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  • Fertility & IVF

Male infertility

Male infertility is more common than many people realise. A third of the couples that visit Dr Joseph with fertility concerns find out that it is due to factors involving the male.

A male infertility test can be done via a simple, non-invasive semen analysis which is the recommended first step before the discomfort and expense required to assess if the issue is present in the woman.

If you have not been able to conceive after lengthy periods of unprotected sex, men should be screened to assess their fertility. Read on to learn more about this process.

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What is male infertility?

Male infertility is often caused by sperm-based issues, including sperm transport and blockages and functional and hormonal problems.

Inability to conceive a child may be due to male infertility, which can be summarised as:

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

It is important to know that a man’s sperm production can be affected by their general health, which means the sperm function can vary in relation to other health issues.

Signs and symptoms of male infertility

The primary symptom of male infertility is the inability to conceive a child after 12 months of unprotected sex. The main signs that may indicate this is an issue include:

  • Problems with sexual function — 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

Testing for sperm antibodies should be routine for men with infertility. Anti-sperm antibodies may lead to sperm movement disorders or cause interference with sperm-to-egg binding.

Common causes of male infertility

A number of factors can cause male infertility, and it is important to book an assessment as a first step if you are worried this may be an issue for you.

Some of the possible causes include:

How to diagnose male infertility

The first step is a consultation with Dr Joseph, in which he will work to understand your medical history. This will include a physical examination and semen analysis to understand your sperm count and the shape and movement of the sperm.

Dr Joseph will also check the sperm samples for abnormalities and the presence of antibodies. If abnormalities are present, we may require blood tests to assess hormone levels. All of this information will assist in the final diagnosis.

A testicular biopsy may also be recommended, which involves a fine needle and microscope to assess the network of tubes within the testicles. Ultrasound scans may also be required to evaluate the prostate gland and other organs.

Additional male infertility test options

It is not uncommon for several semen analysis tests to be performed over a specific period to ensure more accurate results. Some additional tests may be required to help identify the cause of infertility, and these can include:

  • Scrotal ultrasound: High-frequency sound waves produce inner-body images to confirm if there is a varicocele or any other issue in the testicles.
  • Transrectal ultrasound: A small wand is inserted via the rectum to check the prostate and assess if the tubes that carry semen are blocked.
  • Hormone testing: The pituitary gland, hypothalamus and testicles produce hormones that help sexual development and sperm production. A blood test will check for abnormalities by measuring the level of hormones and testosterone.
  • Post-ejaculation urinalysis: If sperm is travelling backward into the bladder (retrograde ejaculation), it can be identified via sperm in the urine.
  • Genetic tests: Your issue may be genetic, and a blood test can reveal a genetic abnormality to diagnose a congenital or inherited syndrome.
  • Sperm function tests: The survival of your sperm after ejaculation can be tested to assess how well they can penetrate or attach to an egg.

Options for male infertility treatment

While sperm quality cannot be improved with any form of treatment, your chances of having a baby can be strengthened with assisted reproductive technologies.

Infertile men can increase the chances of pregnancy with:

  • Surgery
  • Hormone therapy
  • Artificial insemination
  • In vitro fertilisation (IVF)
  • Intracytoplasmic sperm injection (ICSI)

As with most issues, prevention is the best method of avoiding a problem. In the case of male infertility, men should quit or avoid smoking, avoid unnecessary drugs or toxins, take antioxidants and try to have children at a younger age.

Keeping the scrotum cooler than your core body temperature can also help, and try to avoid STIs as they can cause infertility. If you are concerned about male fertility, book an appointment with Dr Joseph by calling (03) 9416 1586. Dr Joseph is an IVF fertility specialist who provides holistic medical care to help couples realise their dreams of starting a family.

Frequently asked questions