Up to 40 per cent of couples’ infertility problems can turn out to be on the man’s side but the focus is still, generally, on the woman. From the beginning your partner should be involved in finding out what is preventing both of you from getting pregnant and tackling the problem – it could well be a combination of factors.
Here are some common conditions that make men less fertile.
Low Sperm Count
If his sperm count is low (less than 20 million per milliliter) then this could definitely be reducing your chances of conceiving. Levels of 40 million would be much better.
Poor Sperm Movement
Even if there is a good sperm count, fertility will be affected if the sperm’s capacity to move itself along (its ‘motility’) is poor. The way the sperm move is important because if they are going round and round in circles they won’t be able to travel up through the cervix and into the uterus to reach the egg. Good motility is also needed to help the sperm penetrate the egg.
Agglutination
This is when sperm clump together in a circle, going nowhere. This can be caused by an infection or by antibodies.
Abnormal Sperm
All men have a percentage of abnormal sperm and up to 70 per cent is considered acceptable. The abnormal sperm can have two heads or no tails, for example. But only if there is a very high percentage of abnormal sperm will a man’s fertility be affected.
Many specialists believe that these abnormal sperm would find it difficult to get to the fallopian tube and, once there, would not be able to penetrate an egg. But some studies have shown that abnormal sperm are actually capable of reaching the fallopian tube.
Others claim that a high concentration of abnormal sperm could be connected with a high rate of miscarriages.
Research has shown that, while the possibility of conception increases with higher sperm counts, it is also vital that the sperm are normal. One study, published in the Lancet in 1998, showed that a man with a lower sperm count can still be fertile as long as there is a high proportion of normal sperm.
Varicoceles
These are enlarged veins around the testes. They need not cause any discomfort and do not affect the man’s health in any way. However, it is thought that they can overheat the testes and damage sperm production, though there are men who have varicoceles and do not have any fertility problems. For some men with infertility, tying off these veins has helped them conceive. For other men, it has made no difference at all. Unfortunately doctors cannot predict which men with varicoceles will benefit from having them treated.
Obstructions
Blockages in certain parts of the male reproductive system can affect fertility by stopping sperm getting through to be ejaculated. These blockages can occur because of scarring caused by an infection such as mycoplasma or ureaplasma, or because of previous surgery, or due to an injury (e.g. a kick in the groin while playing sport). A severe sports injury could also stop the testes producing sperm.
Undescended Testes
If the testes did not come down properly after birth, then they may not be producing sperm. The incidence of this problem is increasing and many scientists now feel that (like the drop in sperm count) it is related to environmental factors. Surgery is often used to bring down a young boy’s testes (which, earlier in childhood, have got stuck inside the body) into the scrotum. If undescended testes were not diagnosed early enough and surgery was delayed then the man’s fertility may have been affected.
Diseases
Glandular diseases, such as thyroid or diabetes mellitus, can interfere with hormonal control of sperm production. Infections of the prostate and epididymis (tubular structure on top of each of the testes, into which secretions drain) can interfere with sperm production or block the exit of sperm from the body. Other infections such as mumps orchitis (an inflammation of the testicles following the mumps) can result in permanent infertility.
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