Though there may often be a sense of shame and failure surrounding an inability to conceive, male infertility is more common than you might think. In fact, fertility factors in the male partner account for almost 50% of all infertility presentations. Fortunately, with the right investigations and guidance, we can often correct the causes of male infertility, getting you and your partner on the way to building the family you’ve always wanted.
Certain health conditions and lifestyle factors are known to reduce fertility in men. Many of these can be modified or treated with medications or surgery.
Similar to lifestyle factors that are discussed at a preconception advice consultation, certain behaviours and lifestyle choices have the potential to affect your ability to conceive as a couple. These factors include diet, the use of alcohol and recreational drugs, and cigarette smoking.
Hormones aren’t important only for female reproductive health. Sperm production and male sexual development are directly influenced by hormones such as testosterone, follicle-stimulating hormone, luteinising hormone, prolactin, and thyroid-stimulating hormone. Balancing these hormones with medication can help to restore normal fertility.
Low sperm count, abnormally shaped sperm, impaired swimming ability, or an complete absence of sperm in the semen can be caused by a number of conditions, including hormone disorders, medications, anatomical problems, and genetics. Another test that we routinely recommend is a DNA fragmentation, which, if elevated, can be an obvious cause of subfertility. This is an advanced sperm parameter that can be elevated even when basic parameters are normal. Pleasingly, it is something that responds well to lifestyle modification and supplementation.
Some medications, including testosterone supplements, steroids, some antidepressants and blood pressure medications, and chemotherapy drugs are known to be detrimental to male reproductive health and sperm production. Modifying or ceasing these medications where possible can avoid them impacting your fertility.
Barriers to healthy sexual performance, such as erectile dysfunction or premature ejaculation can make it difficult to conceive. Managing these situations can involve referral to a psychologist or counsellor to address the contributing stress or anxiety, medications, or the use of medical devices.
Some couples may wish to expand their family after a decision to have a vasectomy. This does not mean that your family planning goals have to end. We have the ability to perform surgical sperm retrieval to allow use of sperm after a vasectomy if desired.
The primary baseline test for male fertility is a semen analysis. This can be ordered by your GP before you’re referred to us and the results discussed at your first fertility appointment, or Elle can organise this test for you during your consultation. We may order further tests based on the outcome of your semen analysis and your medical history.
A basic semen analysis will provide information about your sperm concentration, motility, and shape. Often, Elle will also recommend an advanced semen analysis, which looks at additional factors such as sperm antibodies and DNA fragmentation.
Commonly abbreviated to TESA for testicular sperm aspiration or TESE for testicular sperm extraction, these are techniques that can be used both to aid sperm analysis during diagnosis of male infertility and also to retrieve sperm for IVF or ICSI. A tiny tissue sample is taken from the testicles under anaesthetic, which can then be evaluated under a microscope for the presence of sperm.
This is a genetic test that looks at an individual’s chromosomes. Rarely, couples may have an underlying abnormality in their chromosomal arrangement that is contributing to their subfertility or recurrent miscarriage. This test is recommended for both the male and female partner.
A genetic carrier is someone who has the genes for a certain condition without having the condition itself. Having the gene means there is potential to pass it to your future children. The results of this genetic test can help to inform the likelihood of your child having the condition.
If preliminary investigations indicate a concern, we may organise further testing to better understand your fertility situation. This can include ultrasound scans or hormone tests.
Of course! Lots of men will come for a fertility assessment without their partner and like to ensure they are the healthiest that they can be before embarking on parenthood.
Not necessarily. Lifestyle can have a big impact on sperm and the life cycle of any given sperm is approximately 72 days. We recommend an updated advanced semen analysis within 12-18 months if you have not had one prior.
Dr Danielle Robson, fertility specialist, consults at three locations across Sydney: the CBD, Chatswood, and Manly. A referral from a general practitioner is required for all initial appointments.
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Danielle is a fertility specialist and gynaecologist with an interest in fertility preservation, premature ovarian insufficiency, and menopause management. She is a Fellow of the Royal Australian and New Zealand College of Obstetrics and Gynaecology and a sub-specialist in Reproductive Endocrinology and Infertility.
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