Sometimes getting pregnant is a challenge. Infertility in men is more common that you think. Contrary to popular belief, men face an equal likelihood of experiencing infertility as women do. According to Meggan Zunckel from the Infertility Association of South Africa (2015), one in six couples in South Africa struggle with fertility. Written by BabyYumYum.
Male infertility is a condition that affects millions of men worldwide and is responsible for about 30-40% of all infertility cases. According to John Hopkins Medicine, male infertility means a man is not able to start a pregnancy with his female partner. Infertility can stem from various factors, including hormonal imbalances, physical blockages, lifestyle choices, and genetic conditions. Understanding these underlying causes is crucial for developing effective treatment strategies.
Statistics from Leon Swartz (2003) and IndexMundi (2017) prove that infertility in men is a growing trend, with the total number of children born per South African woman decreasing from 6/7 in the baby boomer era to 2.47 in 2000 and 2.29 in 2017. What can you do if you experience infertility? Here’s a summary of some of the most common male fertility concerns in SA and the treatment options available.
Infertility in men
According to the Infertility Awareness Association of South Africa , men have an equal chance of suffering from infertility as women do, the most common issues being low sperm count and poor sperm health. Dalene Barton-Schuster of Natural Fertility Info (2014) says that a sperm count of 20 million+ per millilitre is healthy. Poor sperm health, she explains, relates to sperm motility (movement/tail whip) and morphology (form / DNA). It can result from:
- Genetics
- Cancer and chemotherapy
- Damage to the reproductive organs
- Anti-sperm antibodies, where sperm is attacked by the immune system
- Poor lifestyle habits, like smoking, alcohol consumption, poor diet, and stress
- Environmental factors like pollution
Common causes of male infertility
Blocked Vas Deferens
Tim Taylor at innerbody.com (2018) says the Vas Deferens is “a tiny muscular tube in the male reproductive system that carries sperm … to the ejaculatory duct”. Barton-Schuster (2014) elaborates that a blockage of this tube can result from a sexually transmitted disease (STD), or varicocele (varicose veins in the testes). The latter can be treated with surgery.
Hormonal imbalances
Hormonal imbalances can significantly impact sperm production and quality. The primary hormones involved in male fertility are testosterone, luteinising hormone (LH), and follicle-stimulating hormone (FSH). Conditions such as hypogonadism, where the body produces insufficient testosterone, can lead to reduced sperm count and motility. Dr. Paul Turek, a renowned expert in male reproductive health, explains, “Hormonal issues can disrupt the delicate balance needed for optimal sperm production, leading to infertility.”
Varicocele
Varicocele is a condition characterised by the enlargement of the veins within the scrotum, similar to varicose veins in the legs. This enlargement can lead to increased scrotal temperature, which adversely affects sperm production and function. Varicoceles are found in approximately 15% of all men and 40% of infertile men. Surgical repair of varicoceles has been shown to improve sperm parameters and fertility outcomes in many cases.
Genetic factors
Genetic abnormalities can play a significant role in male infertility. Conditions such as Klinefelter syndrome, Y chromosome microdeletions, and cystic fibrosis can lead to azoospermia (complete absence of sperm) or oligospermia (low sperm count). Genetic testing can identify these issues, allowing for targeted treatments and counselling for affected individuals.
Lifestyle factors
Lifestyle choices can have a profound impact on male fertility. Factors such as smoking, excessive alcohol consumption, drug use, and obesity can negatively affect sperm quality and quantity. Additionally, exposure to environmental toxins, such as pesticides and heavy metals, can impair reproductive health. Making positive lifestyle changes, such as maintaining a healthy diet, exercising regularly, and avoiding harmful substances, can improve fertility outcomes.
ALSO READ: The common issues of infertility in women and how to treat them
Diagnosing male infertility
Diagnosing male infertility typically involves a comprehensive evaluation, including medical history, physical examination, and specific diagnostic tests.
Medical history and physical examination
A detailed medical history and physical examination can provide crucial insights into potential causes of infertility. Doctors will inquire about sexual habits, lifestyle factors, previous medical conditions, and any medications taken.
Semen analysis
A semen analysis is the cornerstone of male infertility diagnosis. It assesses sperm count, motility, morphology, and other parameters. Abnormal results can indicate issues with sperm production or function.
