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Male infertility

Male infertility

Infertility is generally defined as the inability to conceive after a least one year of regular, unprotected sex and affects around one in six couples. A male issue is estimated to be present in about 50% of couples, with the male factor only in 30 % of cases and both male and female co-contributing factors in about 20% of cases.

Male fertility requires that the testicles produce enough healthy sperm and that the sperm is ejaculated effectively into the vagina and travels to the egg. Assessment and testing of male fertility determines whether any of these processes are impaired.

I would advise you to see a doctor if you have been unable to conceive a child after a year of regular, unprotected intercourse or sooner if you have any of the following:

– Erection or ejaculation problems, low sex drive, or other problems with sexual function, pain, discomfort, a lump or swelling in the testicle area.

– A history of testicle, prostate or sexual problems

– A groin, testicle, penis or scrotum surgery

 

Male fertility assessment

At your first appointment I will have a discussion with you to ensure I have a thorough understanding of your medical history, your general health and your lifestyle. Based on the results of this initial discussion I will recommend some preliminary tests and investigations. These may include; a semen analysis, blood tests to check hormones and genetics, a physical examination of the testicles and in certain situations, an ultrasound scan of the testes may be advised.

 

Causes of male infertility

These may include:

– Abnormal sperm production or function due to undescended testicle, genetic defects, health problems or varicocele (enlarged veins on the testes).

– Problems with delivery of sperm due to sexual issues, some genetic diseases, structural problems or damage to the reproductive organs.

– Overexposure to certain environmental factors such as pesticides, radiation, cigarettes, marijuana, alcohol, anabolic steroids and certain medications.

– Frequent exposure to heat such as in spas and saunas and as generated by tight underpants, extended bicycle or motor bike riding.

– Damage related to cancer and its treatment.

 

Treatments

Not being able to conceive a child can be stressful and frustrating, but a number of male infertility treatments are available;

Surgery: For example, a varicocele can often be surgically corrected or an obstructed vas deferens repaired. Prior vasectomies can be reversed. In cases where no sperm are present in the ejaculate, sperm can often be retrieved directly from the testicles or epididymis using sperm-retrieval techniques.

Treating infections: Antibiotic treatment might cure an infection of the reproductive tract, but doesn’t always restore fertility.

Treatments for sexual intercourse problems: Medication or counselling can help improve fertility in conditions such as erectile dysfunction or premature ejaculation.

Hormone treatments and medications: I might recommend hormone replacement or medications in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones.

Assisted reproductive technology (ART): ART treatments involve obtaining sperm through normal ejaculation, surgical extraction or from donor individuals, depending on your specific case and wishes. The sperm are then inserted into the female genital tract, or used to perform in vitro fertilisation or intracytoplasmic sperm injection. Intracytoplasmic Sperm Injection (ICSI) is a technique where a single sperm is given a helping hand to ‘enter’ the egg. Since it only takes one single sperm to fertilise the egg, the embryologist catches a single sperm and injects it directly into the centre of the egg.  ICSI can be an option for patients who have:

– an abnormally low sperm count or poor motility

– a high percentage of abnormal sperm or few healthy sperm

– sperm obtained via testicular biopsy or micro TESE

– previously low fertilisation rates with standard IVF

 

When treatment doesn’t work

In rare cases when male fertility problems can’t be treated, and it’s impossible for you to father a child, I may suggest that you and your partner consider using sperm from a donor or adopting a child.

 

Lifestyle and home remedies

There are a few steps you can take at home to increase your chances of achieving pregnancy:

Increase frequency of sex. Having sexual intercourse every other day beginning at least four days before ovulation increases your chances of getting your partner pregnant.

Have sex when fertilisation is possible. A woman is likely to become pregnant during ovulation — which occurs in the middle of the menstrual cycle between periods. This will ensure that sperm, which can live several days, are present when conception is possible.

Avoid the use of lubricants. Products such as Astroglide or K-Y jelly, lotions and saliva might impair sperm movement and function. Ask me or your GP about sperm-safe lubricants.

 

Alternative medicines

Evidence is still limited on whether — or how much — herbs or supplements might help increase male fertility. None of these supplements treats a specific underlying cause of infertility, such as a sperm duct defect or chromosomal disorder. Some supplements might help only if you have a deficiency.

 

Prevention

Many types of male infertility aren’t preventable. However, you can avoid some known causes of male infertility. For example:

Don’t smoke.

Limit or abstain from alcohol.

Steer clear of illicit drugs.

Keep the weight off.

Don’t get a vasectomy.

Avoid things that lead to prolonged heat for the testicles.

Reduce stress.

Avoid exposure to pesticides, heavy metals and other toxins.

 

Support

Coping with infertility can be difficult. It’s an issue of the unknown — you can’t predict how long it will last or what the outcome will be. Infertility isn’t necessarily solved with hard work. The emotional burden on a male can be considerable and the following suggestions for coping may help;

Decide in advance how many and what kind of procedures are emotionally and financially acceptable for you and your partner, and determine a final limit.

Discuss alternatives; it can help to reduce anxiety during treatments if you know there is a backup plan.

Locate support groups or counselling services for help before and after treatment

Practice stress-reduction techniques such as yoga, meditation and massage therapy.

Consider going to counselling for help with relaxation techniques and stress management.

Express yourself and reach out to others rather than holding in feelings of guilt or anger.

Most importantly, take time do things that you like to do with the people that you love. 

