An insight into male infertility
People often jump to the conclusion that difficulty in conceiving is mainly due to a woman’s infertility. However, studies show that 30 per cent of infertility is due to the male factor, 30 per cent is due to the female factor, 30 per cent is because of a combined male/female factor and up to 10 per cent remains unexplained.
Regardless of the cause, diagnosing the problem quickly is important.
For men, understanding possible infertility causes will help them feel more in control, allowing the couple to ask the right questions regarding treatment options.
The good news is, technology has advanced to the stage where men who previously could not have children now have a good chance of fathering a child.
What causes male infertility?
Developing and transporting mature, healthy, functional sperm depends on a specific sequence of events occurring in the male reproductive tract. Many disturbances can occur along that path, preventing cells from maturing into sperm or reaching the woman’s fallopian tube, where fertilisation occurs. Male infertility may be caused by:
- Damage to sperm production: low sperm count; poor sperm motility; abnormally shaped sperm; testicular cancer.
- Obstruction of the ducts leading out from the testis: tubes in the epididymis become blocked.
- Hormonal problems: hormonal or chromosomal deficiencies, including insufficient testosterone.
- Health problems: other health issues, such as kidney failure, and past childhood infections, including mumps.
- Genetic problems: genetic factors that impair the normal production of sperm cells.
- Lifestyle choices: for example, smoking, alcohol and certain medication.
- Functional problems: impotence or erectile dysfunction, and vasectomy (acquired factor).
- Unexplained: not being able to conceive after one year despite everything appearing normal.
What are the tests for male infertility?
There are a number of ways to test for male infertility, including:
- Semen analysis: testing for volume of semen; sperm concentration (number); sperm motility (the ability to swim); sperm morphology (shape); white blood cells and sperm antibodies.
- Ultrasound: useful for diagnosing testicular cancer, prostate issues and other abnormalities.
- Genetic and hormonal tests: Kariotype Y deletion studies, FSH, LH, TSH, PRL testosterone.
- Vasography: useful when diagnosing obstructions and abnormalities (not often used).
- Testicular biopsy: allows direct inspection of the sperm-making tissue. If this procedure is carried out by a properly qualified doctor, it may offer a chance of being a biological father despite the absence of sperm in the ejaculate. It is an important method of investigating lack of sperm (azoospermia).
What are the treatment options?
Diagnosing the cause of male infertility will dictate the best course of treatment and path forward to achieve a successful pregnancy. Treatment options include:
- Lifestyle changes: maintaining a healthy weight, exercise, limiting caffeine and alcohol intake, stopping smoking and drug use, reducing stress, etc.
- Hormonal therapy: if a hormonal problem is the cause.
- Surgery: if an obstruction or abnormality is the cause.
- Vasectomy reversal.
- Surgical sperm extraction: when sperm is not being ejaculated in semen despite it being produced.
- Donor sperm.
Following a diagnosis and treatment plan, patients are then advised the best path forward, which could be to try to fall pregnant naturally, utilise assisted reproductive technology (e.g. Intra-Uterine Insemination) or proceed to IVF.
For further information and facts on male infertility, please refer to our Male Fertility Fact Sheet or our Patient Information Booklets page and download the PDFs: “Overcoming Male Infertility” and “In the Know – What No One Tells You About Male Fertility”.
Watch Dr Marcin Stankiewicz as he shares advice on what to do if you have been trying to conceive for more than a year.
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