Healthy male fertility depends on a high count of good quality sperm, delivered effectively through the male reproductive tract. To fertilise an egg, sperm need the ability to swim through the female reproductive tract and break through the egg’s outer layers, fusing its DNA material with that of the egg.
Problems with sperm production or sperm delivery will interfere with conception, leading to what we call male factor infertility. You may find this causes stress in your relationship or a sense of shame. But with the right guidance, a diagnosis of male infertility doesn’t necessarily need to stop you from having children.
Common causes of infertility in men include:
Hormones are often discussed in the context of female fertility, but are integral to your fertility, too. An imbalance in your levels of follicle stimulating hormone, testosterone, luteinising hormone, and prolactin can upset sperm production. Such disruption to your reproductive hormones may be due to taking testosterone supplements, certain systemic conditions, brain tumours, or congenital syndromes.
Two of the main parameters of sperm we consider are motility (swimming ability) and morphology (shape and size). The concentration of sperm in your semen with each ejaculation is also important in determining the chances of fertilisation, as is the number of live sperm (sperm viability). Abnormal sperm may be caused by genetics or hereditary conditions, certain medications, exposure to environmental toxins, lifestyle factors, and testicular conditions including infection, trauma, or varicoceles.
Sperm is produced in the testicles and matured in the epididymis tubes before proceeding through a series of other channels until being released from your body through ejaculation of semen. A blockage or distortion of any of these tubes can prevent sperm from being added to your semen. Sperm obstruction may be caused by injury or infection and scarring to the epididymis or vas deferens, as well as congenital defects.
At Flow Fertility, we take a comprehensive approach to male fertility testing. Dr Sacks will review your medical history, including looking for evidence of an endocrine disorder, genetic condition, or medications that may be interfering with your fertility. This will guide his investigations, which may include:
From here, he can provide you with a personalised treatment plan. This may involve treating the underlying cause of your fertility problems with surgery or medications, or recommending assisted reproduction, such as IVF or IUI.
Though many causes of male infertility may be out of your control and require management with a fertility specialist, there are some lifestyle changes you can make to improve your natural fertility and preconception health.
Tobacco smoke is known to have significant detrimental effects to male fertility. By quitting smoking, you can lower your risk of tobacco-related reduced sperm motility, morphology, and viability. Men who smoke are also more likely to have lower sperm production overall, hormonal dysfunction, and lower semen volume with each ejaculation.
Consider your exposure to toxins in your workplace or around your home, such as pesticides, herbicides, and heavy metals. Radiation is also known to have an impact on male fertility, as are industrial chemicals such as polychlorinated biphenyls and flame retardants. Removing or avoiding these toxins where possible can help improve your sperm quality and reduce the risk of sperm DNA damage.
Illicit drugs such as marijuana and cocaine are not the only substances that can impact your sperm health. Testosterone replacement therapy, anabolic steroids, certain antidepressants, and even blood pressure medications can interfere with sperm production. Chemotherapy is also well-known to affect male fertility; in men with cancer, we recommend considering fertility preservation prior to starting therapy. Before reducing or ceasing any of your prescribed medications, speak to your doctor about whether it is safe to do so.
