Male Fertility Factors

Problems with sperm production

The most common causes of male infertility are called:

  • Azoospermia, no sperm cells are produced
  • Oligospermia, where few sperm cells are produced
  • Teratospermia, where a high proportion of sperm is abnormally shaped
  • Blocked or absent vas deferens:
    • Vas deferens is the tube that transports the sperm from the testes
  • Genetic condition such as cystic fibrosis or chromosomal abnormality
  • High sperm DNA fragmentation that can affect a sperms ability to fertilise an egg
  • Sperm antibodies that can interfere with sperm motility and fertilisation

It’s usually a good sign if you have ever conceived a baby with any partner in the past, but this may not mean that your sperm is compatible with your current partner.

What affects sperm quality?
  • Health & lifestyle factors such as smoking, excessive drinking, drugs including steroids and recreational use, and weight and Body Mass Index
  • Past medical conditions such as an undescended testes, hernia, STD or severe trauma.
  • Acute viral illness can also temporarily affect sperm health.

There is no scientific evidence that wearing tight clothes or bike shorts affects the quality of your sperm. Diet, vitamins and supplements actually have very little impact on your sperm count - but they do help you stay healthy.

Sports injuries to the groin will only have an impact on sperm production in extremely severe cases.

While the effect of age on a man's fertility is not as significant as it is with women, there is a decline in the quality of sperm after the age of 45. After this age, sperm volume, motility and morphology declines and damage to sperm DNA increases.

Other causes of male infertility

Retrograde ejaculation

Retrograde ejaculation is a condition in which some or all semen flows backwards into the bladder rather than out through the urethra during ejaculation. Symptoms include producing little or no semen during ejaculation and can be diagnosed with a urine sample and semen analysis. If you are trying to conceive, retrograde ejaculation can be treated using assisted reproductive technology such as intrauterine insemination, IVF or ICSI procedures. Sperm can be collected from the urine or surgically retrieved from the testis. A fertility specialist can explain your options and help you choose the best path for you.

Immunological infertility

Male immunological infertility occurs when a man develops antibodies against his own sperm. These anti-sperm antibodies attach to the sperm affecting the way they move and their ability to penetrate a woman’s cervical mucus and fertilise the egg. The presence of anti-sperm antibodies is commonly the result of vasectomy, injury or injection but it does not mean a man won’t be able to conceive a child. Intracytoplasmic Sperm Injection (ICSI) can be used to help achieve a pregnancy.

Hyperprolactinemia

Hyperprolactinemia refers to elevated levels of the prolactin hormone in the blood stream. In men this can cause infertility by affecting the function of the testicles, decreased testosterone levels, decreased sex drive and abnormal sperm production. If hyperprolactinemia is affecting your fertility there are treatments available and your fertility specialist will guide you on the one most appropriate for you.

Occlusion

Occulsion refers to a blockage in a man’s reproductive system, often in the epididymis or vas deferens, which prevents sperm reaching the urethra. Occlusions in men could be a result of injury, vasectomy or a congenital condition. It can be treated using a Vasovasectomy which is a surgical procedure which reconnects the ends of the vas deferens together or a testicular biopsy to surgically retrieve sperm from the testis for use in IVF or ICSI treatment.

Male fertility tests

A semen analysis is the most important test male fertility test. 

If a male has had repeated abnormal semen analysis a specialist may suggest a sperm DNA fragmentation test.

Read more about semen analysis > 

Treatment for male infertility

There are not many treatments that will improve the quality of the sperm themselves. However there are a number of treatments available to help a couple make the best of sperm quality as it is, and achieve a pregnancy include:

  • Lifestyle changes
  • Simple drug treatments such as Gonadotrophin to improve sperm numbers
  • Intrauterine insemination if sperm abnormalities are not too severe
  • In-vitro fertilisation with Intra-cytoplasmic Sperm Injection (ICSI) for severe sperm abnormalities which involves injecting a single sperm into each egg to achieve fertilisation
  • Micro-epididymal sperm aspiration or (MESA) to surgically retrieve sperm from the epididymis if there are no sperm in the ejaculate or from the testes themselves with Testicular Sperm Aspiration (TESA)
  • Digital high magnification for high level of DNA fragmentation to view and select the healthiest sperm
  • Donor insemination in the most severe cases

Causes of Male Infertility

What’s next?

If you want to know more about your sperm quality call 1800 111 483 or email us to book an appointment with a fertility specialist. Appointments are available within the next couple of weeks and will cost approximately $150 for a couple after the Medicare rebate.

Find an IVFAustralia andrologist or male reproductive disorder specialist...
Find out more about male infertility tests...
Find out more about ICSI...