Did you know that one in five couples will be challenged by fertility issues when trying to conceive? And of these couples who require fertility management, male factor sub-fertility accounts for approximately 30 per cent.
Couples are starting their families later and this, along with the general decline in sperm count over centuries, has led to a rise in the number of couples requiring male factor fertility management.
Read a personal account of what it’s like to be infertile and male.
Females tend to be more proactive when it comes to fertility. So, prior to undergoing months of monitoring the female cycle, it is wise to identify factors that may affect male fertility.
Sperm count for men varies from month to month. For a healthy male sperm, it takes approximately seventy days to mature and many transient health issues (e.g. the flu) can affect sperm count and quality. Genetic causes such as YQ Micro-deletion of the DAS gene are known to be associated with decreased numbers of sperm. Some infectious diseases, including mumps and gonorrhoea, cause marked reduction in sperm numbers. Additionally, lifestyle factors such as smoking, excessive alcohol consumption and marijuana use, along with the consumption of anabolic steroids or muscle building drugs, are known to contribute to reduced sperm numbers.
Some men have extremely low sperm in their ejaculate and this may be due to genetic or hormonal disorders. Low levels of FSH injections have been found to be helpful for some patients. For males experiencing very low sperm numbers, a procedure known as testicular aspiration may be required. By aspirating the testes, it is possible to retrieve a small number of sperm, which will be sufficient to use in an IVF cycle. This procedure is the best option for males having undergone a previous vasectomy. Vasectomy reversal is more expensive than IVF with ICSI (ICSI is where one sperm is injected into each egg in the laboratory) and often the result is compromised by the presence of sperm antibodies. The longer the time between when the vasectomy was performed to the time of reversal, the higher the sperm antibodies. Even if a vasectomy is technically able to be reversed, if the sperm antibody levels are too high, natural conception is unlikely. The test to identify antibodies is not available through pathology providers, but only offered by fertility clinics.
Recent advances in technology have enabled the analysis of sperm for DNA damage. Sperm with high levels of DNA damage are associated with significantly reduced pregnancy rates, even when the numbers of sperm are normal. Holistic treatments including anti-oxidants and utilising fresh sperm on the day of fertilisation in an IVF cycle have been shown to markedly improve fertility outcomes.
The good news is that, in many cases, male infertility can be overcome using IVF in combination with ICSI. A semen analysis early on in the workup of sub-fertility is one of the most important tests a couple can have. It is recommended that if you have been trying to conceive for a while, you should consult your general practitioner with a view to seeking assistance from a fertility specialist.
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– this article was written by Dr Sonya Jessup, Life Fertility Clinic, Brisbane