When a couple is trying to get pregnant and things aren’t happening quite as quickly as expected, nine times out of 10 it is the woman who will head to the doctor to get checked out. That’s despite the fact that male infertility is just as likely to be the cause for the couple’s trouble conceiving as female infertility and in many cases, it’s easier to diagnose.
You have to wonder if men realised that, would they still be hesitant to investigate male infertility as the reason they were struggling to conceive with their partner.
If you’ve been trying to get pregnant for 12 months or more (six months if you’re over 35), then some investigations are warranted to find out if anything is wrong.
Consideration of factors on the male side of the equation should certainly be part of the plan. To help out, here’s a 101 on male infertility.
What is male infertility?
In a nutshell, male infertility relates to the quality and quantity of a man’s sperm or a physical issue preventing it from getting where it needs to go – either a problem with production or a problem with transport. The trick with male infertility though is that, in most cases, there are no obvious signs of a problem. Usually, intercourse, erections and ejaculation happen without difficulty and the quantity and appearance of ejaculated semen seems normal to the naked eye.
“We need to conduct some testing to find out if a man’s fertility is normal or reduced. The good news is that the majority of those tests can be conducted on a single sperm sample which a man can give in a specially designed Andrology facility,” Genea Fertility Specialist Dr Anthony Marren says.
Approximately two thirds of infertile men have sperm production problems – with low numbers being made, the sperm not functioning properly or a combination of both problems. While sperm do look a little like the pictures you saw in sex education at school – an aerodynamic tadpole – they aren’t as tough or strong as you might have been led to believe.
“Sperm are highly specialised cells with a head that stores chromosomes (genetic material) and a tail that helps them swim. And it’s more common than you might think for men to produce a large number of abnormal sperm,” Dr Marren says.
Some of the main sperm production problems include:
- not enough sperm (oligospermia – a normal amount is considered to be more than 15 million sperm per millilitre of semen);
- sperm that do not swim well (poor motility);
- sperm that are misshapen (morphology – at least four per cent of sperm should be perfect at any given time for maximum fertility);
- no sperm in the semen (azoospermia); and
- presence of sperm antibodies.
These problems can be caused by a number of things – including injury or lifestyle factors – or perhaps the cause can’t be identified:
- excessive alcohol;
- recreational drugs;
- infections such as mumps;
- genetic issues;
- testicular injury;
- undescended testes;
- twisted testis (torsion); and
- radiation damage.
Sometimes the quality and quantity of sperm is fine but a physical issue is causing the problem. Here are some of the most common ones:
- Erectile dysfunction – the inability to achieve or sustain an erection;
- Ejaculatory dysfunction – the inability to achieve ejaculation;
- Retrograde ejaculation – everything retro might be in fashion but this is one area where it’s not cool, as ejaculate containing the sperm flows backwards into your bladder;
- Undescended testis – your testis has not reached its normal position in your scrotum which stops it from functioning properly and may stop it from producing sperm;
- Scrotal varicocele – large veins (varicose veins) wrapping around one or both of your testicles which impairs the ability of the scrotum to cool down and therefore affects sperm numbers and movement;
- Testicular injury;
- Previous vasectomy; and
- Abnormal penile anatomy.
Diagnosing male infertility
The first step in understanding what’s happening with your sperm and finding out why it might not be performing the way you’d like is to conduct a semen analysis. This can be organised through your GP or (with a referral) by a Fertility Specialist.
The area of medicine which assesses male reproductive health is called Andrology – it’s essentially the male equivalent of Gynaecology. Testing for male infertility is a straightforward process and the basic analysis of your semen will examine three factors:
- Sperm count – the number of sperm per ml of ejaculate;
- Sperm motility – the sperm’s ability to swim; and
- Sperm morphology – the shape and size of the sperm.
The semen analysis provides a relative measure of semen quality compared to the general population of proven fertile men. The sample will be assessed for unusual amounts of debris (pieces of dead cells), suspected presence of bacteria, clumping of the sperm and for the presence of cells other than the sperm.
“A top-notch Andrology lab will have specialist experts, called Andrologists, processing and evaluating every sample and it will be doing so promptly, samples should be assessed within 60 minutes of collection to ensure reliable answers are determined quickly,” Dr Marren says.
“Another diagnostic tool which gives us useful information is the SCIT (Sperm Chromatin Integrity Test). It’s used to calculate fertility potential and provide your doctor with a greater prediction of pregnancy outcomes from sperm. It tests for DNA fragmentation (amount of damage to genetic material within the head of the sperm) which can be a factor in miscarriage and male infertility.”
The information in this article does not replace medical advice. Medical and scientific information may or may not be relevant to your own circumstances and should always be discussed with your own doctor before you act on it.
This blog post is sponsored by Genea
If you’re having trouble getting pregnant and would like to investigate male infertility as the cause, learn how to Get Started at Genea. Visit genea.com.au/my-fertility/i-need-help/getting-started