Understanding male infertility

Male infertility isn’t something we often talk about, so here’s what you need to know. 

At a glance:

  • 1/3 of couples who present with fertility concerns are predominantly due to the male
  • Major contributors are problems with sperm, obstructions to the passage of sperm, functional and hormonal issues
  • Even though you can’t ‘prevent’ male infertility, there’s plenty you can do to decrease the possibility of it affecting you or your partner
  • Male infertility is a sensitive subject, but there are ways you can support him and it’s worth working with a fertility expert who can guide you along the way


If you have a male partner and are thinking about starting a family together, it’s important to be aware of how male infertility could affect your journey to parenthood. It isn’t something we typically talk about – the truth is, most of the emphasis tends to be on women’s fertility challenges – but given that male fertility is a factor for a significant number of couples struggling with fertility, it’s well worth being aware of.

“A third of couples who present with infertility are due to male factor infertility;” explains reproductive endocrinologist and infertility specialist Dr Hossam Elzeiny. “Another third are due to female factor and another third are due to a combination of male and female or unexplained.”

The major contributors to male infertility can be divided into four groups:

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


In 40 per cent of male infertility cases the cause is unknown, but seeing a specialist can help identify any factors that are evident. So let’s explore those a little further.

 

Problems with sperm

It’s believed that issues with sperm numbers or quality are due to genetic problems. Sperm problems include azoospermia, where the semen doesn’t contain any sperm; oligospermia, where ejaculation doesn’t contain enough sperm for conception; abnormal shaped sperm, meaning it can’t penetrate the surface of the egg; or poor motility, meaning the sperm swim badly or not at all.

Obstructions to sperm’s passage

These are responsible for one in three male infertility cases, so to better understand it, here’s a very quick biology lesson about how sperm moves through a man’s body.

After they’re made in the testicles, sperm pass through a series of tubes called the epididymis – a process which takes two to 10 days – followed by a larger tube called the vas deferens, which empties the sperm into the ejaculatory duct. From there, it’s mixed with seminal fluid from the seminal vesicles and the prostate gland. During ejaculation, muscular contractions force it into the urethra and out of the penis.

A blockage or absence of any of these tubes (due to vasectomy or injury, for example) can cause fertility problems.

 

Functional issues

Here are some of the issues that fall under the umbrella of functional issues:

Impotence – being unable to initiate or maintain an erection for sexual intercourse
Ejaculation problems – including premature ejaculation and retrograde ejaculation, when semen enters the bladder during orgasm instead of the penis. Retrograde ejaculation can be caused by conditions like diabetes, as well as spinal injuries and medications
Testicle issues – injury, infection or chemotherapy can damage the testicles, or they might not have descended correctly when the man developed as a baby
Health conditions – having conditions like multiple sclerosis and diabetes can affect fertility
Antibodies – if immune system cells mistakenly identify sperm as harmful invaders, they can attempt to destroy them
Hormonal problems – where hormone production is affected, fertility can be compromised as a result


Prevention

Even though you can’t ‘prevent’ male infertility, there’s plenty you can do to decrease the possibility of it affecting you. Here’s how: 

  • Stay in a healthy weight range - obesity can adversely affect sperm and cause hormonal changes that reduce fertility
  • Avoid high doses of radiation and X-rays
  • Stop smoking. Men who smoke may have a lower sperm count than those who don’t, and second-hand smoke can also adversely affect male fertility
  • Steer clear of tight-fitting underwear which causes heat stress to the testicles
  • Try not to take long, hot baths or use hot tubs and saunas frequently
  • Avoid anabolic steroids (taken for body building or sports)
  • Limit exposure to pesticides, heavy metals and other toxins
  • Keep your stress levels in check, as stress can interfere with hormones needed to produce sperm
  • Limit your alcohol intake. Alcohol can lower testosterone levels, cause erectile dysfunction and decrease sperm production
  • Steer clear of illicit drugs


Supporting your male partner

Male infertility is a sensitive topic, so it’s important for men to find people they can count on to be supportive, starting with their partner. Society tends to focus on female infertility, so it can be difficult for men diagnosed with male infertility to feel supported.


If your partner has been diagnosed with male infertility, here are some ways you can help:

  • Encourage him to talk about it. There are male infertility support groups and online forums, and your fertility doctor might recommend a counsellor trained to offer support in this area
  • Avoid pressure. Allow him time and space to process the diagnosis, without pushing him to start making lifestyle changes, for example
  • Don’t place blame. Fertility is a team effort, so refer to any reproduction challenges as ‘our problem’ rather than ‘his’ or ‘your’ problem


Remember – if you need support, there is plenty available. See your GP or fertility expert for advice.


