Are We Overlooking Male Infertility?
Couples hoping to experience the joys of parenthood may encounter the serious obstacle of infertility. Doctors consider a couple infertile if pregnancy does not occur within 12 months of frequent unprotected sexual intercourse. What is sometimes overlooked is that male infertility makes up 1 in 3 of these cases, a number which may increase in the coming years. Male infertility occurs when an underlying condition or reason is preventing the man from conceiving a child. The root cause is often sperm related. Understanding how sperm affects fertility can lead to strategies to improve fertility.
Placing a microscope on sperm
For conception, healthy sperm travel to the fallopian tubes and fertilize the egg. Unhealthy sperm is determined by poor sperm production, motility, morphology, or a combination of these conditions. Sperm can take over 2 months to mature. In some cases, sperm maturation can be disrupted, leading to infertility. As part of fertility treatment, a doctor will recommend and perform semen analysis. Reviewing a sample under a microscope can reveal a potential underlying cause of infertility. The information can help a doctor or fertility clinic devise a plan to improve sperm health or increase pregnancy rates.
What's causing these sperm issues?
Sperm are living cells subject to the many internal and external factors that damage cell production. External lifestyle behaviors, like smoking, alcohol abuse, and some recreational drugs can damage sperm. Environmental triggers like certain chemicals or toxins can degrade sperm health. Major hormone imbalances, particularly gonadotropins and testosterone, affect sperm quantity and quality. Genetic abnormalities and conditions like Klinefelter syndrome can stop the production or maturation of sperm. Finally, sexually transmitted infections (STIs), certain medical conditions like varicocele, or medication use can cause male infertility.
Diagnosing male infertility and your first steps
After sperm analysis, a reproductive specialist, urologist, or fertility clinic will provide a report with markers that signal infertility. For instance, a severely low sperm count is known as oligospermia. There may be a low number of motile sperm or less than 4% sperm morphology, a sign of significantly impaired fertility. Addressing sperm issues can start with simple lifestyle changes. Improving diet, weight management, increasing exercise, and quitting harmful habits can help over time. Studies show that weight loss and exercise can dramatically improve sperm issues. In most cases, lifestyle changes are combined with other strategies to achieve pregnancy.
Hormone medication and surgical interventions
Medical treatments like hormone medication improve sperm health. The doctor may prescribe hormone therapy consisting of drugs like clomiphene citrate, human chorionic gonadotropin (hCG), or medicines to lower estrogen production. Antibiotics can address infections, and surgical interventions can repair conditions like varicocele. These strategies may need several months to improve fertility but may work best with assisted reproductive technology (ART) treatment.
The power of ART
Severe cases can benefit from ART, a series of reproductive techniques that handle eggs and sperm outside the body. In vitro fertilization (IVF) is the most effective form of ART, where embryos are made with egg and sperm samples. The healthiest embryo is then surgically implanted into a woman's uterus to achieve pregnancy. IVF is a multi-step process that can need multiple cycles to achieve success. Some cases require intracytoplasmic sperm injection (ICSI), where a single healthy sperm is used to fertilize the egg. IVF and ICSI are rising in popularity with high success rates.
Supporting the infertility journey
Most men overlook sperm health as a necessary factor of fertility. The numbers show sperm issues cause at least 1 in 3 cases. Men can feel stressed or inadequate with the unfortunate news of infertility, but there is hope. Sperm count and quality can be confirmed with the appropriate sperm analysis. This information, coupled with lifestyle changes and treatment, can be transformative on the journey to parenthood.