If you would like to discuss your situation you’re welcome to book an appointment, book a fertility assessment or book a free phone chat with Fertility Nurse Pam

Infertility is generally defined as the inability to conceive after a least one year of regular, unprotected sex and affects around one in six couples. A male issue is estimated to be present in about 50% of couples, with the male factor only in 30% of cases and both male and female co-contributing factors in about 20% of cases.

Male fertility requires that the testicles produce enough healthy sperm and that the sperm is ejaculated effectively into the vagina and travels to the egg. Assessment and testing of male fertility determines whether any of these processes are impaired.

I would advise you to see a doctor if you have been unable to conceive a child after a year of regular, unprotected intercourse or sooner if you have any of the following:

– Erection or ejaculation problems, low sex drive, or other problems with sexual function, pain, discomfort, a lump or swelling in the testicle area.

– A history of testicle, prostate or sexual problems

– A groin, testicle, penis or scrotum surgery

 

Male fertility assessment

At your first appointment I will have a discussion with you to ensure I have a thorough understanding of your medical history, your general health and your lifestyle. Based on the results of this initial discussion I will recommend some preliminary tests and investigations. These may include; a semen analysis, blood tests to check hormones and genetics, a physical examination of the testicles and in certain situations, an ultrasound scan of the testes may be advised.

 

Causes of male infertility

These may include:

– Abnormal sperm production or function due to undescended testicle, genetic defects, health problems or varicocele (enlarged veins on the testes).

– Problems with delivery of sperm due to sexual issues, some genetic diseases, structural problems or damage to the reproductive organs.

– Overexposure to certain environmental factors such as pesticides, radiation, cigarettes, marijuana, alcohol, anabolic steroids and certain medications.

– Frequent exposure to heat such as in spas and saunas and as generated by tight underpants, extended bicycle or motor bike riding.

– Damage related to cancer and its treatment.

 

Treatments

Not being able to conceive a child can be stressful and frustrating, but a number of male infertility treatments are available;

Surgery
For example, a varicocele can often be surgically corrected or an obstructed vas deferens repaired. Prior vasectomies can be reversed. In cases where no sperm are present in the ejaculate, sperm can often be retrieved directly from the testicles or epididymis using sperm-retrieval techniques.

Treating infections
Antibiotic treatment might cure an infection of the reproductive tract, but doesn’t always restore fertility.

Treatments for sexual intercourse problems
Medication or counselling can help improve fertility in conditions such as erectile dysfunction or premature ejaculation.

Hormone treatments and medications
I might recommend hormone replacement or medications in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones.

Assisted reproductive technology (ART)
ART treatments involve obtaining sperm through normal ejaculation, surgical extraction or from donor individuals, depending on your specific case and wishes. The sperm are then inserted into the female genital tract, or used to perform in vitro fertilisation or intracytoplasmic sperm injection.

Intracytoplasmic Sperm Injection (ICSI) is a technique where a single sperm is given a helping hand to ‘enter’ the egg. Since it only takes one single sperm to fertilise the egg, the embryologist catches a single sperm and injects it directly into the centre of the egg.  ICSI can be an option for patients who have:

– an abnormally low sperm count or poor motility

– a high percentage of abnormal sperm or few healthy sperm

– sperm obtained via testicular biopsy or micro TESE

– previously low fertilisation rates with standard IVF

 

When treatment doesn’t work

In rare cases when male fertility problems can’t be treated, and it’s impossible for you to father a child, I may suggest that you and your partner consider using sperm from a donor or adopting a child.

 

Lifestyle and home remedies

There are a few steps you can take at home to increase your chances of achieving pregnancy:

Increase frequency of sex. Having sexual intercourse every other day beginning at least four days before ovulation increases your chances of getting your partner pregnant.

Have sex when fertilisation is possible. A woman is likely to become pregnant during ovulation — which occurs in the middle of the menstrual cycle between periods. This will ensure that sperm, which can live several days, are present when conception is possible.

Avoid the use of lubricants. Products such as Astroglide or K-Y jelly, lotions and saliva might impair sperm movement and function. Ask me or your GP about sperm-safe lubricants.

 

Alternative medicines

Evidence is still limited on whether — or how much — herbs or supplements might help increase male fertility. None of these supplements treats a specific underlying cause of infertility, such as a sperm duct defect or chromosomal disorder. Some supplements might help only if you have a deficiency.

 

Prevention

Many types of male infertility aren’t preventable. However, you can avoid some known causes of male infertility. For example:

Don’t smoke.

Limit or abstain from alcohol.

Steer clear of illicit drugs.

Keep the weight off.

Don’t get a vasectomy.

Avoid things that lead to prolonged heat for the testicles.

Reduce stress.

Avoid exposure to pesticides, heavy metals and other toxins.

 

Support

Coping with infertility can be difficult. It’s an issue of the unknown — you can’t predict how long it will last or what the outcome will be. Infertility isn’t necessarily solved with hard work. The emotional burden on a male can be considerable and the following suggestions for coping may help;

Decide in advance how many and what kind of procedures are emotionally and financially acceptable for you and your partner, and determine a final limit.

Discuss alternatives; it can help to reduce anxiety during treatments if you know there is a backup plan.

Locate support groups or counselling services for help before and after treatment

Practice stress-reduction techniques such as yoga, meditation and massage therapy.

Consider going to counselling for help with relaxation techniques and stress management.

Express yourself and reach out to others rather than holding in feelings of guilt or anger.

Most importantly, take time do things that you like to do with the people that you love. 

If you would like to discuss your situation you’re welcome to book an appointment, book a fertility assessment or book a free phone chat with Fertility Nurse Pam