Male infertility is an important cause of a delay in conception for many couples. In 30% of couples that struggle to conceive, a malefactor is the sole problem. In up to 60% of couples, male factor infertility is part of the problem faced.
While most men make sperm every day of their life after puberty, male factor infertility can develop over time. This means a man can have conceived normally in the past but may now be infertile.
Many medical illnesses, environmental influencers, and of course the ageing process can damage male fertility.
Some sperm production problems are reversible, by modifying a man’s diet and lifestyle for the better. Removing toxic exposures like smoking and certain recreational drugs and prescribed medications can improve sperm quality, shape and movement.
Antioxidant therapy and a healthy nutritious diet can help improve sperm quality too. Too much alcohol can damage sperm and carrying excess body weight can impair sperm production. Obese men have high levels of the hormone estrone, made in adipose tissue, which causes reduced libido and impaired spermatogenesis.
Men who use anabolic steroids recreationally to build muscle in the gym can completely shut down their sperm production. Testosterone and testosterone-like steroid hormones can do this even when used as a transdermal gel.
Varicose veins around the testes and scrotum are common and develop over time. Varicoceles impair testicular cooling and can cause overheating damage to sperm on the production line. For some men, having varicoceles repaired can improve fertility.
Too much physical exercise can impair sperm production, as can physical illnesses of any kind. Mental illnesses like anxiety and depression are very common in modern life. Men using medications to treat depression and anxiety may experience sexual difficulties like erectile and ejaculatory dysfunction as well as depressed libido. These side effects can make it difficult for men to have sex with their partners with optimal frequency to achieve their best chance of conceiving naturally.
Some sperm problems are irreversible. Some men experience testicular failure and stop making sperm entirely. This can happen the following infection, such as mumps orchitis, or can be genetic. Many men in this circumstance will need the help of a sperm donor to have children.
Some genetic conditions, like being a carrier for a cystic fibrosis gene mutation, can mean a man is missing a vital pipe to connect the testis to the urethra, known as the vas deferens. This means sperm cannot be released, although it is being made. Other causes of a sperm blockage problem, known as obstructive azoospermia, include past sexually transmitted infections or spermatic duct overgrowth, and of course, past vasectomy.
If a man is making even a small amount of sperm, this can often be collected and used in IVF, which stands for In Vitro Fertilization. A technique known as ICSI can allow a woman’s egg to be injected and fertilized in the lab with a single sperm.
We all carry our genes on structures called chromosomes. A silent cause of male infertility can be a chromosome rearrangement, such as translocation or inversion of DNA. The only way to discover this problem (which can cause a man’s female partner to fail to conceive or to miscarry continuously) Is by doing a male karyotype test.
Technology is amazing and for many men suffering from either primary or secondary infertility, a solution can be found.
Women’s Health Melbourne is a holistic fertility practice, lead by Dr Raelia Lew. Dr Lew holds a CREI qualification and is expert at solving the most complex problems causing male and female infertility.