thing called cbavd. Congenital bilateral absence of the vas deferens, where they're missing the tube that connects the testicle to the penis. Now, common sense would tell you, oh, well, if they don't have that tube there, just like a vasectomy, then the sperm going to be much less and they're going to know something's wrong. But that's not true. Most of the sperm that's ejaculated could fit on the tip of a pen. Most of the fluid you see is not the sperm. And so you can't look at the volume and think things are good. Now, the volume is low, that's a concern. But the volume is normal. That doesn't mean that there isn't an issue. Now, interesting enough, when you do have cystic fibrosis keas and you do have cbavd, you actually do have low volume, very similar to the situation with retrograde ejaculation. So if you feel your volume is low, then there might be an issue. Now, all guys think it's low because they're used to seeing like videos where people have a whole bunch. But the point is, 2 ML is about the normal amount. So if it's just drops, there's a problem. If it's not a lot, it's probably normal. Now there are some conditions that can also lead to male factor. One of them is called Klelinefelter syndrome. And it's hard to know if you have Klinefelter syndrome because you're going to be a guy, you look like a guy and you are a guy, but because of an extra chromosome, what happens is, is that you can have infertility. Usually these men have more of a female like body and have other appearances that can sometimes tell the doctor that they may have Klinefelter syndrome. Other things you should think about is going to be lifestyle choices. There are lifestyle choices that can affect your sperm. For example, smoking and heavy alcohol use can absolutely affect the sperm quality. Recreational drugs like marijuana can cause a sperm not to move as much. And then we talked about testosterone, anabolic steroids, which will actually shut down the sperm production completely. But the other thing is things like heat exposures, hot tubs, saunas, putting your laptop on your lap and keeping your legs really close together. Even just being overweight causes heat to build up in the testicular region. Or maybe you work a job like you're an H vac worker and you're outside all the time and you don't wear boxers. The point is, heat is one of the biggest problems. And it's not always directly causing a problem. It might be one of the things where, like the straw that breaks the camel's back, maybe your sperm counts good enough, but now all of a sudden you'rejoying to marijuana. You also work outside the hot sun. And now the heat and all those things add up and it's causing the sperm count to go down. So if you're in one of those situations where you are smoking or drinking alcohol heavily, using marijuana, and you guys are having problems getting pregnant, it might be worth getting checked out. One of the kind of weirdest things I think when you think about fertility in men is that testosterone hurts your sperm it's kind of, an oxymoron in some ways. You think? I thought they need testosterone to make sperm, and you actually do not. Having testosterone can cause your sperm count to go down. But when you take testosterone, what happens is your brain says, oh, I guess there's plenty of testosterone. I don't need to make any anymore. And so what happens is, is the B then shuts down the system that makes the sperm. And so, yes, natural intrinsic testosterone is good and what helps make sperm. But if you take a testosterone externally, it's like a birth control and it's going to make your sperm count go to zero. So if you've heard that testosterone helps, that is wrong. Do not take testosterone when trying to get pregnant. If you are taking it, you might want to let your partner know because you're going to have a hard time getting pregnant while taking it because your sperm count is likely going to be zero. Now, there are some clinics out there that will tell you, oh, but you know, if you take HCG with it or you take Clomid or some other medication, your sperm count will be fine. They're not completely wrong, but it depends on where you start. If you start at superman levels, sure, you might be fine even with taking testosterone as long as you're taking those other meds. But for most people who have normal sperm counts, it may not be enough. For people with normal sperm counts, that drop may be enough to prevent you from getting pregnant. So again, if you're taking it, I don't care what they tell you, get the sperm count tested. Don't just believe them, that by taking HCG or Clomid, that's going to make the sperm count come back. Now, in the end, do you need a reason to go get semen analysis? No. You guys are a couple. If you want to go get figured out, go for it. I mean, you prevent her from undergoing more testing than she needs. But more important, you're able then to be part of the solution. If you come back normal. Great. Now we know we have to look elsewhere. If you come back abnormal, we're still going to look at other things. At least now we have a path to look for. Honestly, I think all men should, especially when they're like 20, because if you do have a problem, you could potentially freeze your sperm early. And that way you can avoid getting your testicles cut or a needle stuck in them to get sperm in the future. That alone is enough for me to go get a SEME analysis. But if I didn't scare you, and you didn't get a SEME analysis earlier, then the times you should be thinking about it are times where it will benefit your partner. So you don't need to wait 12 months and not get pregnant to start the testing. Even after six months. Check it. There's no harm if your partner is over 35. Definitely check it even sooner because she doesn't have time to waste. But if you have any of those risk factors that I talked about before or one of those histories where, man, you're just that lucky guy who never gets anyone pregnant, a seam analysis is going to help answer a lot of questions and help you both be on the right path towards success. So here's the deal. Fertility is a team sport. Blame doesn't help anyone. But awareness? That's power. A, seam analysis is easy, it's noninasive and can provide a ton of answers, sometimes even uncovering treatable issues preventing you from potentially having to have major procedures. If you're in this journey with your partner, be all in. Don't just cheer her on from the sidelines while she goes through testing, poking and prodding. Step up. Get tested. Be a full part of the solution. As always, thanks for listening to this episode of Talkac about Fertility Tuesday. You found this helpful, share it with a friend, or better yet, your partner. And remember, sometimes the strongest move a man can make is handing over a cup. If you like this podcast, tell your friends about it and most of all, give us a five star review on your favorite medium. But most of all, keep coming back. Until next time, take care of your health, your partner, and your swimmers. And I'll see you next week on Taco Belt Fertility Tuesday.