For conception to happen, the hormones, the genes and the environmental conditions need to be right.

Conceiving when neither partner has infertility problems, still takes on average from 6-8 months. If the female partner is over 35 and conception hasn’t happened after 6 months of regular, unprotected sex, it is advisable to contact a doctor, as fertility wanes with age. The recommendation for women under 35, is to contact the doctor after a year of unsuccessfully trying. Causes of male infertility can be difficult to diagnose, but are mostly associated with sperm production or motility. The good news is that in many instances of male infertility, doctors have used drugs or surgery to increase fertility and normal conception through sexual intercourse has then taken place.

Male infertility and IVF

Causes of male infertility:

  • Something that the man was born with, that affects his ability to produce normal sperm
  • Lifestyle choices like smoking or drinking, that reduce his sperm production
  • Illness or medication
  • Hormone levels
  • Chromosomal defects
  • Damage to the reproductive organs by surgery, injury or infection

Visible signs of infertility in men:

  • Testicular pain or swelling
  • Small, firm testicles
  • Erectile disfunction
  • Changes in virility/sexual desire
  • Trouble ejaculating

How is male infertility diagnosed? What will I have to do?

Diagnosis starts with a conversation. If, as a couple, you have been trying for a baby unsuccessfully, it’s advisable to contact your GP. The doctor will want to know about your lifestyle (use of alcohol, tobacco or drugs), medical conditions, current medication, working conditions (any exposure to chemicals or metals, etc), any injury to the area, genetic issues, sexual history and length of time spent actively trying to conceive. They may also do a physical examination of your genital area, to see if there are any apparent indicators.

Your doctor will probably request a semen analysis. You will need to produce a sample, so that the quality, quantity and motility of the sperm can be assessed. Sperm disorders can include unusually shaped sperm, low numbers of sperm, less mobile sperm or no sperm produced.

Can infertility in men be treated?

Once a diagnosis has been made, the doctors can advise you on the next steps. Fortunately, many diagnosed male infertility problems can be fixed with drugs or surgery, allowing conception through normal intercourse to take place. For problems like retrograde ejaculation, over the counter medication can help. Varicoceles can be treated during outpatient surgery. Blocked ducts can also be treated surgically. What happens if treatments don’t work, or if unexplained infertility is diagnosed? Assisted reproductive techniques can enable conception without sexual intercourse.

These techniques include:

  • Intrauterine Insemination (IUI). The sperm is placed into the female partner’s uterus via a tube. This method can help if the male partner has a low sperm count or poor motility
  • In Vitro Fertilisation (IVF). For IVF, drugs are used to stimulate the ovaries, so that multiple eggs are produced. Sperm is then added to each egg and after 3 to 5 days, any viable embryos are put back into the uterus. The number of embryos put back depends on the age of the female and the viability of the embryos.
  • Intracytoplasmic Sperm Injection (ICSI). A form of IVF, ICSI treats severe male infertility by injecting a single sperm into the egg with a needle. When the egg is fertilised, it is placed into the female partner’s uterus. Surgical techniques can be used to remove sperm from the testicles or epididymis, meaning that it bypasses any problems with ejaculation.

If sperm needs to be retrieved from the testicle in order to facilitate IVF or ICSI, biopsies or fine needle aspirations can be performed. MESA (Microsurgical Epididymal Sperm Aspiration) can retrieve high amounts of sperm from the epididymal tubes. Some methods allow sperm to be frozen for future IVF procedures.

Support for men:

There is often a stigma attached to male infertility and opening up the conversation can prove difficult. It’s important as a couple you make time to discuss your feelings when it comes to infertility. This blog gives an overview of the signs, symptoms, causes and treatment of male infertility. It’s a complex subject and consulting a doctor early on in your fertility journey, will ensure that you get the best advice for your own personal circumstances.