A urinary tract infection (UTI) occurs when bacteria invade and multiply within any part of the urinary system, which includes the kidneys, ureters, bladder, and urethra. Male infertility refers to any health issue in a man that reduces his chances of impregnating a female partner. This condition often involves problems with sperm production or its delivery, making it difficult to achieve pregnancy after a year of unprotected intercourse. Understanding the potential connection between UTIs and male infertility is important for those seeking to start a family.
Male Urinary Tract Infections
Urinary tract infections in males result from bacteria, often E. coli, entering the urethra and ascending into the urinary tract. While less common in males compared to females due to anatomical differences, UTIs in men can be more complex. Symptoms include a painful or burning sensation during urination, frequent urges to urinate, and sometimes pain in the central lower abdomen or back. Urine might also appear cloudy, have a strong odor, or contain blood. Factors increasing the risk of UTIs in males include an enlarged prostate, kidney stones, diabetes, or the use of urinary catheters.
How UTIs Can Impact Male Fertility
Urinary tract infections can affect male fertility through several mechanisms, by causing inflammation that spreads to reproductive organs. An untreated UTI can lead to bacterial infection of the prostate gland, known as bacterial prostatitis. Prostatitis can impair the prostate gland’s production of semen, the fluid that carries and nourishes sperm. This inflammation within the seminal tract can also alter sperm characteristics and may lead to obstructive azoospermia, where sperm are absent from ejaculate due to blockage.
The infection can also spread to the epididymis, a coiled tube at the back of the testicle that stores and carries sperm. Known as epididymitis, this causes inflammation and intense pain. Severe epididymitis can damage the epididymis and testicle, or block the epididymis tube, preventing sperm from traveling to the vas deferens and reaching the seminal vesicles for ejaculation. In some cases of epididymitis, the body may produce anti-sperm antibodies, which can attack and destroy a man’s own sperm, further contributing to infertility.
Severe infections spreading to the testes, called orchitis, can directly impact sperm production. Inflammation and damage to the testicular tissue can lead to reduced sperm count or impaired sperm quality. While less common, the systemic inflammation from a severe UTI can also indirectly affect spermatogenesis, impacting the number, shape, or movement of sperm.
Diagnosing Fertility Concerns
Diagnosing male infertility, especially when a UTI is suspected as a contributing factor, involves a comprehensive evaluation. An initial step includes a thorough medical history, discussing past illnesses, surgeries, and lifestyle factors. A physical examination is performed to assess the genitals, including the testicles, epididymis, prostate, and penis, checking for any abnormalities, swelling, or tenderness. Testicular size and consistency are also evaluated, as small or firm testicles can indicate sperm production issues.
A semen analysis is a primary diagnostic tool, evaluating the volume and quality of sperm. This test measures parameters such as sperm count, motility (movement), and morphology (shape), and can identify white blood cells, which may indicate an infection.
For very low or absent sperm counts, hormone testing may be conducted to measure levels of testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin, as imbalances can affect sperm production. Imaging studies, such as scrotal or transrectal ultrasound, can identify structural issues like varicoceles or blockages within the reproductive tract, prostate, or seminal vesicles. If retrograde ejaculation is suspected, a post-ejaculation urinalysis can detect sperm in the urine. Genetic testing may also be considered for extremely low sperm concentration to identify underlying genetic causes.
Treatment and Management
Addressing male infertility linked to a UTI begins with treating the underlying infection. Antibiotics are commonly prescribed to clear bacterial infections in the urinary tract or reproductive organs. Antibiotic treatment duration varies, but completing the full course ensures eradication and prevents recurrence. Prompt treatment of infections like epididymitis or prostatitis reduces inflammation and minimizes long-term damage to reproductive structures.
Once the infection is resolved, healthcare providers will reassess fertility. If sperm parameters remain affected, further medical interventions may be considered. These include medications for improving sperm production or addressing hormonal imbalances. Surgical procedures may be necessary to correct blockages in sperm ducts caused by severe inflammation or scarring.
For couples still facing challenges conceiving, assisted reproductive technologies (ART) such as in vitro fertilization (IVF) may be recommended. IVF involves combining sperm and eggs outside the body, bypassing issues with sperm transport or function. Lifestyle adjustments, including a healthy diet, avoiding smoking and excessive alcohol, and managing stress, also support reproductive health. Consulting a urologist or fertility specialist is important for personalized advice and treatment planning.