Male infertility is still a topic suffering from a lack of open discussion and one result of this is insufficient information for men and their partners. Yet with around a third of couples struggling to conceive because of male infertility, it’s time to shed some light on the subject.
There are numerous causes for male infertility, including medical, lifestyle, age-related and even mental health issues. Even though IVF can increase the chances of having a baby, there are many steps men can take before IVF should be considered.
Options other than IVF for male infertility
For couples undergoing IVF treatment, it can be a daunting, stressful and expensive process. Depending upon the causes of male infertility, doctors will usually suggest other options before the prospect of IVF is raised.
One of the first areas that doctors will look at will be your lifestyle. Poor diet, obesity, alcohol, smoking, medicines and insufficient exercise can all cause male fertility problems.
If your doctor spots an issue in one of those areas – or with your levels of stress – they’ll suggest making some lifestyle changes and see if they help you to conceive. They might also recommend taking a fertility supplement shown to be effective in clinical trials.
When you should be recommended the IVF route
Fertility treatment is normally only proposed after two years of trying for a baby, as many couples conceive during that second year. During investigation obvious causes of male infertility might be discovered.
IVF will only be suggested once other options have been exhausted. The process is both expensive (with one cycle costing £5,000 or more at a private clinic) and emotionally challenging.
Although it’s not always possible to determine causes for infertility, various tests will be carried out long before IVF is mentioned. As well as lifestyle factors, other causes of male infertility can include testicular infections or injury, ejaculation defects, genetic defects, hormonal defects, cancer and drug use (notably steroids). One of the most common manifestations of male infertility is a low sperm count.
Low sperm count issues and solutions
Although 15 million sperm might sound like a lot, if a man has less than 15 million per millilitre of semen, that qualifies as a low sperm count. Approximately one in three couples who can’t conceive a baby are affected by a low sperm count or low sperm quality, and the problem is growing.
If you and your partner have been trying to conceive naturally for more than a year, the male partner should get his sperm count checked. Rather than being tempted to use one of the home testing kits now available, it’s recommended to let your GP arrange a semen analysis through an accredited clinic.
Problems with sperm count and quality can be caused by a wide variety of factors, including:
- hormone imbalances
- an infection such as chlamydia, gonorrhoea or prostatitis
- previous surgery on your testicles
- enlarged testicular veins (varicocele)
- overheated testicles
- damage to the tubes carrying sperm
- undescended testicles during infancy
- obesity
- alcohol, smoking and substance abuse
- medicines such as anabolic steroids, chemotherapy and some antidepressants or antibiotics
Fortunately, even if you have a low sperm count, there are various measures you can take to increase your chances of becoming a father.
In addition to leading a healthier lifestyle, one of the main ways to counteract a low sperm count is regular sex. Aim to have sex every two or three days, particularly when your partner is ovulating.
Then there are male fertility supplements such as Impryl, which can help improve sperm motility (the sperm’s ability to move) and enhance the quality of DNA within your sperm.
The main advance in Assisted Reproductive Technologies (ART) is called intracytoplasmic sperm injection (ICSI). It involves undertaking IVF but achieving fertilisation by injecting a single sperm directly into an egg. Many men with low sperm counts are able to have children this way.
Semen collection and process
To make sure there’s enough sperm for ICSI, avoid ejaculating for three days before the day of the procedure.
On the day itself, the preferred method of collection is masturbation, either at home or at the clinic. Alternatively, you may be able to have sex with your partner using a special condom that preserves sperm.
If you have no sperm in your semen, depending on the cause, you might be able to have your sperm surgically extracted, from one or more sites. This could involve a simple syringe, a small incision or going under a general anaesthetic.
Once the sperm have been collected, they are washed and spun at a high speed so the healthiest and most active sperm can be selected to fertilise your partner’s eggs. The eggs are checked after 16 to 20 hours to see if any have been fertilised. Those that have (now termed embryos) are allowed to grow in a lab for six days, before one or two are transferred to the female partner’s womb.
