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February 07, 2018

Managing Male Infertility

Managing Male Infertility

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Having trouble conceiving? Fertility problems could lie with either partner in a relationship.

What are the causes of male infertility?

In general, the cause of male infertility fits into one of four categories:

  1. 60-80 percent of cases: Sperm production. This could be a genetic condition such as Klinefelter’s syndrome or functional issues such as undescended testes  or varicocele. Also an infection or significant environmental exposure could cause male infertility.
  2. 10-20 percent of cases: Idiopathic (Unexplained). These men have mostly normally functioning sperm yet they have never contributed to a pregnancy despite attempts with a normal female partner.
  3. 2.5 percent of cases: Endocrine or systemic disorders that disrupt the brain’s ability to communicate with the testicles and therefore sperm production is curtailed. These disorders can be the result of a head trauma or brain tumors.
  4. Rare cases: Sperm is unable to move for some reason. This is rare and is called Kartagner’s syndrome.

What does a ‘low motile sperm count’ mean?

Low motile sperm count means that the number of moving sperm found in a sperm analysis is below a reference point based on a large study of fathers published in the most recent WHO 5th guidelines for semen analysis. Motile sperm count combines both concentration (number of sperm in the sample) and motility (percent of moving sperm).

Can men with a low motile sperm count still conceive naturally?

Yes they can and this is why it is an important variable to understand. The media often only focuses on sperm count, but this is misleading. If you have 40 million sperm but none of them are moving, you will not achieve a pregnancy in normal intercourse. If you know that your sperm are moving (motile) this provides much more information about your fertility potential.

Are there any external factors such as diet that can affect your sperm?

  • High doses of caffeine (>300 milligrams per day) are not helpful for sperm motility
  • Marijuana and narcotic use disrupt the brain’s communication with the testes and can impair sperm production.
  • Testosterone use will stop the brain’s communication with the testes completely and is generally not recommended for men who are trying to conceive. It’s important your doctor knows if you are taking testosterone, especially if you are having trouble conceiving.
  • In general, foods rich in lean protein, low in fat, high in vitamin C and zinc are good for sperm production.

Can you still conceive if there is no sperm in your ejaculate?

You may not be able to conceive naturally. However, there are surgical procedures for retrieving sperm directly from the testicles or epididymis such as TESE or MESA . The sperm is retrieved in these procedures and then used for IVF-ICSI to obtain a pregnancy.

Is it true that wearing tight underwear/trousers is bad for your sperm?

Testes evolved outside the abdominal cavity for a reason; to keep them cooler than the rest of the body. Heat can be detrimental to the testes, but the hypothesis that tight fitting underwear (which might raise the scrotal temperature by 1C) impairs reproductive outcome has yet to be proven. So wearing briefs is fine.

However, routine soaks in a hot jacuzzi is likely to result in a temporary reduction in sperm production.

How can you increase your sperm motility?

A Google search on this topic will have you trapped in a deep internet rabbit hole for days! Take a multivitamin, extra vitamin C, stop caffeine and smoking and then go from there. There are a host of supplements, but first, try to keep it simple and affordable.

How can you avoid or reduce emotional stress when it comes to infertility?

You may not be able avoid emotional stress when you are facing infertility but there are some strategies that may help.

  • The most important thing is to support each other in an open and thoughtful manner and to speak with intimate friends or family who are willing to share their infertility experience.
  • If you want some relaxation techniques, I have found that my patients benefit the most from acupuncture on one level and even reproductive counseling on another.

How long should you try to conceive naturally before going to see a doctor?

This hinges on the age of the female.

  • If she is under 35 and has been having unprotected intercourse in an attempt to conceive for 12 months without success, she should see a fertility specialist for a workup and treatment. 85 percent of couples should have conceived at this point.
  • If she is over 35 and has not achieved a pregnancy within six months of unprotected intercourse, then she should see fertility specialist.
  • If she is under 35 AND has irregular periods, a history of endometriosis, tubal disease, fibroids or there is a risk of male factor, she should be seen within six months if she is not pregnant.

YO Sperm Test is a sperm tests for men that check count AND motility that you can use in the comfort of your own home. This easy-to-use test clips onto your smartphone for fast and simple results. For more information visit www.yospermtest.com