How often are male factors responsible for infertility?

Conceiving and giving birth to a healthy baby depends on male factors as much as female. In Australia/New Zealand, male infertility has a role to play in half of all cases of infertility and in about one third of cases it is solely responsible.

What causes male infertility?

Infertility can be the result of various factors that affect the production and movement of sperm. Problems with sperm production affect about two-thirds of men with infertility. The sperm produced are either poor quality or do not function well. Approximately one fifth of males with infertility have sperm transport issues. Sperm takes about 2.5 months to develop in the testes, a process which is sensitive to health conditions, lifestyle and environmental factors. As a result, poor sperm production and quality at any given time, may be caused by an illness 2-3 months prior. Poor sperm quality not only affects the sperm’s ability to travel and fertilize an egg but can also affect the genetic makeup and health of the child in the future.

What are the factors associated with male infertility?

Habits such as smoking, drinking, and recreational drug use that are generally bad for health and shorten life expectancy also affect sperm production. A sedentary lifestyle and obesity can have a negative influence on fertility. Sperm quality may decrease with age. Decreased libido or erectile dysfunction can indirectly contribute to infertility. Exposure to certain chemicals such as pesticides and heavy metals have also been associated with infertility.

Other factors associated with male infertility include:

• Tube blockage
• Groin injury
• Previous vasectomy
• Previous testicular surgery
• Undescended testicles
• Torsion (twisting) of testicles
• Varicocele (swollen testicular veins)
• Tumour in the testis
• Medical problem affecting the direction of ejaculation
• Chronic illnesses such as heart disease, diabetes and thyroid disease
• Infections and sexually transmitted disease
• Mumps after puberty
• Certain medications such as hypertensives and anti-histamines taken regularly
• Chemotherapy for cancer
• Radiation therapy
• Alcohol and tobacco use
• Hormone imbalance due to impaired functioning of the pituitary gland or steroid intake
• Sperm antibodies

How can one optimise male fertility?

To optimise sperm production, one is advised to avoid the negative lifestyle habits as discussed above. In addition, you should also avoid prolonged sitting, tight undergarments, long hot baths or saunas. A balanced diet containing fresh fruits, vegetables, natural antioxidants and minerals is recommended. Exercise, weight control and stress management are important. Chronic health conditions such as blood pressure or diabetes must be well controlled. To improve chances of achieving a pregnancy your doctor will recommend intercourse every 2-3 days timed with the ovulation period. The first portion of the ejaculate is rich in sperm and should be introduced into the vagina. Lubricants used may sometimes affect sperm function so try to avoid or use one with a better formulation.

How is male infertility diagnosed?

Male infertility may not be associated with any symptoms. To make a diagnosis, your doctor will review your medical history, perform a physical examination and order a semen analysis.

How is male infertility treated?

Problems with sperm production are often reversible with lifestyle changes and appropriate medical care for any health conditions. If the condition does not resolve, your doctor will recommend assisted reproductive techniques such as IVF or intracytoplasmic sperm injection which are very effective.