Hormonal testing
Hormonal testing measures levels of testosterone, LH, FSH, and other hormones involved in reproductive health. Imbalances in these hormones can provide clues about underlying conditions affecting fertility.
Genetic testing
Genetic testing can identify chromosomal abnormalities or specific genetic mutations that contribute to infertility. This testing is particularly important for men with azoospermia or severe oligospermia.
Imaging studies
Imaging studies, such as scrotal ultrasound, can detect structural abnormalities, such as varicocele, testicular tumours, or blockages in the reproductive tract.
Treating male infertility
Treatment for male infertility depends on the underlying cause and may involve medical, surgical, or assisted reproductive techniques. According to Hethir Rodriguez, founder and president of Natural Fertility Info (2014), male infertility treatments include:
Nutrition and lifestyle
By incorporating a spectrum of vital nutrients such as zinc, selenium, folic acid, vitamin B12, vitamin C, L-carnitine, and antioxidants into one’s daily fare, individuals can fortify their reproductive health.
Simultaneously, curtailing exposure to hormones lurking in meat and dairy products and steering clear of estrogen-mimicking toxins pervasive in pesticides, plastics, and soy-based merchandise is imperative for fostering fertility.
Herbal remedies
Herbal supplementation emerges as a promising frontier in the realm of male fertility enhancement.
- Improving the diet, including nutrients like zinc, selenium, folic acid, vitamin B12, vitamin C, L-carnitine, and antioxidants.
- Reducing exposure to hormones in meat and milk, as well as oestrogen-mimicking toxins in pesticides, plastics and soy products.
- Taking herbal supplements like American ginseng, ashwagandha root, horny goat weed, ginkgo biloba, goji berries, maca root, and saw palmetto berries.
Medical treatments
- Hormonal Therapy: Hormonal imbalances can be treated with medications that regulate hormone levels, such as clomiphene citrate, human chorionic gonadotropin (hCG), or testosterone replacement therapy.
- Antibiotics: Infections in the reproductive tract can be treated with antibiotics to restore fertility.
- Lifestyle Changes: Adopting a healthy lifestyle, including quitting smoking, reducing alcohol intake, and maintaining a healthy weight, can improve sperm quality.
Surgical treatments
- Varicocele Repair: Surgical correction of varicoceles can improve sperm production and function.
- Vasovasostomy and Vasoepididymostomy: These microsurgical procedures can reverse vasectomies or correct blockages in the reproductive tract, restoring fertility.
- Sperm Retrieval Techniques: For men with obstructive azoospermia, surgical sperm retrieval methods, such as testicular sperm extraction (TESE) or percutaneous epididymal sperm aspiration (PESA), can be used in conjunction with assisted reproductive techniques.
Assisted Reproductive Techniques (ART)
- Intrauterine Insemination (IUI): IUI involves placing washed and concentrated sperm directly into the uterus, increasing the chances of fertilisation.
- In Vitro Fertilisation (IVF): IVF is a widely used ART procedure where eggs are fertilised with sperm in a laboratory setting, and the resulting embryos are transferred to the uterus.
- Intracytoplasmic Sperm Injection (ICSI): ICSI is a specialised form of IVF where a single sperm is injected directly into an egg. This technique is particularly useful for men with severe male factor infertility.
Can male infertility be cured?
The possibility of curing male infertility depends on the underlying cause. Some conditions, such as hormonal imbalances and infections, can be effectively treated with medication and lifestyle changes. Surgical interventions can correct structural abnormalities, such as varicocele or blockages, restoring fertility in many cases.
However, genetic conditions and severe damage to the reproductive organs may not be curable but can often be managed with assisted reproductive techniques like ICSI. Dr. Thinus Kruger, a leading South African expert in reproductive medicine, notes, “While not all cases of male infertility can be cured, many men can achieve fatherhood with the appropriate treatment and assistance.”
Is male infertility permanent?
Male infertility is not necessarily permanent. Many factors contributing to infertility can be treated or managed, allowing men to father children. Early diagnosis and intervention are crucial in improving the chances of successful treatment. Even in cases where natural conception is not possible, assisted reproductive techniques offer viable options for achieving pregnancy.
