Can't get pregnant? Guys, get yourself checked too

There are a number of causes of male infertility, which need to be properly investigated and diagnosed before they can be treated. — Positive Parenting

It is estimated that half of infertility cases worldwide are due to male infertility.

For women, the quantity of eggs in their ovaries is determined at birth and will naturally decline as they age.

For men, their testicles are capable of producing millions of new sperm every day, but this process depends on making and delivering normal sperm.

Male infertility can occur if the testicles fail to produce healthy and motile sperm.

Aside from being well-formed and undamaged, the sperm’s ability to “swim” or move through the female reproductive system to reach the woman’s egg (i.e. motility) is critical for fertilisation.

The main causes of male infertility are:

> Sperm disorders

Typically caused by chromosomal abnormalities that lead to low sperm count, poor sperm motility and abnormal sperm.

> Retrograde ejaculation

Also called a “dry orgasm”, it refers to a situation where semen is released into the bladder during orgasm, thus resulting in little to no semen being ejaculated.

> Immunologic infertility

Occurs when the man’s immune system targets his own sperm, resulting in a decline in sperm production, as well as impaired sperm motility.

> Obstruction of sperm passages

Obstructions may occur in the epididymis (the tubes connected to the testicles where the sperm mature and are stored), vas deferens (the tube that connects the epididymis to the urethra through the ejaculatory duct) or the ejaculatory duct (comprised of the vas deferens and seminal vesicle ducts; allows the sperm to enter into the urethra).

> Varicoceles

This condition refers to enlarged veins in the scrotum.

It can cause low sperm count due to poor blood flow to the testicles.

> Hormonal issues

Certain hormones such as follicle-stimulating hormone (FSH), luteinising hormone (LH) and testosterone can affect sperm production and motility.

> Certain medications

Testosterone replacement therapy, long-term use of anabolic steroids, chemotherapy, and even some ulcer and arthritis medications, have been known to lead to male infertility.

Other possible factors include stress, obesity, erectile dysfunction (ED) and decreased libido.

Environmental factors can also contribute to male infertility, e.g. exposure to excessive heat due occupational hazards (such as in the case of welders or firefighters), lifestyle habits (such as excessive use of saunas or hot tubs), and even frequently wearing tight clothing.

Dealing with the problem

In order to cope with male infertility, you must first take the initiative to get a proper diagnosis.

This will involve consulting a doctor who will do the necessary physical examination.

You will also need to provide a semen sample for analysis, as this will reveal crucial information such as the sperm volume, count, concentration, movement and structure.

Blood samples may be taken to provide further information on your hormone levels as well.

You may also be required to undergo further tests that involve procedures such as ultrasound or a biopsy.

The treatment will be dependent upon the results of these tests.

But be reassured that many problems can be managed with changes to your lifestyle, medication and/or surgery.

If this still fails to result in natural conception, you may then opt for assisted reproductive techniques such as intrauterine insemination (IUI), in vitro fertilisation (IVF) and/or ICSI (intracytoplasmic sperm injection).

However, if your tests show that you have no viable sperm, then your only other option would be to consider the use of donor sperm.

It’s important to note that male infertility is not always permanent or untreatable.

The crux of the problem lies in acceptance of the fact that the male partner is the cause (or contributing factor) of fertility issues.

Remember, having a baby requires effort from both partners, thus it is crucial for both to take equal responsibility, not just for bringing up a child, but also for conceiving one.

Dr H Krishna Kumar is a consultant obstetrician and gynaecologist, and Past President of the Obstetrical and Gynaecological Society of Malaysia. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.