Understanding Male Infertility and Treatment

Please take heart that experiencing male infertility doesn’t mean there aren’t options for you to conceive. Some of the male infertility treatment options available to you may include lifestyle changes, surgery, IVF, ICSI, or even donor sperm. We receive lots of questions about male factor infertility, so in this blog post, we’ll answer some of the common questions we hear about male infertility and share information about male infertility treatment options.

How Common is Male Infertility?

Male fertility problems are common, affecting about 1 in 20 men. We know that 30% of fertility issues are due to female fertility issues, 30% are due to male factor infertility, 30% are due to a combination of female and male factor infertility, and 10% are due to unexplained fertility, where a cause for infertility cannot be found. As people are increasingly choosing to postpone parenthood into their mid-late 30s and 40s, women often experience infertility due to their age. Female fertility naturally begins to decline at 30 years of age, with a sharp decline after 35 years of age. In comparison, male fertility declines much more gradually than female fertility. The odds of being infertile for men do increase with age. Men older than 40 years of age are more likely to experience male infertility but many remain fertile into older age.

How Does Age Affect Male Fertility?

In men, increasing age is associated with a number of changes in their reproductive system. Some of these changes include:

• Erectile dysfunction and reduced ejaculatory volume
• In those with chronic health problems, a decrease in testosterone levels and libido
• Reduced ejaculatory volume
• A decline in sperm motility
• Increase in sperm with DNA damage
• Increased chance of sperm carrying genetic problems
• Reduced frequency of sexual intercourse

If you’re planning on postponing parenthood, you might want to consider sperm freezing as an option for fertility preservation. You can learn more about sperm freezing here.

What are the Causes of Male Infertility?

Male infertility can be caused by any number of factors, including genetic abnormalities, hormone problems, or damage to the testes. As a result, there is a failure to produce enough sperm. Some problems develop before puberty and others in adulthood.

Several factors can contribute to male infertility, including medical issues (including heritable and non-heritable diseases), lifestyle and environmental exposures.

What are the Issues that Cause Infertility in Males?

Some of the common medical issues that are causes of male infertility include:

Medical Causes for Male Fertility Issues

• Endocrine disorders - these are conditions that disrupt normal hormone production needed to stimulate sperm production.
• Genetic abnormalities - conditions that cause changes to the genes or chromosomes; e.g. Klinefelter syndrome, Y chromosome microdeletions.
• Sexual dysfunction - difficulties with sexual response, desire, arousal, or orgasm; e.g. erectile dysfunction.
• Malignancies – either testicular cancers leading to damage or removal or the effects of treatment for other cancers.
• Injury - circumstances, where testicles are injured, can impact future sperm production and testicular function; e.g. testicular torsion, and trauma.

Sexually transmitted infections e.g. Gonorrhea, Chlamydia, Ureaplasma urealyticum,Trichomonas vaginalis, Human Immunodeficiency Virus (HIV) Idiopathic - unexplained infertility.

How Can Environmental Exposure Cause Male Infertility?

Numerous chemicals and toxins have been suggested to contribute to male infertility, some acting to disrupt the hormonal balance that drives sperm production.

This wide range of chemicals and toxins include various pesticides, insecticides, fungicides, metals, additives, and contaminants commonly found in food and personal care products. Smoking definitely damages sperm and excessive alcohol consumption can also contribute to male infertility.

What Lifestyle Changes Can Help Male Infertility?

There are things you can do today that can have a positive impact on your reproductive health. There is strong evidence for some of these strategies (e.g. quitting smoking) while for others the evidence is weaker but the ‘precautionary principle’ would be to take action ‘just in case’. And positive lifestyle changes add up ... so doing many as possible is ‘the way to go’.

