Male infertility

Medically, infertility is diagnosed when a couple cannot get pregnant after having unprotected sex (every two – three days) for a year. After trying to get pregnant for one year, about 85 per cent of couples conceive.  After two years, about 95 per cent of couples do conceive.

Male reproduction depends on making healthy sperm, and the ability to have an erection and ejaculate. Problems with either of these may affect fertility.

Male infertility is complex and there are many causes. The most common cause of male infertility is the lack of ability to develop mature, healthy sperm that travel to the site of the oocyte. This can be affected by

• Blockages to the passages through which sperm travel in the male tract
• Problems with sperm production, including low or no sperm produced, sperm motility or shape deficiencies
• Functional problems such as impotence relating to erectile or ejaculatory disfunction
• Inflammatory illnesses and infection, and immunological disorders.

In addition, injuries, chronic health problems, lifestyle choices (drug, alcohol, steroid use) and environmental exposures to toxins and endocrine disruptor chemicals can contribute to reduced male fertility.

• Smoking – smoking damages some reproductive organs
• Excessive alcohol use
• Using illegal drugs and certain prescribed medications
• Weight – being overweight
• Inflammatory conditions and infections, particularly viral infections like mumps, and sexually transmitted diseases
• Immune problems where antibodies are made against your own sperm
• Overheating testicles
• Existing medical conditions
• Genetic diseases eg; cystic fibrosis or haemochromatosis
• Environmental – exposure to pesticides, solvents and metals.

To maintain health sperm production avoid

• Smoking
• Excess alcohol drinking
• Catching or failing to adequately treat sexually transmitted infections
• Heat stress, restrictive underwear or clothing, sitting for long periods, heated seats, holding laptops on the groin
• Anabolic steroids, taken for bodybuilding or sport, which can reduce sperm count and mobility
• Pesticides and toxins.

In addition, maintaining a healthy weight, eating a healthy, balanced and nutritious diet and reducing stress help.

If a man has been unable to conceive a child after a year of unprotected intercourse, every two-three days, see a doctor. See a doctor earlier if you have any of the following

• Erection or ejaculation problems, low sex drive, or other problems with sexual function
• Pain or lump in the testicle area
• A history of testicle, prostate or sexual difficulties.

One in eight men have a treatable condition.  In other cases, treatments are focused on increasing the odds of conception including surgery, hormone therapy, artificial insemination, in vitro fertilisation (IVF) and intra-cytoplasmic sperm injection (ICSI).