Male infertility is a topic that touches the hearts of many couples on their journey to conceive. Defined as any medical condition in a man that reduces the likelihood of his female partner conceiving, male infertility can be a complex and challenging issue to navigate.

In this blog post, we delve into the various aspects of male infertility, from its causes and evaluation to treatment options and lifestyle changes that can improve sperm quality. Whether you’re a man facing infertility or part of a couple trying to conceive, understanding male infertility is the first step towards finding solutions and achieving your dream of parenthood.

How can Male Infertility be Defined?

Male infertility refers to any medical condition in a man that reduces the likelihood of his female partner conceiving.

Roughly 13 out of every 100 couples struggle to achieve pregnancy through unprotected intercourse. Infertility can stem from various factors affecting both men and women. In more than a third of infertility instances, the issue lies with the male partner, typically attributed to issues related to sperm production or delivery.

Making mature, healthy sperm that can travel depends on many things. Problems can stop cells from growing into sperm. Problems can keep the sperm from reaching the egg. Even the temperature of the scrotum may affect fertility.

These are the main causes of male infertility:

  • Sperm Disorders
  • Varicoceles
  • Retrograde Ejaculation
  • Immunologic Infertility
  • Obstruction
  • Hormones
  • Medication

Understanding the Male Anatomy: What Happens Under Normal Conditions?

The male body produces minuscule cells known as sperm, which are typically delivered into the female’s body during sexual intercourse. The male reproductive system is responsible for generating, storing, and transporting sperm, with hormonal regulation playing a crucial role in this process.

Sperm production and the synthesis of the male sex hormone (testosterone) occur within the two testicles located in the scrotum, a pouch of skin beneath the penis. From the testicles, sperm move into a tube situated behind each testicle called the epididymis.

Before ejaculation, sperm transition from the epididymis to a separate set of tubes known as the vas deferens. These vas deferens tubes extend from the epididymis to the pelvic area behind the bladder. Here, they merge with the ejaculatory duct from the seminal vesicle.

During ejaculation, sperm combine with fluids from the prostate and seminal vesicles, forming semen. This mixture then travels through the urethra and exits the body via the penis.

Male fertility relies on the production and proper delivery of healthy sperm, which enter the female partner’s vagina during intercourse.

From there, the sperm journey through her cervix, into the uterus, and ultimately reach the fallopian tubes, where fertilization can occur if a sperm encounters an egg.

The functionality of this reproductive system hinges on a harmonious interplay of genetic factors, hormonal balance, and environmental circumstances.

If you feel that you may be a candidate for male infertility testing, or are struggling to conceive, it is a good idea to consult with one of our trusted fertility specialists

How will my Fertility Specialist Evaluate the Cause of My Infertility?

Our specialist will inquire about your medical and surgical backgrounds, focusing on factors that could affect fertility such as reproductive system anomalies, hormone imbalances, illnesses, or injuries. They will discuss childhood ailments, current health issues, medications, and lifestyle habits like alcohol, tobacco, and drug use, as well as exposure to environmental hazards like radiation and heavy metals.

The physical exam will assess the penis, epididymis, vas deferens, and testicles, and check for varicoceles, which are easily detectable during the exam.

Semen Analysis:

A routine lab test called semen analysis evaluates sperm production, motility, count, concentration, and structure. This test may be repeated if abnormalities are found to assess fertility potential and identify any issues with sperm growth or delivery.

Testicular Biopsy:

In cases of meager sperm count or absence of sperm, a testicular biopsy may be necessary to investigate infertility causes and retrieve sperm for assisted reproduction techniques like IVF.

Hormonal Profile:

Our specialists may also assess hormone levels, particularly follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), Prolactin, and testosterone, to understand testicular function and rule out underlying health issues affecting sperm production.

Transrectal Ultrasound:

If needed, a transrectal ultrasound performed by a urologist can provide detailed images of the ejaculatory ducts and seminal vesicles, checking for abnormalities or blockages.

Treatment Options for Male Infertility

Male infertility can be treated through various surgical options tailored to specific conditions.

Here are key procedures for addressing different causes of infertility in men:

  1. Varicocele Treatment: Corrects swollen veins to enhance sperm quality.
  2. Azoospermia Treatment: Addresses sperm blockages or low production, often combined with assisted reproduction.
  3. Microsurgical Vasovasostomy: Reverses vasectomy by reconnecting vas deferens segments.
  4. Vasoepididymostomy: Connects vas deferens to the epididymis, useful for epididymal blocks.
  5. Transurethral Resection of the Ejaculatory Duct (TURED): Treats ejaculatory duct blockages, with some success but potential risks.
  6. Empiric Therapy for Unknown Causes: Utilises hormone balancing and other empiric treatments for idiopathic infertility.

