Fertility challenges can be a deeply emotional and often confusing experience for couples trying to conceive. While much attention is given to female infertility, male infertility is just as significant a problem, contributing to nearly half of all infertility in couples. It can arise from a variety of causes, ranging from medical conditions to lifestyle factors, and is difficult to diagnose without professional help. However, with advancements in medical science, many cases of male infertility are treatable, offering hope to those affected.
Leading consultant gynaecologist and subspecialist in reproductive medicine and surgery, Dr Ishola Agbaje explores common questions about male infertility, including its causes, diagnosis, and treatment options.
Male infertility refers to difficulties a man may face in achieving a pregnancy with his partner. It occurs when a man has problems with his sperm or reproductive system, which make it harder for conception to occur. While infertility is often thought of as a female issue, studies show that male factors are responsible for about 40-50% of infertility cases in couples. Understanding the causes, symptoms, and available treatments is key for anyone who might be affected.
Male infertility can result from a variety of causes, which may be physical, hormonal, or lifestyle related. A common cause is low sperm count, meaning there are fewer sperm than normal in the semen. Other factors include poor sperm motility (the ability of sperm to move properly) and abnormal morphology (sperm shape), which can prevent them from reaching or fertilising the egg.
Physical conditions, such as varicoceles (enlarged veins in the scrotum), infections, or blockages in the reproductive tract, can also contribute to infertility. Hormonal imbalances may affect sperm production. Additionally, lifestyle factors like obesity, smoking, excessive alcohol use, poor diet, use of anabolic steroids and exposure to environmental toxins can all negatively impact fertility.
Certain medical treatments, such as chemotherapy or surgery, may also impair reproductive function. In some cases, male infertility is due to genetic conditions that affect sperm production or delivery.
Diagnosing male infertility typically begins with a medical history and physical examination. Your doctor will ask about your overall health, past medical conditions, and lifestyle habits that might influence fertility. A key test used in diagnosis is a semen analysis, where a sample of semen is evaluated for sperm count, motility, and shape.
Additional tests may include blood tests to check hormone levels, imaging studies like an ultrasound to examine the reproductive organs, or genetic testing if inherited conditions are suspected. These assessments help identify underlying causes and guide the choice of treatment.
The treatment of male infertility will depend on the cause. In cases where lifestyle factors are contributing, losing weight, improving diet, quitting smoking, reducing alcohol intake or stopping the use of training supplements which may contain anabolic steroids can make a significant difference. For hormonal imbalances, medication may be prescribed to regulate hormone levels and improve sperm production.
For physical issues like varicoceles or blockages, surgical procedures can often correct the problem. If sperm abnormalities persist, fertility treatments such as in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) may be recommended. In these procedures, sperm is either mixed with an egg or injected directly into the egg for fertilisation to occur.
In rare cases where no sperm is present in the semen (a condition called azoospermia), sperm may sometimes be retrieved surgically from the testes. Even in challenging scenarios, options such as sperm donation or adoption can provide alternative paths to parenthood.
If you and your partner have been trying to conceive for a year or more without success, it’s a good idea to consult a doctor. For men, symptoms like reduced sexual function, pain or swelling in the testicular area, or a history of health conditions related to fertility e.g surgery on the testicles as a child may warrant earlier evaluation.
Male infertility is more common than many realise, and seeking medical advice is the first step towards finding a solution.
If you are struggling with fertility and would like to book a consultation with Dr Agbaje, visit his Top Doctors profile today.
