Did you know that male factor infertility is the second biggest cause of why a couple cannot conceive (behind a woman’s age)? Close to half of couples experiencing fertility problems are related to male fertility.
If you’re having trouble falling pregnant, or you just want a better idea of your fertility health, undergoing testing at Create Fertility can help you paint a picture of what’s going on.
In a healthy young man, an average of 100 million sperm are produced every day. The process of production and maturation takes just under three months (therefore, any serious illness may affect sperm for up to three months).
Sperm production begins in the testes (which is also where the hormone testosterone is produced) before travelling along a channel system that begins at the epididymis and ends at the vas deferens. Mature sperm then pass out of the urethra as part of the ejaculate.
A sperm consists of a head, tail, and midsection. The head carries all of the genetic information that the male will pass on, the tail propels the sperm forward, and the midsection contains mitochondria (which create the power that the sperm needs to move).
To successfully reach and fertilise an egg, the sperm needs to be able to move its tail to propel itself through the cervical mucus, uterus, and fallopian tube. It also needs to be normally shaped so that it can penetrate the outer shell of the egg and deliver its genetic material.
To determine whether a man has a reproductive concern that is causing infertility, a fertility specialist may run several different tests to reach a diagnosis. This usually includes a physical exam, semen analysis (also known as a sperm count), and blood test. Depending on the results of these initial tests, more testing may be required (such as sperm DNA fragmentation, immunobead test, or testicular biopsy).
Genetic testing is recommended for both partners when struggling to conceive.
A doctor will ask questions about your lifestyle and medical history, including any medications you take or health conditions you may have. They’ll also ask you details about your sex life, including whether you’ve ever had an STI. They will also perform a physical exam of your genitals.
You may be asked to provide a semen sample, which looks at sperm quality – motility (movement), morphology (shape), count (number of individual sperm), and vitality (how many are alive). Samples are usually collected by masturbation either at home or in the clinic after a few days of abstinence.
Doctors can use blood tests to check for several things, including follicle-stimulating hormone (FSH) and testosterone. In some cases (such as having a zero or low sperm count or in recurrent miscarriage), a chromosome analysis (karyotype) may be performed.
This test provides an analysis of the sperm’s DNA integrity. A high level of DNA fragmentation can be a cause of male infertility that a standard semen analysis will not detect. It involves sperm being captured in a gel and then treated with an acid denaturant and a lysing agent.
This test checks for anti-sperm antibodies, which is when the male immune system reacts to its own sperm as if they were invading cells. Its causes include infection, cancer, and vasectomy. The presence of antibodies can prevent the sperm’s ability to fertilise an egg.
You may be sent for a scrotal ultrasound (to see if there is a varicocele or other problem), transrectal ultrasound (to check your prostate and for tube blockages), or a testicular biopsy (to test sperm production) to aid in diagnosis. A post-ejaculation urinalysis may also be performed.
Depending on the cause of male factor infertility, different treatments may be appropriate. Surgery, for example, can be used to correct a varicocele or repair an obstructed vas deferens. Hormone replacement therapy and medications, on the other hand, can be used to treat problems with the way that the body uses hormones. There are also ways to increase sperm count, such as limiting alcohol intake, maintaining a healthy weight, and keeping the scrotum cool.
Assisted reproductive technology (ART) is used when there are no other options or when other treatments have failed. Intracytoplasmic sperm injection (ICSI) or intrauterine insemination (IUI) are popular treatments when male infertility is at play, but in vitro fertilisation (IVF) can also be used.
Your fertility specialist will advise you on the best care plan for realising your dream of starting a family.
Many men experience fertility challenges. In fact, male factor infertility is responsible for around half of couples who cannot conceive. The good news is that there are treatment options available.
If you suspect male infertility or would like to undergo a semen analysis to check your sperm health, book an appointment with a specialist at Create Fertility. Our friendly and compassionate team can take you through the process and help you take charge of your fertility health.
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