Navigating male infertility

Male infertility is a multifaceted condition that can become a challenging issue for couples trying to conceive.

Here, Mr Majed Shabbir, renowned consultant urological surgeon, offers an expert insight into male infertility, shedding light on the possible causes, diagnostic approaches, and available treatment options.

What are the most common causes of male infertility?

The most common causes of male infertility include:

• Low sperm count: When a man produces fewer sperm than normal, it can significantly reduce the chances of fertilising the egg.
• Poor sperm motility: Sperm motility indicates the ability of sperm to move effectively. If sperm have poor motility, they may struggle to reach and fertilise the egg.
• Abnormal sperm morphology: Sperm morphology refers to the size and shape of sperm. Abnormalities in sperm morphology can impair their ability to penetrate and fertilise the egg.
• Genetic factors: Genetic abnormalities can affect sperm production or function, leading to infertility. Examples include chromosomal abnormalities.
• Hormonal imbalances: Imbalances in hormone levels, such as testosterone or thyroid hormones, can disrupt sperm production and fertility.
• Varicocele: A varicocele is the enlargement of veins that drain the testicle. It can lead to overheating of the testicles, which can impact sperm quality and production.

Can male infertility be a sign of an underlying health condition?

While infertility itself is often viewed as a reproductive issue, it can also reflect broader health concerns affecting overall wellbeing. Underlying health conditions that can contribute to male infertility include:

• Endocrine disorders: Hormonal imbalances resulting from conditions such as diabetes, thyroid disorders (hypothyroidism or hyperthyroidism), or pituitary gland disorders (such as hypopituitarism) can impact sperm production and fertility.
• Sexual dysfunction: Conditions like erectile dysfunction or ejaculatory disorders (such as retrograde ejaculation) can interfere with the ability to conceive.
• Infections: Sexually transmitted infections (STIs) or other infections of the reproductive tract, such as prostatitis or epididymitis, can impair fertility by damaging sperm or causing blockages.
• Chronic illnesses: Health conditions like cancer, kidney disease, liver disease, or autoimmune disorders can affect fertility due to their impact on overall health, hormone levels, and reproductive organs.

When should I see a doctor if I suspect male infertility?

Infertility is defined as the inability to conceive after one year of regular, unprotected intercourse. However, you may wish to see a specialist sooner if:

• You or your partner are over the age of 35, it is generally recommended to seek medical advice sooner, as fertility declines with age.
• You have known risk factors for infertility, such as a history of undescended testicles, testicular trauma or surgery, genetic disorders, or exposure to environmental toxins or radiation, it is important to discuss your concerns with a specialist.

How is male infertility diagnosed?

Diagnosing male infertility typically involves a comprehensive evaluation. A specialist will inquire about your medical history, including any previous illnesses, surgeries, medications, and lifestyle factors. A physical examination will then be conducted to assess the reproductive organs and identify any abnormalities.

After this, several investigations may be carried out, including:

• Semen analysis: A semen analysis is a crucial test to evaluate sperm count, motility, morphology, and other parameters.
• Hormone testing: Blood tests may be performed to assess hormone levels, including testosterone, follicle-stimulating hormone (FSH), luteinising hormone (LH), and prolactin.
• Imaging studies: Imaging tests such as ultrasound or MRI scan may be used to examine the reproductive organs and identify any structural abnormalities.

What are the available treatment options for male infertility?

Several treatment options are available for male infertility, depending on the underlying cause and severity of the condition. Common treatment options include:

• Lifestyle modifications: Making healthy lifestyle changes can often improve fertility. This includes maintaining a healthy weight, quitting smoking, reducing alcohol consumption, and managing stress levels.
• Medications: Certain medications may be prescribed to address hormonal imbalances, improve sperm production, or treat underlying medical conditions contributing to infertility.
• Surgery: Surgical procedures may be recommended to correct anatomical abnormalities, remove blockages, or retrieve sperm for fertility treatments. Common surgical interventions for male infertility include varicocele repair, vasectomy reversal, or procedures to correct obstructions in the reproductive tract.
• Assisted reproductive technology (ART): ART procedures can help overcome fertility challenges by directly affecting sperm and eggs to facilitate conception. Common ART procedures used to treat male infertility include intrauterine insemination (IUI) and in vitro fertilisation (IVF), which also include intracytoplasmic sperm injection (ICSI) techniques.

What is the success rate of fertility treatments for male infertility?

The success rate of fertility treatments for male infertility can vary depending on several factors, including the underlying cause of infertility, the type of treatment utilised, the age and overall health of both partners, and other individual factors.

It is important to know that fertility treatments may require multiple cycles to achieve success, and success rates can vary widely between individuals and couples. Additionally, success rates may decline with advanced age or in cases of certain underlying medical conditions.

Generally, ART procedures like IVF and ICSI have shown promising success rates, particularly in cases of severe male infertility.

However, before undergoing any fertility treatment, it is essential to consult with a specialist who can provide personalised guidance based on your specific situation, preferences, and goals. A specialist can help you understand the potential success rates of different treatment options and develop a tailored treatment plan to optimise your chances of achieving a successful pregnancy.

If you are experiencing difficulties with fertility, schedule an appointment with Mr Majed Shabbir via his Top Doctors profile today.