Sources

http://americanpregnancy.org/infertility/male-infertility/

https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/infe…

https://www.mayoclinic.org/diseases-conditions/male-infertility/symptom…

https://www.thespark.org.uk/male-infertility-mental-health/

https://andrologyaustralia.org/wp-content/uploads/Male-Infertility-Guid…

 

 

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There’s a sperm donor shortage in Australia – but only 20% of men know about it

The leading fertility clinics in the Virtus Health group, including IVF Australia, Melbourne IVF and Queensland Fertility Group, have joined forces to research sperm donation in Australia.

What did we find out about Sperm Donation?

Only 20% of men are aware that there is a shortage of sperm donors in this country.

While the majority of Australians are aware of the need for blood and organ donation, the requirement for sperm donors is largely unknown.

Who uses sperm donation?

Used by patients as either part of an In-Vitro Fertilisation (IVF) cycle, or via Intrauterine Insemination (IUI), donor sperm can help overcome male factor infertility (15%), or help same-sex couples (35%) and single women (50%) have a child.

What are the common motivations for donation?

The same research also discovered that the common reasons for wanting to donate sperm included:

  • Helping others to have a family (38%)
  • Knowing other people going through fertility treatment (24%)
  • Knowing my sperm count and quality could be assessed at donation (20%)
  • Everyone deserves to be a parent if they want to be (18%)

Sperm donors in Australia can be known to the recipient or recruited via the clinic. Many couples and individuals choose their sperm donor through a clinic, as knowing the demographic profile of the donor but not their identity is a preferred option. In these cases, children of sperm donors are able to access their biological father’s details when they are 18 years old.

The reason for this is that in the past, many donor conceived individuals have reported extreme distress about the absence or lack of information about their biological parents. Nowadays, the exchange of this information, once the child has turned 18 years of age, is considered to be an important part of the use of donated sperm.

While Australians cannot be paid for their sperm, most clinics reimburse donors for legitimate expenses. Sperm donors in Australia are typically aged 25-45, with or without their own families, and of any sexual orientation.

De-identified donor sperm can be used to create up to five or 10 families, depending on what state they’re in, please check with your local state for family limits. Unlike popular belief from movies such as Vince Vaughn’s ‘Delivery Man’. Donors need not worry – fathering 500+ children from their sperm donation is a scenario only Hollywood can create.

Would you or someone you know now consider sperm donation?

After seeing the results of this research, we want to raise awareness of the need for more sperm donors in Australia. If it is something that you would consider talk to your local clinic for more information.

Sperm Donation in Australia Infographic

Sperm Donation in Australia infographic

 

* Research conducted by Woolcott Research in March 2012. 

A Man’s Guide to Fertility

It’s a topic that doesn’t get discussed too often at the pub or on the footy field. But the truth is that there are many men trying to become a dad, and it isn’t always as easy as they first thought.

With Men’s Health week upon us, it seems timely to dispel some myths and discuss some tips about men’s fertility.

Myth: Male Infertility isn’t common

With so much discussion around women’s fertility in the media, men seem to rarely get a mention. In Australia, male infertility affects about one in 20 men – and is actually the biggest factor preventing couples from conceiving after a woman’s age.

Last year, a Cambridge University researcher found that as our society is “obsessed with male virility”, but talking about men’s biological clocks appears to be socially taboo. Since male factor contributes to about half of the causes of fertility issues, the first thing we need to do is talk about it.

Myth: Age isn’t a factor

“But Rod Steward fathered a baby at 66!” Yes, but like celebrity mums over 45, this is the exception rather than the rule. After the age of 45, men have higher rates of fertility complications as their sperm volume, motility and morphology (shape) declines. There is also the increased likelihood of damage or breaks to the sperm DNA that may result in a negative effect on fertility. 

Myth: Lifestyle doesn’t matter

The truth is, like women, a man’s lifestyle can directly affect his fertility. The good news is there are some simple changes you can make to positively impact your overall health and that of your sperm.

What can I do to improve my fertility?

Improve Your Diet

Men should eat a healthy diet rich in fresh foods such as fruits and vegetables, and whole grains; olive oil should replace animal fats; nutrients and vitamins, such as vitamin C and vitamin E that are renowned for their antioxidant qualities and believed to increase sperm health.

Maintain a healthy BMI

Having a low or high Body Mass Index (BMI) can affect sperm count. If you’re overweight, try to reduce the weight as obesity may be linked with infertility – one study suggested a gain of 10kg decreases male fertility by approximately 10%.

Reduce Alcohol Intake

That’s not to say that a beer or a glass of wine here and there is a problem, but regular heavy nights out are not going to serve your purposes well. Long-term effects of chronic alcohol use include erectile dysfunction, reduced libido, and subnormal sperm production. Moderation is the key.

