Male infertility is more common than most people realise. It contributes to approximately 40–50% of all infertility cases, yet it often goes undiagnosed because the focus tends to be on the female partner. Understanding the causes and available treatments is essential for couples seeking to start a family.
Common Causes
- Low sperm count (Oligospermia): Fewer than 15 million sperm per millilitre of semen.
- Poor sperm motility (Asthenospermia): Sperm that cannot swim effectively toward the egg.
- Abnormal sperm morphology (Teratospermia): High percentage of abnormally shaped sperm.
- Varicocele: Enlarged veins in the scrotum that raise testicular temperature and impair sperm production.
- Hormonal imbalances: Low testosterone or elevated prolactin levels.
- Obstructive azoospermia: Blockages preventing sperm from reaching the ejaculate.
- Non-obstructive azoospermia: The testes fail to produce adequate sperm.
- Genetic factors: Conditions like Klinefelter syndrome or Y-chromosome microdeletions.
- Lifestyle factors: Smoking, excessive alcohol, obesity, and exposure to environmental toxins.
Diagnosis
The evaluation of male infertility typically begins with a detailed medical history and a semen analysis. If the semen analysis is abnormal, further testing may include hormonal blood tests (FSH, LH, testosterone, prolactin), scrotal ultrasound, genetic testing (karyotype and Y-chromosome microdeletion analysis), and in some cases, a testicular biopsy.
Treatment Options
- Lifestyle modifications: Weight loss, quitting smoking, reducing alcohol, and improving diet can improve sperm parameters in many men.
- Medications: Hormonal therapy to correct imbalances or antioxidant supplements to reduce oxidative damage.
- Varicocele repair: Surgical correction of varicocele can improve sperm count and quality.
- IUI (Intrauterine Insemination): Suitable for mild male factor infertility with adequate sperm counts.
- IVF with ICSI: Intracytoplasmic sperm injection is the gold standard for moderate to severe male infertility, requiring only a single viable sperm per egg.
- Surgical sperm retrieval (TESA/TESE/Micro-TESE): For men with azoospermia, sperm can be surgically retrieved directly from the testes for use in IVF-ICSI.
Male infertility is treatable in the vast majority of cases. If you have been trying to conceive for over a year without success, both partners should be evaluated. Early diagnosis and appropriate treatment can significantly improve your chances of becoming a parent.