Infertility: when it’s a male thing

We all know that reproduction can only occur when there is a healthy sperm that can fertilise a healthy egg and begin the process of reproduction – but did you know that up to 40 per cent of infertility issues are the result of a male factor?

While it may be worrying to hear that a male functional, hormonal or sperm problem might be contributing to a couple’s troubles conceiving, it is also important to understand they are common and there are many simple and effective treatments available to help conception occur.

Developing and transporting mature, healthy, functional sperm depends on a specific sequence of events occurring in the male reproductive tract. Many disturbances can occur along that path, preventing cells from maturing into sperm or reaching the woman’s fallopian tube, where fertilisation occurs.

Male infertility may be caused by:

·       Damage to sperm production: low sperm count; poor sperm motility; abnormally shaped sperm; testicular cancer.

·       Obstruction of the ducts leading out from the testis: tubes in the epididymis become blocked.

·       Hormonal problems: hormonal or chromosomal deficiencies, including insufficient testosterone.

·       Health problems: other health issues, such as kidney failure, and past childhood infections, including mumps.

·       Genetic problems: genetic factors that impair the normal production of sperm cells.

·       Lifestyle choices: for example, smoking, alcohol and certain medication.

·       Functional problems: impotence or erectile dysfunction, and vasectomy (acquired factor).

·       Unexplained: not being able to conceive after one year despite everything appearing normal.

Diagnosing the cause of male infertility will dictate the best course of treatment and path forward to achieve a successful pregnancy.

Treatment options include lifestyle changes; hormonal therapy; surgery; vasectomy reversal; surgical sperm extraction and using donor sperm.

While some fertility factors you cannot change no matter how much you want to, there are plenty of factors that men have a lot of control over like weight, health and lifestyle. Here are some the fertility factors men can consider prioritising to assist with healthy conception:

  • Age: Start younger if you can. While a female’s age is a significant factor in fertility success, a male’s age also plays a role, although a more subtle one, research has found the older the male is, the lower the success rates are.
  • Medical Conditions: Ensure medical conditions are correctly diagnosed and treated. Some of the more common conditions that impact fertility are diabetes and blood pressure. With correct diagnosis and treatment, these conditions can be managed to a certain degree, thus allowing conception to occur more easily.
  • Weight: Ensure your weight is within the healthy Body Mass Index (BMI) range. Being overweight or underweight can impact your ability to conceive as hormonal imbalances and sperm quality can be affected by being overweight. For men, studies have consistently linked obesity to a lower sperm count because testosterone levels drop while oestrogen levels rise in men who are overweight.
  • Health: Fill your body with nutritious food and minimise vices. Eating well and minimising and eliminating things like caffeine, alcohol, smoking and drugs is wise for healthy conception. Poor habits can impact the DNA of eggs and sperm. Mature healthy sperm take about 60 days to develop, so couples need to ensure their health is on track well before they try to conceive to give them the best chance of starting with healthy eggs and sperm.
  • Vitamin supplements: Zinc deficiency in men can reduce testosterone levels and semen production. Taking an antioxidant and zinc supplement up to three months prior to conception may improve the DNA quality in sperm. 
  • Stress: Minimise stress levels. The process of trying to conceive can be stressful. Relaxation methods such as yoga and meditation can be beneficial in helping to reduce stress levels. A male’s semen quality can also decline during periods of stress so keeping fit may help to reduce your stress levels.
  • Environmental Factors: Eliminate or take safety measures with toxins. We are faced with a wide variety of environmental toxins on a daily basis. If you work with paints, diesel fumes or pesticides, to name a few, you need to be using protective face masks etc. Pollutants can cause DNA damage to sperm. Give them a wide berth while trying to conceive, or take all safety measures possible while using them. Talk with your doctor or specialist if you have any concerns.

This article was written by Clinical Associate Professor Michael Cooper OAM, a fertility specialist at City Fertility Sydney CBD

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