In about a third of couples complaining of infertility the main problem lies with the male. We also find that in up to half (50%) of couples with infertility, there is a problem with sperm. When there is a male problem there are insufficient numbers of normal sperm available to fertilise the female egg.
The easiest way to identify a male factor problem is to do a “sperm test” otherwise known and semen analysis. Semen analysis should be undertaken in all couples seeking investigation for infertility regardless of whether there is an identified female problem or a suspected male factor problem. Even if the male partner has previously fathered children a semen analysis is necessary since problems may have developed in the intervening time.
The analysis is a useful test that reveals important information on several sperm parameters. These include, the number (concentration) of sperm, the percentage of the sperm which are moving (motility), as well as the quality of the movement (progression) and the proportion of sperm that are normally shaped (normal forms). Further test include looking for the presence of antibodies to sperm. However, of all these sperm concentration is usually considered to be the most critical factor.
If semen analysis result is abnormal, further investigations may be necessary to establish the cause. Sperm test results vary and could be normal one day and abnormal the next. Therefore we sometimes request a repeat test. One test to further explore sperm function is a post coital test, where the ability for the sperm to swim in a partner’s cervical mucus is assessed, another way is to do an advanced sperm recovery test.
The causes of male infertility may be hormonal, genetic or physical. Exposure to certain chemicals and infections or illnesses could also hamper male fertility. However, in most cases no obvious cause is found. Sometimes, if the sperm count is borderline or slightly low, some of the following factors may be worth considering:
Problems with male infertility can sometimes be improved by changes in lifestyle, diet or by taking vitamins. However, because sperm takes at least 3 months to develop on has to wait a while to see any improvement.
In other cases sophisticated Fertility treatment ma be required. The most successful of these is a form of IVF treatment called “Intracytoplasmic sperm injection” (ICSI). ICSI is the process whereby a sperm is injected directly into an egg and can be carried out even when there are very few sperm present. This technique has allowed many men too father children with their own genetic material where before sperm from a “donor” would have been used. Another option would be to undertake intra uterine insemination (IUI), where the best sperm are filtered and injected in to the female partner’s womb at the time of ovulation.
It is useful to remember that in many cases even if the sperm count is low or quality is poor, conception could still occur naturally, so don’t give up trying.