One third of couples having trouble conceiving are affected by fertility problems in the male partner alone. Male infertility may still come with an unwarranted social stigma, but it’s important to seek the advice of a fertility expert as your fertility is just as important as your female partner’s when it comes to making a baby.
Problems with the testicles directly impact sperm production and contribute to the majority of male fertility issues. To create a baby, sperm need to be able to find and merge with your female partner’s egg. Disorders of the testicles can include variocele (enlarged veins in the scrotum), genetic low sperm count or complete absence of sperm, genetic syndromes, injury, trauma or infection, or poor sperm quality and quantity of unknown cause.
Unfortunately, some cases of male fertility problems have no detectable cause, and these are known as idiopathic male infertility. Studies vary on how prevalent this condition is, with some estimating up to 40% of couples struggling to conceive being affected. In these situations, the findings from your semen analysis may all be normal but you are still having trouble conceiving.
Disruption to your body’s balance of hormones can also throw your sperm production off. Conditions such as Kallman syndrome or hyperthyroidism can make conception difficult by interfering with your hormones, as can head trauma, a pituitary tumour, and taking testosterone supplements.
Sperm are produced in your testicles and then must travel through two tubes known as the vas deferens, into the ejaculatory ducts, then out the urethra during ejaculation. A vasectomy is a type of sperm transport disorder (albeit an intentional one), involving cutting and tying the vas deferens tubes as a form of sterilisation. Other disorders affecting sperm transport include being born with incompletely formed sperm ducts, or untreated infections that cause scarring and blockage.
Your initial consultation with our fertility specialists will include:
As the majority of male fertility challenges come down to abnormal sperm or semen parameters, the primary test for male fertility is a semen analysis. This will investigate:
Depending on the results from your initial investigations, you may also be referred for ultrasound imaging or blood tests.
If our testing uncovers a hormonal disorder or infection, you may be prescribed medication. Medical treatment may help restore normal hormone levels, improve sperm production or address underlying conditions that are affecting fertility. In some cases, medication can also reduce inflammation or treat reproductive tract infections that may be impacting sperm health.
Some conditions, such as varicocele or obstruction of your vas deferens, may require surgery to repair. In the case of severely abnormal sperm or if there are no sperm in your ejaculate, a surgical procedure known as testicular sperm aspiration or extraction can be used to retrieve sperm directly from your testicles for use with assisted reproduction.
Healthy lifestyle habits can play an important role in supporting male fertility. Maintaining a healthy weight, exercising regularly, eating a balanced diet and getting adequate sleep may help improve sperm health. Reducing alcohol consumption, avoiding smoking and recreational drugs, and minimising exposure to excessive heat and environmental toxins can also have a positive impact on fertility in men.
Unexplained male infertility where no cause can be identified, or any other conditions that cannot be addressed through medications or surgery may be good candidates for assisted reproductive technologies.