 

In the case of male infertility, where conventional infertility treatments fail or are unavailable, assisted reproductive techniques (ARTs) offer alternatives for achieving pregnancy without intercourse.

These methods, recommended based on the specific infertility type and cause, include:

  1. Intrauterine Insemination (IUI):

Sperm is placed directly into the uterus via a tube, beneficial for various fertility issues like low sperm count, retrograde ejaculation, and more.

  1. In Vitro Fertilization (IVF):

Eggs are fertilised with sperm in a laboratory dish after ovarian stimulation. IVF is versatile, addressing hormone imbalances, blocked tubes, idiopathic infertility, and severe oligospermia.

  1. Intracytoplasmic Sperm Injection (ICSI):

A single sperm is injected into an egg, aiding severe male infertility cases or when no sperm is present in semen due to blockages or testicular failure.

  1. Sperm Retrieval for ART:

Microsurgical techniques extract sperm from obstructed areas, aiming for optimal quality and quantity without harming reproductive organs.

There are many ways in which sperm quality can be enhanced through simple lifestyle changes. If you struggle to conceive, it may be worth undergoing a few lifestyle changes to aid in the process.

Lifestyle-Related Changes that can be made to Increase Sperm Quality:

Various factors can influence sperm production and quality, either positively or negatively. Understanding these factors and making appropriate lifestyle choices can play a crucial role in supporting male reproductive health.

Factors Beneficial to Sperm Production and Quality:

Maintaining a healthy and balanced diet, engaging in regular exercise and considering supplements when necessary are all beneficial for sperm production and quality. However, it’s important to note that significantly improving sperm quality can be challenging.

Factors Disadvantageous to Sperm Production and Quality:

On the other hand, several factors can negatively impact sperm production and quality. These include excessive alcohol consumption, drug use, prolonged exposure to heat, frequent long baths, tight underwear, certain chronic medications, excessive stress, radiation exposure, STDs, physiological deficiencies, and specific diseases.

A few over-the-counter supplements can also be used to increase sperm health, consult with our specialists to find out more.

Supplements for Sperm Health:

Supplements such as Vitamin E, folic acid, zinc, and Vitamin C support sperm health. Common multivitamins designed specifically for sperm health include Sperm-i-prove, Staminogro, Insumax-Q and Prelox.

FAQ’s Related to Male Infertility, Answered

  1. Can I recover from testicular trauma? 
    1. Yes, however, it could have a lasting effect on your sperm.
  2. Does age affect my sperm the way a woman’s age affects her egg quality?
    1. Yes! Male sperm DNA fragmentation does tend to increase with age, however, this age limit is not as severe as in females. It can also vary from male to male. This fragmentation starts to show around 50+.
  3. How long are my semen analysis results valid for?
    1. It depends on the use of the results, however they are usually valid anywhere from 6 months to a year.
  4. What is DNA Fragmentation?
    1. DNA fragmentation refers to the DNA damage within the sperm, which can decrease the chances of falling pregnant.
  5. If only 1 sperm fertilises an egg, why are there millions of sperm in an ejaculate?
    1. The journey that sperm make from the deposit of the ejaculate outside of the cervix to meeting the egg in the Fallopian tube is a very long and tough one. The odds are certainly stacked against the sperm making it to the end. For example, sperm have to make it through the cervix, up the uterus and down the correct Fallopian tube all to find one little egg. On top of that, the female environment isn’t conducive to sperm survival – it’s too acidic for the alkaline needs of the sperm.
  6. How long do I need to abstain before giving a semen sample, and why?
    1. One usually expects the abstinence period to be anywhere from 2 to 4 or 5 days.

 

The abstinence period can play a vital role in sperm volume and motility. Different abstinence days could apply to different semen parameters; however, it is always vital to follow the instructed abstinence period to ensure proper efficient handling of the sample.

Male infertility is a multifaceted issue with diverse causes and treatment options. From sperm disorders to hormonal imbalances, various factors can contribute to male infertility, each requiring a tailored approach for evaluation and management.

With advancements in assisted reproductive techniques and lifestyle modifications that support sperm health, there is hope for couples facing male infertility to realise their dream of starting a family.

By working closely with fertility specialists and making informed choices, individuals can navigate the challenges of male infertility and embark on the path towards parenthood with optimism and determination.