Stop Smoking

Scientific evidence suggests that smoking worsens sperm production, motility and morphology (shape.) Nicotine can cause testicular atrophy (a condition where the testes diminish in size and can result in loss of function.) Marijuana can decrease sperm density and motility, and increase the number of abnormal sperm. If you’re a smoker, making every effort to quit is a good idea for your overall health and your fertility!

Some Don’t Like it Hot

Working in hot temperatures, or simply relaxing, such as in a sauna frequently, can increase testicular temperature - resulting in abnormal sperm count and quality. It’s best to avoid taking long hot baths on a regular basis.

Recreational Drugs & Steroids

Cocaine can impair erectile function by suppressing the hormone that produces testosterone. High doses of amphetamines can lead to a diminished libido. Steroids are proven to affect sperm production and function. That’s not even taking into account the other risks associated with these drugs. If you’re a user, you need to stop!

Take the online male fertility check

If you want to know more about your individual circumstance, answer a few simple questions on our Male Fertility Check tool and get some insights into your reproductive health and the things you could do to improve your fertility now.

Male fertility issues can be overcome

If you do get to the point where you need to see a Fertility Specialist, at least for men, fertility tests are pretty straight forward. Secondly, in general, if your specialist then tells you there is a problem with your sperm there are ways to resolve this. This may require lifestyle changes, or surgery. Or you could go through an IVF cycle with ICSI to overcome a problem with sperm count or quality. The point is, once you understand the issue, there are generally ways to address it.

Watch:Hossam discuss Male Infertility

Read more:Male Reproductive System, Abnormal Sperm Production

Find a Specialist in Male infertility:Queensland, New South Wales, Victoria

Does Male Fertility Decline Over Time?

 

Tick, tock… do men have a biological clock?

As a Fertility Specialist and Obstetrician, I’d like to help every man who one day wants children to experience the joy of fatherhood. But like women, men who want to become a father shouldn’t assume it will always be possible... and here’s why.

Dad and Baby

The effect of age on a man’s fertility

It’s common knowledge that women’s fertility decreases with age, but recent studies have indicated that the biological clock is a reality for both sexes – although the decline is not as dramatic and finite for men.

Women are born with all their eggs, so as they get older they’re left with fewer and fewer eggs – as well as a higher proportion of abnormal ones, until eventually a woman reaches menopause and produces no eggs at all. 

Men, however, completely replace their sperm every three months, and continue to do so throughout their life. So sperm don’t have a ‘use by’ date in quite the same way as a woman’s eggs do. But studies indicate that semen volume, morphology (shape) and motility (the way it moves) does decline as a man ages1.

One study showed that the odds of fatherhood for those under the age of 30 was 32%, compared with 20% over the age of 50. That’s almost a 40% drop in male fertility in just 20 years!

While a man can keep producing sperm throughout his life, those sperm won’t necessarily be the best quality as the body producing them is getting older - and less healthy. Age also increases the possibility of DNA damage in sperm as the body becomes less efficient at naturally controlling cells with DNA damage. If sperm with defective DNA go on to fertilise an egg, this may translate into complications in pregnancy and after birth.

What else affects sperm quality?

In addition to age, there are a number of other factors that can make conception a little more challenging, especially for older men:

Obesity, diabetes and unhealthy lifestyles or diet can impact the quality of sperm. Common unhealthy habits that effect fertility include smoking, use of recreational drugs, and excessive or binge alcohol consumption. This is why one of the best things men can do to protect their fertility is to eat well and make positive lifestyle changes if necessary.

An increased risk of being exposed to STD’s can affect a man’s fertility also – and some STD’s can go undetected. This is why as Fertility Specialists we recommend that both the female and the male partner have a general check up by their GP, which includes simple blood tests for infectious diseases, before they start trying for children. 

Additionally, men produce less testosterone as they age – and this can also affect the quality of sperm, as well as sex drive. In general, older men have slower-swimming sperm, and the shape (morphology) of the sperm may also decline with age2.

To all Dad’s – present and future

While it’s clear that the metaphorical ticking biological clock doesn’t have the same rapid impact on men as it does for women, the chances of conceiving, and of having a healthy baby, are better when both parents are younger.

If you want to have a family one day or extend the family you already have, it’s important to keep in mind the effects that age has on both you and your partner, especially as the female partner approaches her late 30’s.
 


References:
1http://www.scientificamerican.com/article/fact-or-fiction-men-have-biological-clocks/
2http://www.babycentre.co.uk/a564598/dads-how-your-age-can-affect-your-fertility-and-your-babys-health

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