Male infertility causes and treatments

Male infertility is the inability of a man to cause pregnancy in a woman. Infertility in men can be caused by numerous factors, including underlying medical conditions or a naturally low sperm count. Mr Michael Booker, a fertility expert, obstetrician and gynaecologist explains male infertility and how it can be treated.

What causes infertility in men?

Healthy fertile men continue to make sperm throughout their lives. Fresh sperm are made on a daily basis in quite large quantities, to the extent that fresh sperm are made with every heartbeat.

For a man who is infertile, this might be due to an underlying medical condition, for example, heart disease, diabetes, high cholesterol or thyroid disease. Hence, it is important to look for any underlying medical conditions.

There may also be features in the man's past medical or surgical history indicating a cause for infertility. For example, a man who has undergone an operation to bring down an undescended testicle. Another example is a man who has a varicocele (a varicose vein around the testicle), which can also be a cause for infertility. If there is a history of infections, particularly repeated infections, this can also affect fertility.

How are the causes of male infertility determined?

With regards to the investigation of male infertility, a key step is a detailed semen analysis and this is done by a fully trained scientist according to criteria set by the World Health Organisation. The man might also need to have a series of blood tests carried out, including measuring testosterone. For men with very low sperm counts, genetic testing with chromosome analysis might be necessary, which can also to look for certain conditions, such as cystic fibrosis. A careful physical examination is also needed and a testicular ultrasound.

What treatments are there for male infertility?

With regards to treatment, IVF treatment involving injecting the sperm into the egg can be an option for men struggling to get their partner pregnant. This is called ICSI treatment and it is used frequently. Some men will have no sperm in their ejaculate and this might be due to a previous vasectomy operation, or it might be that the man is producing sperm in such small quantities that there are insufficient sperm to come out into the ejaculate. These men may need to undergo a surgical procedure to retrieve sperm directly from the testicle, or the collecting tubes around the testicle.

Hence, there are options to help men struggling with infertility. If you and your partner are struggling to conceive, make an appointment with a fertility expert to find out why and to see what options you have.