MEN AND INFERTILITY

Infertility may be due to problems in either the male or female partner. Male problems may be contributory in 30% to 40% of infertile couples. The initial screening evaluation of the male partner includes a history and a properly performed semen analysis. Most general laboratories lack the expertise to perform a detailed sperm analysis and it is recommended that the test is performed in a lab where the testing confirms to the WHO 2010 criteria.

SEMEN ANALYSIS

A sample is collected by masturbation after abstaining from ejaculation for at least 48 hours, but not longer than five days. The complete ejaculate should be collected in a sterile container provided by the clinic or laboratory and should be examined within one hour of collection. Semen quality is known to vary widely for a variety of reasons. It is therefore important to repeat a test if the first report is abnormal. Numerous factors can affect the results of semen analysis quite dramatically.

FURTHER EVALUATION

If the semen analysis is abnormal, your doctor would need to examine you and perform an endocrinological evaluation (checking your hormones). Sometimes additional semen tests are needed. An ultrasound scan of the scrotum and evaluation of the blood flow by Doppler scan is occasionally needed. Genetic testing is needed if the sperm count is very poor or if there are no sperms seen in the semen sample

WHAT CAN I DO TO IMPROVE MY SPERM QUALITY?

Obesity has been clearly linked to impaired sperm production. Overweight men interested in optimizing fertility should attempt to attain an ideal body weight. Antioxidants have been found to result in a slight increase in both sperm count and motility. Fruits and vegetables also provide a natural source of antioxidants and should be part of a balanced and healthy diet. Smoking is associated with reduced sperm quality. Men who are trying to conceive should consider stopping smoking immediately. Also, recreational drugs, including anabolic steroids and marijuana, and excessive alcohol use are associated with impaired sperm function. They should not be used.
Some studies suggest that wearing boxer underwear, avoiding situations that raise scrotal temperature (like hot tubs or using laptops on your lap) might improve sperm quantity and quality. Further studies to confirm this are needed.
Some medications, along with chronic medical conditions and high fevers, may impair the body’s ability to make sperm.

DOES INFERTILITY AFFECT ME AND MY RELATIONSHIP?

Fertility clinics tend to be focused on the treatment and as the vast majority of treatment is centred on women, it is easy for men to feel ignored, marginalised or as if they have no role to play other than to provide the sample when necessary. Many men find visiting the fertility unit uncomfortable and only attend when necessary. It may, of course, not be possible for both partners to attend all appointments but your partner and your relationship will benefit from your occasional presence and your support. The treatment is for both of you.
Men and women often have very different ways of dealing with problems and it can be very difficult to understand and accept this difference when you are going through this together. Women often say that their husbands won’t talk about their feelings and this is sometimes interpreted as not caring. It may be that your wife needs to talk about how she feels, either with you or with somebody else, more often than you. You and your wife will benefit from understanding and accepting each other’s different ways of coping.
Fertility treatment and the associated stress can sometimes have a very negative effect on your sexual life. What was once a pleasure is now a just a way to achieve a pregnancy. This can cause problems in your relationship and sometimes temporarily preventing you from being able to have sex altogether.