What is male infertility?

First of all male infertility is more common than realised. A third of couples that come in to see us because of fertility concerns, consequently go on to find out it is due to factors that involve the male.

In addition, almost all infertility in men is caused by problems with sperm, sperm transport and blockages as well as functional and hormonal issues.

The main sign of male infertility is the inability to conceive a child.

The most common causes of male infertility are:

  • Problems with sperm (including low sperm count)
  • Obstructions to the passage of sperm
  • Functional problems
  • Hormonal problems

What is sperm?

Sperm are the male reproductive cells. First of all to have a child genetic material from the sperm must combine with the genetic material from an egg, in a process called fertilisation.

Most noteworthy healthy, sperm when fully developed can’t be seen by the human eye. They are very small – 0.05 millimetres long.

Sperm and are made up of three parts, a head, neck and tail. In the head is a structure called the nucleus, which contains 23 chromosomes). Next is the head which is designed to bind and enter the egg. The neck of the sperm joins the head to the tail. The tail has the job of pushing the sperm towards the egg and moves in a whipping motion.

The most common causes of male infertility are sperm-related and include:

  • Azoospermia, no sperm cells are produced
  • Oligospermia, where few sperm cells are produced
  • Teratospermia, where a high proportion of sperm is abnormally shaped.

Causes and Symptoms

There are not a lot of symptoms of male infertility. The biggest one is the inability to conceive a child after 12 months of trying. Some other things to look out for include:

  • Problems with sexual function — including difficulty with ejaculation, reduced sexual desire, and difficulty maintaining an erection.
  • Pain, swelling or lumps in the testicle area
  • Recurrent respiratory infections
  • Inability to smell
  • Abnormal breast growth
  • Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality

Causes of male infertility

Sperm production problems

• Chromosomal or genetic causes

• Undescended testes

• Infections

• Torsion – twisting of the testes in scrotum

• Heat

• varicose veins in the testes

• Medicines and chemicals

• Radiation damage

Blockage of sperm transport • Infections

• Prostate-related problems

• Absence of vas deferens

• Vasectomy

Sexual problems • Retrograde or premature ejaculation

• Failure of ejaculation

• Erectile dysfunction

• Infrequent intercourse

• Spinal cord injury

• Prostate surgery

• Damage to nerves

• Some medicines

Hormonal problems • Pituitary tumours

• Anabolic (androgenic) steroid abuse

Sperm antibodies • Vasectomy

• Injury or infection in the epididymis

 

How is it diagnosed?

We will start with a conversation to understand your medical history a physical examination.

Additionally, we will complete a semen analysis so we can check the number, shape and movement of sperm. The samples will be sent to a laboratory and checked for abnormalities and the presence of antibodies.

In the event that abnormalities in the semen analysis, we may require blood tests to help us assess hormone levels too, which will assist in the final diagnosis.

Other things we will consider are a testicular biopsy. This involves a fine needle and microscope being used to check the network of tubes within the testicles.

We will also complete ultrasound scans to enable us to look in more detail at organs like the prostate gland.

 

Treatment

There are no treatments that can improve sperm quality. Certain treatments can increase your chances of having a baby. These include assisted reproductive technologies where eggs are fertilised in a test tube using the partner’s sperm.

Some of the options available to infertile men who are wanting to have a baby include:

  • Surgery
  • Hormone therapy
  • Artificial insemination
  • In vitro fertilisation (IVF)
  • Intra-cytoplasmic sperm injection (ICSI).

 

Can you do anything to prevent male infertility?

Avoid cigarette smoking, excess alcohol, sexually transmitted infections, heat stress from tight-fitting underwear, and anabolic steroids (taken for bodybuilding or sporting purposes). These factors are harmful to the production of sperm.

 

When to get help.

Certainly, if you have been trying to conceive naturally for at least one year, you may have reason to be concerned.

You can make an appointment to come in and have a chat with us at the clinic if you have any concerns.

Read more about female fertility – https://www.drjoseph.com.au/female-infertility/