Male infertility is any condition in which a man is unable to impregnate his female partner. Most commonly, this occurs when the man is unable to produce or deliver fully-developed sperm.

Symptoms
Infertility does not exhibit external symptoms per se, but it can be defined as an inability to conceive after regular, unprotected sexual contact over the period of at least one year.

Treatment Options

• A low sperm count can be treated by collecting and concentrating healthy sperm for use in an artificial insemination procedure.
• Semen without sperm can be treated by using either mature or immature sperm surgically removed from the testicles.
• In cases of retrograde ejaculation, sperm can be recovered from the bladder and used for insemination.
• Structural problems can be treated surgically, increasing the chances of natural conception.
• Sperm production problems caused by hormonal imbalances can be treated with medication

Possible Causes and Prevention
The most common cause of male infertility is low sperm count. Causes of sperm count problems include:

• Hormonal problems
• Testicular failure as a result of injury or disease
• Chemotherapy or radiation treatment for cancer
• Immunologic infertility, which is caused by a man's immune response to his own sperm
• Drug use, including some prescription medications, marijuana and tobacco
• Structural problems and blockages
• Chromosomal problems

Infertility can be related to lifestyle, and it is important to maintain a healthy weight by eating a balanced diet and regularly exercising. In order to protect your fertility, avoid the following:

• Smoking cigarettes and marijuana
• Exposure to harmful chemicals
• Excessive alcohol use
• Sexually transmitted diseases (by using a condom)

Resources
The American Society for Reproductive Medicine: http://www.asrm.org
Reproductive Health Council of the American Foundation for Urologic Disease: http://www.reproductive-health.org

A vasectomy is a minor surgical procedure that involves cutting the vas deferens, the small tube that carries sperm from a man's testicles. Following the surgery, you can continue to perform sexual intercourse as before, but your semen no longer contains sperm. The absence of sperm eliminates your ability to conceive children following the procedure. Our physicians perform hundreds of vasectomies per year and will take the time to answer any questions you may have regarding the procedure.

The Benefits
A vasectomy is among the most effective methods of birth control. It does not disrupt your normal sexual function. A no-scalpel technique is most commonly used, which involves a single tiny puncture hole, which requires no sutures to close, making the procedure relatively painless.

Following the procedure, sperm cells are simply absorbed by the body without any ill effects.

The Drawbacks
Although a vasectomy is considered to be among the safest surgical procedures, there are risks associated with any surgery, including excess blood loss and infection. Following the procedure, you may experience pain, which is most often is treated with medication. A vasectomy is a permanent procedure, and you should not consider the procedure if you wish to conceive in the future. There are procedures to reverse a vasectomy, but there is no guarantee that this procedure will be effective for you.

Resources
Vasectomy.com: http://www.vasectomy.com/index.htm

Erectile Dysfunction (ED), also called impotence, describes a man's inability to achieve and maintain an erection hard enough for sexual intercourse. It is important to remember that male impotence is a condition and not a disease. It most commonly occurs when something in your body or your mind is not working correctly.

Symptoms
Symptoms of erectile dysfunction include being unable to:

• Have an erection at any time, either with masturbation or with a sex partner.
• Maintain an erection firm enough for sexual intercourse.
• Maintain an erection long enough to complete sexual intercourse.

Even with an erection problem, a man may still have sexual desire and be able to have an orgasm.

Treatment Options
About 85% of male impotence is due to physical causes, while the remaining 15% results from psychological causes. Your physician will perform a complete history and physical exam to devise a treatment plan specifically for you. Common treatments for impotence include:

• Therapy using drugs like Viagra®, Levitra®, and Cialis® that work to increase blood flow to the penis.  
• A penile implant can be surgically inserted that creates an artificial erection. This involves implanting a small, saline-filled medical device, which is completely concealed and transfers fluid to the penis when an erection is desired.
• An erection can be achieved by using a vacuum erection device, which draws blood into the penis by creating a vacuum, making it erect. A elastic band is then placed around the base of the penis to keep it firm.    
• Injection therapy can be used, which requires an injection of medication into the side of the penis. The medication makes the blood vessels dilate, allowing increased blood flow to create an erection.
• A suppository can be inserted into the urethra, which increases blood flow, creating an erection. 
• Psychotherapy is often helpful in teaching a man how to reduce anxiety associated with sex. 

It is important to realize that impotence treatments all have different complications and side effects. The best treatment for you will depend on a variety of factors, and a thorough evaluation prior to starting therapy is necessary.

Possible Causes and Prevention
For most men, erections gradually become more difficult to get and maintain with age. A few things you can do to reduce the chance of developing erectile dysfunction include:

• Quit smoking
• Avoid use of excess alcohol and illegal drugs
• Eat a healthy, well-balanced diet
• Manage high blood pressure
• Exercise regularly
• Reduce stress