Male infertility is in some ways more common than female infertility and quite often the failure to conceive is caused by a problem with the male’s reproductive system. It is a lot less complicated to examine and test a male than a female which is why it is often chosen as the first port of call when it comes to conceivement problems rather than to test the female.
Thorough and extensive examinations and reviews of the man’s medical and surgical history are imperative because any chronic and severe disease, injury to the pelvis, childhood illnesses, recreational drug use, abdominal or reproductive organ surgery and some medications can have a dramatic effect on fertility. Physical examinations may show up testicular irregularities, for example, absence of vas deferens, tumours, a varicocele, or even a hormonal disorder; enlarged breast tissue or underdeveloped reproductive organs or testosterone deficiency (hypogonadism).
A semen analysis is performed to examine the ejaculate because seminal fluid can affect the function and movement of sperm. It is common for a fertility specialist to take three semen samples to account for any errors or differences in temperature. If three samples do not differ more than 20% from one another they will then make a diagnosis. Six factors are analysed in sperm analysis:
• Concentration of sperm (ml/cc)
• Motility (movement of sperm)
• Morphology (sperm shape)
• Volume (volume of ejaculate)
• Total motile count (total number of moving sperm)
• Standard semen fluid test (thickness and colour of semen)
Other semen analysis tests for infertility include a sperm-mucus interaction test, to measure the sperm’s ability to swim through female reproductive tract and post ejaculation urinanalysis may identify diseases that could affect fertility such a chronic urinary tract infections (UTI) kidney disease or diabetes. Additionally, blood tests can help to pick up any previously undetected disorders that would effect testosterone and sperm production.
The causes for male infertility are vast, but generally it is down to an impaired production of sperm, impaired delivery of sperm and testosterone deficiency. Causes for male infertility include the following:
• Disease. (e.g. cystic fibrosis, sickle cell anaemia, STD (Sexually transmitted diseases
• Chemotherapy used in treating some cancers
• Medications such as those that treat high blood pressure, arthritis etc.
• Injury to the testicles
• Retrograde Ejaculation (a rare condition where the semen flows backwards through the bladder during ejaculation)
• Testicular Cancer
Once a definite diagnosis is made then treatment can commence. There are three categories of treatments; Assisted reproduction, drug therapy, or surgery. Which category you fall into depends on the nature of the problem but your specialist can advise you which the best treatment for you is.