When it comes to fertility, the media can often be dominated with information about the issues women encounter when they are trying to conceive however, in many circumstances men may also experience problems with their fertility. In fact, the latest research shows that 35-40 per cent of the fertility complications couples experience when trying for a baby, are because of male infertility problems.
Unfortunately, male infertility can be a taboo topic across much of the UK, and as a result, many men remain uninformed about the potential fertility problems they may come up against when they want to start a family. This also leaves many unsure about the best course of action if they do experience a problem.
The IVI Group is a European leader in assisted reproduction and to date has helped over 100,000 children to be born all across the globe. With 40 clinics, in 10 different countries, IVI are pioneers within the fertility industry and are at the forefront of medical development and advancement within the field. IVI Fertility provides help and support for men, women, and couples attending the clinic together.
Here, to separate the fact from the fiction on the subject of male fertility, is Dr Castillón from IVI Barcelona.
- Male infertility is complex– FACT
Dr Castillón says: 90 per cent of male infertility cases are due to low sperm count or poor sperm quality, which can be caused by a number of reasons. These can include varicocele, an abnormal collection of bulging veins above the testicle, an undescended testicle, infections, genetic abnormalities and hormone problems.
However, male infertility is complex and there are a number of other causes which encompass the genetic, the hormonal or the environmental. Slow sperm motility, which makes it harder for sperm to swim to the egg, and abnormal morphology, in which the abnormal shape and size of sperm makes it harder for the sperm to move and fertilise the egg, are two further common causes.
In addition, damage to the testes (which is where sperm is produced) can also have an impact on fertility. This damage can occur in many ways, with a congenital defect causing damage from birth, or trauma and infection causing damage later down the line. Some men suffer from a complete absence of sperm in their semen, known as obstructive azoospermia, which can be due to a blockage in one of the tiny tubes within their reproductive system. Other men suffer from hypogonadism, an abnormally low level of testosterone, which again can lead to problems with male infertility, as can ejaculatory disorders.
- Male infertility is untreatable – MYTH
Dr Castillón says: One in eight infertile men has a treatable condition, and after treatment, couples can become pregnant naturally. These treatable conditions included undertaking surgery to block off the abnormal veins within varicoceles, surgically correcting obstructions in sperm transport, and treating hormonal abnormalities with medicine. After this treatment, if couples fail to conceive naturally, the doctor can recommend that the couple seek assisted reproductive technologies (ART), such as IVF (in vitro fertilisation). ART do not cure or treat the cause of infertility but they can help couples achieve a pregnancy, even if the man’s sperm count is very low.
Intracytoplasmic sperm injection (ICSI) is a form of IVF where a single sperm is placed directly into each egg, which is particularly beneficial for men with poor sperm production. Sperm are collected from the semen or removed carefully from the testis or epididymis.
- Only women need to worry about reduced fertility as they get older – MYTH
Dr Castillón says: A women’s age is the single most important factor in conception, but a man’s age also matters, an issue which many people are not always aware of. The quality of a man’s sperm decreases with age and it therefore takes longer for his partner to get pregnant. There’s also an increased risk of not conceiving at all.
In addition, the risk of miscarriage is twice as high if the father is over 45, which is completely independent to the age of the mother. The children of older fathers are also at greater risk of autism, mental health problems and learning difficulties. For couples who are undoing assisted reproduction, the risk of not having a baby is still more than five times higher if the male partner is aged 41 or older.
- High temperatures can kill male sperm – FACT
Dr Castillón says: For sperm to be produced healthily, they require a very precise environment — 4 degrees cooler than body temperature. Therefore, if sperm are exposed to elevated temperatures, they begin to die. If this heat exposure is prolonged, it can affect the sperm production processes. Over an extended period, the body can produce fewer sperm, often abnormally shaped. Exposure to heat can come in the form of hot tub or saunas, resting a laptop on your lap, or working in warmer environments. Therefore, it is important to consider the prolonged impact of heat on male infertility. Avoid resting computers on your lap, don’t spend too long in the sauna and keep hydrated.
- How your underwear fits doesn’t matter – MYTH
Dr Castillón says: There is often a lot of speculation about tight underwear leading to male infertility problems. Although there is no concrete evidence, tight briefs can lead to the testes overheating. As mentioned previously, if the testes are too hot – several degrees above where they should be – they are not able to produce sufficient sperm, resulting in low sperm count. Therefore, men who wear loose boxer shorts are often to found to have higher-quality sperm.
- Stress can play a part in infertility – FACT
Dr Castillón says: There is a lot of speculation surrounding stress and infertility, predominantly because stress is an extremely difficult factor to measure. In fact, the whole issue of struggling to conceive can itself be stressful, and therefore, can often be a contributory factor. Stress can affect sperm count by lowering levels of a hormone called gonadotrophin-releasing hormone (GnRH), which is needed for sperm production. Therefore, although there is no solid evidence that stress can cause male infertility problems, it can be helpful to try some relaxation techniques, such as yoga, to feel less stressed when trying for a baby.
- Unhealthy habits play a part in your fertility – FACT
Dr Castillón says: For general health reasons, it is advised that alcohol is drunk in moderation, and cigarettes are completely avoided, but it is also vital when discussing fertility. Alcohol can damage the quality, structure and movement of sperm by preventing the liver from properly metabolising vitamin A, which is required for sperm development. In addition, alcohol is toxic to the testes and it is proven that if a man consumes more than 20 units per week, it will take his partner longer to conceive. Smoking can also have a huge impact when trying to conceive. Heavy smokers can produce up to 20 per cent fewer sperm than non-smokers, with the DNA in the sperm also being damaged by the chemicals in cigarette smoke.
- Exercise improves fertility – MYTH
Dr Castillón says: Although exercising is extremely beneficial to both mental and physical wellbeing, it is important not to overdo it when trying to conceive. Men who have heavy exercise schedules, as opposed to men who exercise 3 times a week, can have lower quality sperm. If men exercise too much, with little rest, this can have a direct impact on sperm count, morphology and motility. Excessive exercise can lower a man’s testosterone levels and cellular damage can occur as a result of oxidative stress. Therefore, as well as considering the impact exercise has on infertility, men should also consider the impact of diet on infertility. Foods that are rich in antioxidants, such as tomatoes, blueberries, and pomegranates can provide an added boost when trying for a baby.