Male infertility is still such a stigma, with so many men not wanting to even think about the possibility that they could have a problem

The reality is though, that infertility affects both men and women equally. For this reason, it is imperative that both women AND men get checked out and understand what is going on in their bodies.

We turned to the urology and embryology team at IVF Turkey for more information on the reasons behind male infertility.

Q: How long should you wait, if you are trying to conceive, until you have a sperm test? 

A: If you are under 35 years old, you can wait for a year, but over 35 you should consult your physician after six months of trying to conceive.

Q: Are there any visible signs of male infertility?

A: Some men will have visible signs, but not all. For example, the small size of the testis can be related to hormonal abnormality and infertility. Gynecomastia, (which is an enlargement or swelling of breast tissue in males), obesity, lack of facial or body hair and low body height are also physical signs of male infertility. 

Q: What are the reasons for not being able to conceive naturally? Can you explain each one in a little more detail?

A: Sperm Disorders

This is when the sperm is either odd-shaped, doesn’t move in the right way, is low in numbers or there is in fact no sperm at all. All of these different features are analysed – the number, shape and movement. 

  • A normal sperm count ranges from 15 million sperm to more than 200 million sperm per ml
  • The motility of the sperm should be over 40 %T
  • The normal forms of the sperm should not be less than 4%

The abnormality of either the number, shape or movement may cause infertility

Varicoceles

This is an enlargement of the veins within the scrotum – the loose bag of skin that holds your testicles. The Varicoceles harm sperm growth by blocking proper blood drainage.

There is a relation between varicoceles and infertility. It can decrease sperm count, decrease motility of sperm, and cause an increase in the number of deformed sperm.

The varicoceles may also cause excessive heat. The excessive heat damages sperm by elevating the temperature of the testis, which is supposed to be about 2 °C colder than the body.  

Retrograde Ejaculation

This occurs when semen enters the bladder instead of emerging through the penis during ejaculation, so essentially going backwards in the body.

Immunologic Infertility

This is when antibodies attack the man’s own sperm, by binding to the sperm surface. This can interfere with sperm motility.

Obstruction

Sometimes the sperm canal can be blocked which means sperm from the testicles can’t leave the body during ejaculation. This blockage can be caused by various reasons such as infections or surgery ( a vasectomy).

Hormones

Very low hormone levels cause poor sperm growth. Any disorder of the thyroid stimulating hormone, prolactin and blood sugar hormones might cause male infertility. Testosterone and FSH (the follicle-stimulating hormone, which regulates the development, growth, and reproductive processes of the body.) can be markers of male infertility.

Chromosomes

Changes in the number and structure of chromosomes can affect fertility.

Y chromosome infertility is a condition that affects the production of sperm and causes male infertility, which means it is difficult or impossible for affected men to conceive. Any other chromosomal abnormality can also affect the sperm.

Medication

Certain medications can change sperm production, function and delivery. Hypertension medications and antidepressants have been found to be responsible for erectile dysfunction. Chemotherapy can completely damage the sperm production.

Q: Can you treat any of the above? If so, how?

A: Sperm disorders should be evaluated thoroughly, and treatment planned accordingly. A surgical approach or hormonal support are methods commonly used in the treatment of male infertility. 

Male infertility cases are treated with the use of intracytoplasmic sperm injection (injection of sperm into the egg under a microscope) that yields satisfying pregnancy rates even in severe cases.

For blockages, testicular aspiration can be done during IVF treatment.

Q: When do you know that a sperm donor is your only option?

A: In the cases of azoospermia with no sperm available in the testis after micro TESE procedures, then the use of donor sperm can be the only option. 

Massive thank you to the team at IVF Turkey for this Q&A for our Ask an Expert section – if you have a questions you would like to ask an expert then please email info@ivfbabble.com 

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