• Quit smoking: Cigarette smoke contains hundreds of hazardous chemical compounds, including carcinogens and heavy metals. Smoking is associated with a decline in sperm count and motility, and abnormal morphology. Quitting smoking has positive impacts on male fertility.
• Cease recreational drug use and excess alcohol: It can be suggested that recreational drug use and alcohol consumption are negatively correlated with semen quality and volume and impair the production of male reproductive hormones.
• Have a healthy diet: A healthy, balanced diet can improve semen quality, while a poor diet and obesity are correlated with low sperm concentration, count, and motility.
• Exercise: Frequent, intensive exercise can result in testicular heat stress; a significant risk factor for male infertility.
• Minimise stress: The hormones produced in response to psychological stress impact testosterone levels and suppress sperm production.
• Keep your phone out of your pockets: When mobile phones are frequently carried in pants pockets, the testicles may be exposed to chronic levels of low-level radio-frequency electromagnetic fields (RF-EMF), which could be associated with the production of low-quality semen.

What are the Symptoms of Male Infertility?

In many cases, male infertility has no symptoms other than the inability to conceive. However, some people with established testicular or other male reproductive problems may experience the following symptoms:

• Low testosterone (e.g. tiredness, low mood or sex drive, poor muscle strength)
• Sexual dysfunction (e.g. erectile dysfunction or difficulty with ejaculation)
• Testicle pain, swelling, or lumps
• Changes in facial or body hair growth

Men with fertility concerns, or bothered by such symptoms require a holistic review of their health This often begins with the GP and then further investigation by a fertility specialist in male reproductive health. If you’re experiencing difficulties conceiving, it is recommended that you see a fertility specialist.

What Are Male Infertility Treatments?

Monash IVF offers a range of male infertility treatments. For advice about what male infertility treatment options are available to you, book an appointment with a Monash IVF Fertility Specialist.

Male infertility treatment options include:

Sperm Freezing

Sperm cryopreservation, more commonly known as sperm freezing, is used to preserve male fertility. This treatment is recommended for individuals who are about to undergo treatments that may compromise their fertility, such as chemotherapy, radiation therapy, vasectomy, or gender affirmation surgery. It is also recommended for people that are planning on postponing parenthood.

ICSI

Intracytoplasmic sperm injection (ICSI) is a specialized in vitro fertilisation (IVF) technique that involves the injection of a single sperm into an egg. This treatment is suitable for individuals with abnormalities in sperm morphology, motility, and sperm count. ICSI was designed to treat male factor infertility.

IUI

Intrauterine insemination (IUI) involves the injection of washed sperm (healthy sperm that have been separated from mucus and non-motile sperm in the semen) directly into the uterus via a catheter. This technique allows the sperm to bypass the cervix, which can be difficult to penetrate if the sperm have low motility. IUI is only a male infertility treatment option for people that have a good sperm count and sperm quality but have low sperm motility.

Donor Sperm

Some men don’t produce sperm, which means that in order to conceive they will need to use donor sperm. Donated sperm (from a healthy friend/relative or anonymous donor) can be used in combination with ICSI or IUI.

Going Beyond Treatment

Monash IVF recognises the psychological impact of fertility difficulties. Individuals may experience heightened levels of stress, depression, guilt, and anxiety - which can in turn affect sexual desire and function. We offer psychological support for individuals and couples, which may assist you on your reproductive journey. If you’re experiencing male factor infertility, you’re not alone. There are experts that can help you. You can find a Monash IVF Fertility Specialist closest to you here.

The Importance of Initial Investigations

The key to successful conception starts with developing a treatment plan that is tailored to you. At Monash IVF, you’ll begin your reproductive journey with an initial fertility assessment, carried out by one of our experienced fertility specialists. Once we have an overview of your medical history and, if applicable, your partner’s medical history, we will undertake a semen analysis to assess your fertility and identify any abnormalities. Using this information, your fertility specialist will then design a tailored treatment plan to give you the best chance of conception.

Book in a Consult with Monash IVF

Monash IVF has been providing leading fertility services for 50+ years. We have clinics across Australia and have helped bring more than 50,000 babies into the world. Find your nearest Monash IVF clinic here, or book a complimentary nurse chat to discuss your questions, concerns, and treatment options with a fertility expert.