Let’s talk about male infertility. A common statistic you will hear in relation to fertility is that 1 in 6 couples worldwide struggle to conceive. Many people assume that in the majority of these cases of infertility, treatments such as IVF are used to overcome female fertility issues. However, it has been found that over a third of cases are due to male factor infertility. Dr James Hopkisson, Medical Director at TFP Fertility Group is on hand to answer our questions on male infertility.
What are the causes of male infertility?
Generally, millions of sperm cells are produced in the testes every day, with each sperm remaining in the testes for approximately 10 weeks. The most common cause of male infertility is the sperm being of low quality. Common sperm abnormalities are:
- Low sperm count, or no sperm present at all
- Sperm that are not moving properly
- Abnormally shaped sperm – making it harder for them to move and fertilise an egg
Problems with sperm are a common issue and can occur for a number of reasons including lifestyle factors, testicular infections or injury, hormonal defects, cancer, genetic conditions and uses of different medicines. It is also worth noting that fertility can change over time, even if you have already fathered a child. This may be due to illness, a change in lifestyle or age.
Fertility tests for men
The first test when looking at male fertility is a semen analysis which, in addition to the sample’s volume and pH, assesses the following:
Sperm Count: the number of sperms present in each millilitre of semen
Sperm Motility: how well the sperms are moving
Sperm Morphology: the number of sperm that are of normal size and shape
The results from this test can help to diagnose possible sperm problems and to help determine which treatment is required.
What is/what happens in a semen analysis?
A semen analysis is an assessment of the number, motility and morphology of sperm in what is ejaculated. It should be carried out in a specialist laboratory and the normal parameters are dictated by a population survey by the World Health Organisation. A sample should be ejaculated into a sterile pot provided by the lab, usually after two to three days abstinence, to optimise sperm quality. The sample needs to be delivered to the lab within an hour of production to be analysed. If this proves difficult you can do your sample at the Fertility Unit so as not to have the anxiety of brining the sample in.
What happens if I have low sperm motility or a low sperm count?
If you have a low count, motility or morphology it is worth repeating 2-3 months later after lifestyle change. Sperm count can fluctuate so sometimes it is not something to worry about. If there are persistent issues with a sperm count then referral to get advice on types of treatment available is required. If there is no sperm in the ejaculate (azoospermia) other tests maybe required such as hormonal assessments, genetic tests and a medical examination of the testes including ultrasound. These will require review by your doctor and referral onto a fertility specialist. This can either be in the NHS or at a fertility group such as TFP Fertility Group.
What does sperm morphology means?
Morphology is what a sperm looks like down the microscope. A sperm has a head a midpiece and a tail. We can look at different parts of the sperm and see if they look “normal”.
What does a normal-shaped sperm look like?
A bit like a tadpole. It should also be swimming in a characteristic way
Is there anything I can do to improve the health of my sperm?
Yes there are many:
- Avoid binge drinking alcohol
- Minimise caffeine intake
- Loose fitting underwear
- Avoid long hot baths
- Healthy lifestyle, vitamin C Zinc and selenium. L-Carnitene may be beneficial
- Anti-oxidants may also help, but evidence is not strong
- High protein diets and gym supplements: always be careful and check what is contained in them
- Never use anabolic steroids: although you may want to be beech ready for the summer, they will suppress sperm production and sometimes this is not recovered.
Which fertility treatments can help to overcome male infertility?
Treatment of male infertility is tailored to the individual, and there may be simple lifestyle changes that can be made in order to improve the quality of the sperm. However, in some cases, treatment may be required, with options including:
- Intracytoplasmic Sperm Injection (ICSI): In many cases of male factor infertility, a procedure called ICSI is used. This is when sperm is injected directly into the egg as part of the IVF process. This can help to overcome low sperm count or motility.
- Surgical Sperm Retrieval: Men who have no sperm in the ejaculate, may have to have sperm surgically retrieved prior to ICSI.
- Donor Sperm: In some cases, it may be that donor sperm is required in order to achieve a pregnancy, through known or altruistic donation. One of the first questions you need to ask yourself is whether donor conception is the right fertility treatment for you. Special counselling sessions are available at fertility clinics to discuss implications and feelings surrounding donor treatments
What support is available for men as they go through fertility treatment?
Male fertility issues can often be seen as a taboo subject, and research has found that over half of men wouldn’t be open to discussing infertility with their partner. Due to the fact, men are less likely to be open about their feelings during fertility treatment, it can be challenging to find someone to talk to and confide in who understands.
Fertility counselling can help throughout treatment to give you the opportunity to talk through your concerns with a trained and qualified professional. This can help you cope, make the best choices for you, and feel in control again.
Other Resources you may wish to explore:
Fertility Network UK – The National Charity for anyone experiencing fertility problems.
HIMfertility – The HIMfertility campaign was set up by comedian, Rhod Gilbert, to encourage men to talk about fertility problems and signpost them and their partners to much-needed support.
Men’s Health Forum – The Men’s Health Forum is a charity supporting men’s health in England, Wales and Scotland.
Article by Dr James Hopkisson, Medical Director at TFP Fertility Group
For more information about fertility checks and treatments please visit TFP Fertility Group. TFP Fertility Group, one of the UK’s largest IVF providers and fertility specialists, looks to encourage men to speak up about their experiences to open the conversation up around male fertility.