What is it and what are the possible causes
Why could this be happening to me
Did you know 30% of fertility problems are male related!
On this page we will help you explore:
What is male infertility
Male infertility refers to a male’s lack of capacity to help a fertile female fall pregnant whilst trying to conceive.
What are the potential causes of male infertility
There is a large amount of false information, misleading facts and general misconceptions on the internet about male infertility.
Every person is different. So it’s best to speak to a male fertility specialist like Dr. Myran who can explore your unique issues and provide advise specific to your situation.
Common causes of male infertility
Just the idea of undertaking an infertility investigation can be very confronting for a man. In most cases it’s surprisingly easy to assess infertility in men.
The major causes of male infertility may include:
Obstructions to the passage of sperm
Problems with sperm – Low sperm count or inactive (lazy) sperm
Functional problems (such as impotence)
Obstructions to the passage of sperm causing male infertility
A block or the absence of tubes (potentially due to an injury or vasectomy) are the cause of around one in three cases of male infertility.
Male infertility caused by sperm problems
A low sperm count and/or poor sperm quality can be an underlying factor in male infertility. This could be caused by genetic factors such as the male chromosome missing. This may cause:
- Absent sperm (azoospermia) – The semen not containing any sperm due to a tube blockage or testicular failure
- Low sperm count (oligospermia) – The ejaculate does not contain enough sperm to achieve conception
- Abnormally shaped sperm – A healthy sperm looks like a tadpole. Abnormally shaped sperm may have problems penetrating female eggs
- Sperm motility problems – A healthy sperm has a tail which helps to propel it through a women’s reproductive system. Sperm with poor motility may not swim well decreasing the chances of conception.
Functional problems causing male infertility
Functional problems that may cause male infertility include:
Impotence – Inability to get or maintain an erection
Ejaculation problems – Retrograde and premature ejaculation (see Dr. Myran’s help centre)
Testicular problems – These are commonly caused by injury, disease or previous medical treatments
Surgery prostatectomy – Removal of the prostate gland
Certain disorders such as diabetes can cause erection and ejaculation difficulties
A man’s immune system can sometimes make antibodies that hinder the activity of sperm.
Retrograde ejaculation happens when sperm enters the bladder instead of the urethra (the tube through which urine passes).
Premature ejaculation is where a male ejaculates too quickly during sexual intercourse.
Definition with assistance from National Health System United Kingdom.
Hormonal problems causing infertility in men
The pituitary gland and the hypothalamus influence hormone production in the testicles. A relatively uncommon cause of male infertility is the failure to make enough of the hormone gonadotrophin.
How can male infertility be diagnosed
Diagnosing male infertility may involve:
- Charting and analysing medical history
- Physical examination
- Semen analysis – Analysing a sperm sample in a laboratory and checking for abnormalities and the presence of antibodies
- Blood tests – To assess hormone levels
- Testicular biopsy – To check the network of tubes within the testicles to see if they contain any sperm
- Ultrasound scans – To check the reproductive organs.
Please remember – Investigating suspected causes of infertility requires testing for both partners.
As a male – What can you do to improve your fertility
To help improve your fertility, avoid:
Sexually transmitted diseases
Tight fitting underwear and clothing around the genitals
Male infertility treatments we offer
As a fertility specialist, I don’t take a “one size fits all” approach to treating male infertility. I will ensure you understand your fertility treatment options so you can confidently choose the most appropriate action based on thorough investigation, assessment, expert clinical advice and what you and your partner feel comfortable with undertaking.
I have a sensitive and understanding approach to fertility. I will ensure you are guided through this emotional time to give you the best opportunity to start a family.
Fertility treatments depend on the underlying cause
I specialise in:
Checking the quality of your semen
Testing of a males semen is done via a semen analysis. The results outline:
Number of sperm – A higher sperm count is a requirement for normal fertility. A lower sperm count may hinder you in having success starting a family.
Sperm size and shape – Abnormal shape sperm may find it difficult to swim through the fallopian tubes and reach an egg and/or not be successful in penetrating an egg for fertilisation.
Motility – Is an important factor as it indicates the sperms ability to swim through the female reproductive tract to reach the egg to initialise fertilisation.
No Sperm – No sperm in a sample doesn’t necessarily indicate you don’t have sperm. Further investigation through a minimally invasive procedure known as a testicular biopsy may reveal more.
Blood and testicular testing
Treatment of male infertility is based from the results of the above investigations combined with my (Dr. Myran’s) extensive knowledge of fertility.
Hormone replacement therapy
Male infertility can be caused by the lack of a hormone called gonadotropins. The pituitary gland in the brain releases gonadotropins to help the testicles to produce sperm. Taking gonadotropins as a medication may help boost sperm production.
Artificial insemination is the process where the man’s semen is collected, washed and concentrated, then introduced into the partner’s uterus through the cervix.
This option may be best used when:
- Sperm concentration in the man’s semen is low
- Functional problems occur (such as impotence)
- Seminal fluid contains sperm antibodies
- Cervical mucus in the woman is abnormal and it interferes with sperm transport.
In Vitro Fertilisation (IVF) for male infertility
In vitro fertilisation (IVF) is where sperm is collected from the man and eggs are collected from the women. Both sperm and the eggs are placed in a special incubator to assist in fertilisation. The fertilised eggs develop into embryos, which are then implanted into the woman’s uterus.
Intra-Cytoplasmic Sperm Injection (ICSI) for male infertility
In some circumstances a male’s semen may contain low quality or too few normal sperm to make fertilisation possible through IVF. So intra-cytoplasmic sperm injection (ICSI) may be used.
Eggs are harvested from the woman’s ovaries and each egg is injected with a single sperm. The fertilised eggs develop into embryos that are transferred into the woman’s uterus at the appropriate time.
Tablets or injections may be prescribed to assist with erectile function.
Exploration of testis
Exploration of the testis may be used to ascertain if the testicals have undergone any trauma, showing any signs of disease or effects from medication that may be inhibiting them from producing healthy sperm.
A testicular biopsy is the process where a small sample of tissue is removed from one or both testicles. The sample is examined under a microscope to help evaluate the potential causes of male infertility.