Current statistics on male infertility
- Globally, male infertility affects approximately 56.5 million people, with a significant increase observed since 1990¹.
- The prevalence of infertility worldwide stands at 17.5% of the adult population, indicating a substantial global health challenge⁴.
- In high-income countries, about 7% of men experience infertility, with approximately 1 in 7 heterosexual couples affected⁶.
Addressing male infertility requires a multifaceted approach encompassing dietary modifications, lifestyle changes, and herbal supplementation. While some of the best medicine boils down to diet and exercise, more complex cases should always be discussed with a medical professional. With advancements in medical and surgical treatments, as well as assisted reproductive technologies, many men can overcome infertility and achieve their dream of fatherhood. If you suspect you might be facing fertility issues, consult a healthcare professional for a thorough evaluation and personalised treatment plan.
Do you have a fertility story to tell? Share in comments.
Frequently asked questions (FAQ’s) about male infertility
Q1. What are the common causes of infertility in men?
A1. Common causes of infertility in men include low sperm count, poor sperm motility (movement), abnormal sperm morphology (shape), hormonal imbalances, blockages in the reproductive tract, genetic factors, and lifestyle factors such as smoking, excessive alcohol consumption, and obesity.
Q2. How does a low sperm count affect male fertility?
A2. A low sperm count, known as oligospermia, reduces the chances of fertilising an egg, making conception more difficult. It can result from various factors such as hormonal imbalances, genetic issues, or environmental factors.
Q3. What role does poor sperm motility play in male infertility?
A3. Poor sperm motility, where sperm struggle to move effectively, can hinder their ability to reach and fertilise an egg. It can be caused by factors such as hormonal imbalances, genetic factors, infections, or lifestyle choices.
Q4. How does abnormal sperm morphology impact male fertility?
A4. Abnormal sperm morphology, referring to sperm with irregular shapes or sizes, can affect their ability to penetrate and fertilise an egg. It may indicate underlying genetic issues, hormonal imbalances, or environmental factors.
Q5. What hormonal imbalances can contribute to male infertility?
A5. Hormonal imbalances, such as low testosterone levels or high levels of prolactin, can disrupt sperm production and function, leading to infertility. These imbalances may result from conditions like hypogonadism or hyperprolactinemia.
Q6. Can blockages in the reproductive tract cause male infertility?
A6. Yes, blockages in the reproductive tract, such as those in the vas deferens or epididymis, can prevent sperm from being ejaculated or reaching the egg, resulting in infertility. Blockages may be due to infections, scarring, or congenital abnormalities.
Q7. How do genetic factors influence male fertility?
A7. Genetic factors can affect male fertility by disrupting sperm production, function, or transport. Conditions such as Klinefelter syndrome, Y chromosome microdeletions, or chromosomal abnormalities can lead to infertility.
Q8. What lifestyle factors can impact male fertility?
A8. Lifestyle factors such as smoking, excessive alcohol consumption, drug use, obesity, and exposure to environmental toxins can adversely affect sperm quality and fertility. Adopting a healthy lifestyle can improve fertility outcomes.
Q9. What are the treatment options for male infertility?
A9. Treatment options for male infertility depend on the underlying cause and may include lifestyle modifications, hormone therapy to correct imbalances, surgical interventions to address blockages or abnormalities, assisted reproductive technologies such as intrauterine insemination (IUI) or in vitro fertilisation (IVF), and sperm retrieval techniques such as testicular sperm extraction (TESE) or sperm aspiration.
Q10. When should men seek medical advice regarding infertility?
A10. Men should seek medical advice if they experience symptoms such as low sperm count, poor sperm motility, abnormal sperm morphology, or have been unable to conceive with their partner after one year of regular unprotected intercourse. Early evaluation by a healthcare provider can help identify and address potential fertility issues.
Sources:
- Infertility Awareness Association of South Africa (2013)
- Natural Fertility Info: Male Infertility Treatments
- Global Burden of Male Infertility (2019)
- World Health Organization: Global Prevalence of Infertility (2023)
- Fertility Family UK: Male Infertility Statistics
- ET HealthWorld: Fertility Outlook in 2023
Fertility treatment can be a significant financial undertaking and requires careful planning, advises JustMoney.
