MALE CONCEPTION PROBLEMS
BLOCKED TUBES
Your partner's sperm must make its way from his testes through a whole series of
tubes, large and small, before being ejaculated during sex. In a small proportion
of cases of male infertility, blockages or absences of these tubes are the cause
of infertility. The blockages may be present at birth, or they can be the result
of a sexually transmitted infection or a previous vasectomy. Either way, they will
result in low numbers of sperm (oligospermia) or no sperm at all (azoospermia) in
the semen. If a testicular biopsy reveals this problem, a couple may have to consider
artificial insemination or in vitro fertilisation (IVF).
LOW SPERM COUNT
While tube blockages account for some cases of low sperm count, there can be other
causes: exposure to toxins, chronic disease or considerable heating of the testes
are just a few. Low sperm count doesn't necessarily mean infertility - it may just
mean that it takes longer than average to conceive. However, when there are fewer
sperm they are more likely to be abnormal and have poor motility.
ABNORMAL SPERM
A healthy sperm has a long, whipping tail that helps it swim through the female
reproductive system. Sperm with poor motility may swim poorly or not move at all.
Abnormally shaped sperm may also have problems penetrating the surface of the egg.
Analysis of the semen is necessary when checking for any abnormalities.
TESTICULAR PROBLEMS
If your partner's testes are small, enlarged or completely absent, it may contribute
to his infertility. While it's very rare for testes to be totally absent, sometimes
they fail to descend; small testes may be a result of a past illness, an injury
or earlier developmental problems. Enlargement of the testes can cause problems
as this condition raises the testicular temperature, which in turn inhibits sperm
production - this can be a symptom of testicular cancer, which is the cause of infertility
in about one in 400 men. If a testicle is enlarged, has an irregular surface or
feels painful, see a GP immediately.
HORMONAL PROBLEMS
Healthy sperm creation relies on the pituitary gland producing testes-stimulating
hormones and follicle-stimulating hormones. If your partner's pituitary gland isn't
releasing enough of these hormones, the production of his sperm will be impaired.
Underactive or overactive functioning of the thyroid and adrenal glands can have
a negative impact on sperm, too. To rule this out as a contributing factor in your
infertility, your partner would need to have blood tests to assess his hormone levels.
If this is thought to be part of the problem, there's effective treatment. But remember
that taking hormone preparations, including testosterone, will hinder fertility
rather than help it.
DEFECTIVE GENETIC MATERIAL
Research has shown that men who have fertility problems have a high number of sperm
with broken or damaged DNA, the molecular chain that makes up a gene. This kind
of DNA damage will make it harder for you to conceive a baby with him.
Making lifestyle changes, such as an improvement in diet and a reduction of exposure
to toxins, can help improve DNA quality. Another treatment is taking Menevit, a
vitamin supplement that's been shown to improve the DNA quality of a man's sperm,
which was created by Dr Kelton Tremellen, deputy medical director at IVF clinic
Repromed.
FUNCTIONAL PROBLEMS
The most significant functional problem that can cause or contribute to male infertility
is impotence, the inability to get or maintain an erection. Some men may even have
difficulty with erections under the pressure of trying to make a baby. There are
many treatments for impotence - some good, some outright dodgy - so it's best for
the man to shelve the embarrassment and speak with his GP if this is a problem.
IMMUNE REACTION
Sometimes the immune system can produce antibodies that attack his sperm as if it
were foreign. The antibodies may hinder the activity of sperm, therefore reducing
the sperm's ability to latch onto the egg. This problem is usually due to an injury
or infection and can be detected by the presence of white blood cells in his semen.
OTHER CAUSES
There are many other conditions, including genetic diseases or chromosomal abnormalities,
that could cause male infertility. Speaking to your doctor is the first step in
finding out why you're having trouble - but bear in mind that you may be part of
the one in 10 couples that have idiopathic infertility, where it's not possible
to find a cause for the infertility. But even without a known cause, you can get
reproductive help.