Genea Fertility Specialist Dr Derek Lok demystifies male reproductive health and explains that infertility is not always a female problem.
‘If a couple is struggling to conceive, anecdotally we know that nine times out of 10 it will be the woman who goes along to her GP to find out what’s not working.
Because of this reality, male infertility is often overlooked or shelved while the woman’s reproductive health is investigated. The other issue influencing the approach of doctors has been the relative lack of effective treatments leading them to somewhat overlook male infertility.
This is despite the fact that male factors alone account for almost one-third of fertility problems in Australian couples and male infertility can be detected through a simple, non-invasive semen analysis – an approach which avoids putting women through the risk and discomfort of unnecessarily invasive and expensive investigations such as laparoscopy.
So we highly recommend that couples struggling to conceive go to see a doctor together to discuss the best course of diagnosis and treatment for both partners.
What causes male infertility?
The main causes of fertility problems in men usually involve one or more of these three areas:
- Issues with sperm
- Physical issues
- Medical and family history
Approximately two thirds of infertile men have sperm production problems – with low numbers being made, the sperm not functioning properly (poor motility or shape) or a combination of both problems.
These problems can be caused by a number of things or it might be a cause that can’t be identified:
- lifestyle issue (smoking, excessive alcohol, recreational drugs)
- genetic issues
- undescended testes
- infections such as mumps testicular injury
- heat, chemotherapy or radiation damages.
Sometimes it is a physical issue that is causing a couple to have trouble conceiving. Some of the most common ones include:
- Erectile or ejaculatory dysfunction including difficulties caused by a spinal injury
- Varicocele – an enlargement of the veins within the loose bag of skin that holds the testicles.
- Urogenital anomalies
Medical and family history and hormonal issues
Other factors which can impact on a man’s fertility may be found in his or his family’s medical background. These are some of the issues that can affect fertility:
- A chronic medical condition such as diabetes or high blood pressure
- Previous chemotherapy or radiation treatment for cancer
- A family history of cystic fibrosis or other genetic disorders
- Hormonal problems
- Urogenital infection or surgery
How is male infertility diagnosed?
While diagnosis of male infertility is straightforward, one of the challenges of dealing with potential male infertility is that in many cases there are no obvious signs of a problem.
The first step to diagnosing male infertility is a physical examination and then a semen analysis. The basic analysis of semen tests the overall appearance, acidity/alkalinity and volume of the semen, measures the sperm concentration, motility and vitality, and assesses morphology.
Treatment for male infertility
The good news for men is that many of the sperm conditions affecting fertility can be overcome and some are actually reversible.
Unlike eggs in women which are all made before birth, men continue to produce new sperm throughout their life offering chances to make changes. It takes approximately 11 weeks for new sperm to be produced and fully mature so, for men who are experiencing sperm problems due to lifestyle factors, a little over two months’ of clean living may help them produce healthier, better quality sperm.
Older treatments for male infertility were largely ineffective but current methods like IVF or ICSI (Intra-cytoplasmic sperm injection) are highly effective in helping the sperm to fertilise the egg.
Another important and not infrequent cause of male infertility and treatment failure is sperm DNA fragmentation which can result from oxidative damage caused by cigarette smoking, infections or ill-health or age.
There are also new, emerging methods which allow us to help men who are azoospermic – no sperm present in the semen – and achieve safer and better treatment results with selection of sperm with low levels of DNA fragmentation.
Note: While we welcome questions about infertility treatment and fertility issues, the best source of information about your specific circumstances is always your fertility specialist.
This blog post is sponsored by Genea.
Genea has almost 30 years’ experience helping people achieve their dreams of a healthy baby and has sponsored this post to answer some of your fertility questions.