How Do I Know If I’m ‘Firing Blanks’? — Ask Dr. Harry Fisch

My wife is having trouble getting pregnant. Could my sperm be the problem?
 -- Ted, 31, Hartford, CT

Yes, your sperm (or lack thereof) could certainly be the problem.

It’s a little-known fact that in any instance of infertility, the problem is on the guy’s side about 40% of the time. The problem is on the woman’s side about the same—40%. The remaining 20% of cases have unknown causes.

You should see a doctor and get a semen analysis—it’s simple and it’ll tell you if you’ve got the normal amount of sperm in your semen and if they’re healthy.

If there’s a problem, it could be caused by a variety of things, including: medical problems (such as enlarged veins in the scrotum, an infection, or obstruction of your ejaculatory ducts), obesity (it lowers your testosterone levels), poor diet, use of steroids to enhance athletic performance, excessive smoking, alcohol use or drug use or genetic causes.

The good news is that these days there are lots of ways for men with fertility problems to father children. But you’ll need a proper diagnosis to determine what option is best for you.

Dr. Harry Fisch is a board certified urologist at New York Presbyterian Hospital/Weill Medical College of Cornell University. He’s here to answer reader questions in an effort to get guys to “man up about health.”