Male infertility is not uncommon. In fact, it is a contributing factor in up to 40% of couples struggling to conceive. Only in about 20% of cases are a couple’s fertility concerns due solely to male-related problems, so it’s important to assess both male and female partners when investigating infertility.
Male infertility causes are varied, including environmental factors, general health, and genetics. In around 30-40% of cases, we can’t find an underlying cause.
Although age is an often cited factor for female infertility, older age can also affect fertility in men, resulting in lower chances of conception the older you are.
There are four broad categories of causes of male infertility.
Certain syndromes, such as Kallmann syndrome, are due to genetic defects, and result in low or absent levels of hormones required for normal sexual development, a situation known as hypogonadism. However, other reasons for hormonal imbalances can also affect male fertility, such as hyperthyroidism, tumours, or testosterone supplements.
The most obvious example of this cause of male infertility would be having had a vasectomy. If sperm and semen are unable to exit the body, they will be unable to fertilise the egg in a woman’s body to conceive a baby. Other causes of sperm blockage include injury, infections, and congenital defects of the reproductive system, such as the vas deferens or epididymis.
In order to fertilise a woman’s egg, a single sperm needs to be able to swim through her reproductive system and merge with the egg. However, barriers to this process can include abnormally shaped sperm, poor movement, low sperm count, or complete lack of sperm in the semen. Genetics, medications, current and previous medical conditions, and environmental hazards can contribute to sperm abnormalities.
Functional problems in men can result in difficulties during intercourse. These include erectile dysfunction, and retrograde or premature ejaculation. Some medical procedures, such as treatment for prostate cancer, can contribute to these problems, as can diseases such as diabetes, and certain medications.
When investigating how your fertility as the male partner may be contributing to difficulties in conceiving a baby, Dr Kate will start with a thorough medical history and physical examination. Guided by this information, we may then organise additional tests such as:
A hormone analysis can reveal any imbalances or atypical levels that may be underlying your fertility problems by causing abnormal sperm production. Specific hormones related to male fertility include testosterone, follicle-stimulating hormone, luteinising hormone, prolactin, and thyroid hormone.
It’s important to know that the results of a semen analysis do not define your fertility. Men with semen results outside the normal range can still conceive naturally while men with normal results may still struggle with infertility. A semen analysis includes sperm count, concentration, sperm motility (movement), appearance, and even the pH of your semen.
Additional tests may be required as guided by earlier investigations. These include ultrasound scans, biopsies, testing for anti-sperm antibodies, or genetic analyses.
Treatment for male infertility will depend on the underlying cause. Some situations can be reversed with medication or a surgical procedure. Other cases of male infertility are not treatable but you may still have a chance at growing your family through IVF or other assisted reproductive technologies.
Did you know there are some steps you can take to naturally optimise your fertility and increase your chances of conceiving? You don’t have to wait til you’re facing infertility to make these changes – these steps are beneficial for your body at any stage of your fatherhood journey.
