Infertility is an unfortunate complication many couples experience. It is estimated that approximately 15% of couples worldwide face infertility issues, and half of those are attributed to male factors. For men with chronic kidney disease (CKD), the risk may be even higher. Discover more about the researched factors that are causing men with CKD to struggle with fertility.* 

What Are the Causes of Male Infertility? 

Infertility is one of many potential health consequences of having CKD. The causes of it vary but can be related to: 

• The chronic inflammation caused by CKD can cause hormonal changes, including lowering testosterone levels. While not fully understood, researchers theorize that hormonal changes affect fertility since men who receive treatment for hormonal imbalance show improved fertility parameters.
• Spermatogenesis, which refers to the production of sperm, is also impaired in men with CKD. Decreased sperm count is commonly seen in combination with uremia (a raised level of waste in the blood) and decreased urine volume, especially as CKD advances.
• CKD has been shown to cause erectile dysfunction, possibly due to uremia’s effects on the nervous system, the use of multiple medications, and/or poor mental health. 

Can A Kidney Transplant Fix Infertility?

Research findings are inconsistent regarding whether or not a kidney transplant can reverse infertility, as the immunosuppressant drugs required post-transplant can also negatively affect fertility in some. In addition, pediatric and adolescent transplant recipients appear to struggle more due to CKD’s impact on their bodies during puberty. In many cases, a transplant may reverse certain causes of infertility, but most will likely experience subfertility (reduced fertility with a prolonged inability to conceive). 

Is There Anything to Help with Male Infertility?

Additional work-up, and a discussion with a physician about assisted reproductive technology (ART) options such as intracytoplasmic sperm injection (ICSI), may be beneficial. Research has shown positive outcomes with ICSI in men with CKD. Through this and other assisted reproductive technology (ART), some men can father healthy offspring.

*Lundy, S. D., & Vij, S. C. (2019). Male infertility in renal failure and transplantation. Translational Andrology and Urology, 8(2), 173–181. https://doi.org/10.21037/tau.2018.07.16