Male Fertility

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• Male Fertility

Medically Reviewed April 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What is Male Fertility?

Male fertility is a man’s ability to conceive a biological child. Infertility occurs when a couple cannot conceive, despite having regular unprotected sexual intercourse.

In order to conceive, a man needs to be able to achieve and maintain an erection and have enough sperm the right shape and moving the right way, along with enough semen to get the sperm to the egg for fertilisation. Problems with sperm production, low sperm quality and low sperm motility can result in difficulty conceiving.

Sometimes simple lifestyle changes, such as improving diet, quitting smoking or losing weight if you are obese, can help to resolve male fertility problems. But sometimes there may be other issues, such as ejaculation problems, a hormonal balance or a structural problem in the male reproductive system, which will require further treatment.

Just like female fertility, male fertility can be affected by age. Sperm motility tends to drop after the age of 55. However age is less of a factor in male fertility than in women.

What causes Male Fertility problems?

There are a number of things which can potentially cause male fertility problems:

The Cost of Male Fertility

What can I do to enhance my fertility?

There are several lifestyle factors that may affect your chances of conceiving, and these should be addressed at an early stage. In order to enhance male fertility, we recommend the following:

• Lose weight if obese or overweight: Studies have shown that the higher a man’s body mass index (BMI), the more likely he is to have a low sperm count. Being obese can also lead to hormonal imbalances which can affect a couple’s chances of conception. By losing weight with a combination of exercise and a healthy, calorie-controlled diet, you will improve your chances of conceiving.
• Cool down the scrotum: Overheated testicles can affect sperm quality and production, so it’s important that you take steps to address this. Avoid saunas, using your laptop on your lap and working in hot conditions if you can help it. Swapping tight underwear for loose-fitting underwear may help to lower the temperature of your scrotum.
• Avoid toxins: Lengthy exposure to certain chemicals, heavy metals and radiation should be avoided in order to preserve male fertility.
• Quit smoking: The chemicals in cigarette smoke can contribute to reduced fertility. Quitting smoking will also be beneficial for your overall health.
• Cut alcohol consumption: Drinking excessive amounts of alcohol can affect testosterone levels and sperm production.
• Stop using illegal drugs: Illegal drugs, such as cannabis and cocaine, can harm male fertility, so by stopping using them, this will help to boost your chances of conceiving naturally.
• Keep stress levels in check: Trying to conceive can be stressful. But it is important that you do your best to keep stress levels in check. While the link between fertility and stress is still a matter of debate, stress can push you towards unhealthy habits and behaviours which may make it harder to conceive, for example smoking, binge drinking and not eating healthily. Stress can also cause a loss of libido.
• Eat a healthy diet: A healthy diet is important for overall health, but particularly when trying to conceive. You should also aim to up your levels of selenium and zinc. Selenium is needed for normal sperm production and development and can be found in fish, meat, poultry, eggs and Brazil nuts. Low levels of zinc have been linked to a low sperm count, but eating meat, dairy products, wholegrain cereals and nuts can help with this.  Avoid trans fats, such as margarine and vegetable oils, which are commonly found in processed snack foods, frozen dinners and fast food as they have been shown to affect fertility.

What treatment is available to help improve Male Fertility?

There are several treatments available to help improve male fertility. The appropriate treatment depends on the diagnosis.

• Medication:  Low testosterone levels can be treated with gonadotrophin injections which will enhance sperm production. Men diagnosed with retrograde ejaculation can take medicine to close the opening to the bladder.
• Surgery: Surgery can help to treat a number of male fertility issues, including removing blockages from the tubes that take sperm from the testicles to the penis, correcting swollen veins in the scrotum and reversing a vasectomy. If no sperm are present in the ejaculate, surgery can retrieve sperm directly from the testicles.
• Assisted conception: If lifestyle changes, medication and/or surgery has not worked, or if the issue cannot be treated, then you may need to undergo assisted conception. This may include intrauterine insemination (IUI), also known as artificial insemination, or in vitro fertilisation (IVF) where an egg is taken from the body, fertilised and placed back in the uterus.

Where male infertility is a factor, a process called intracytoplasmic sperm injection (ICSI) may be used in IVF. This involves taking an individual sperm and injecting it straight into the egg. It is commonly used in cases of low sperm motility.

Sometimes assisted conception may include using a donor egg, donor sperm or donor embryo.

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