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Following on from the results from our reader survey on fertility, we asked you what you want answers to. From male fertility to egg donation, we get the experts’ advice on all things fertility.
This week, we’re tackling a rarely discussed topic: male fertility. Male fertility is often not spoken about and sometimes embarrassment can keep men in the dark about their reproductive health.
Continuing our expert Q&A series, Dr Tim Dineen, Head of Laboratory Services at Waterstone Clinic, answers one reader’s question about her partner’s fertility, the symptoms to look out for, and how men go about having their fertility assessed.
We were trying to conceive for 12 months before seeking medical advice. My husband had suboptimal sperm but from an IVF clinic perspective, it was fine and nothing else was recommended. Two failed cycles later, a fertility expert suggested my husband attend a urologist. He had a varicocele which is one of the main causes of infertility and had surgery to remove it. His sperm numbers have improved so much that now we should be able to achieve a pregnancy naturally. What are the signs for men to look out for with their fertility, what are the typical issues and what should their first steps to getting checked be?
Dr Tim Dineen, Head of Laboratory Services at Waterstone Clinic
It surprises both men and women to know that just as many fertility issues stem from men as they do women. Generally speaking, in every group of 15 men, at least one will have a fertility issue. This means that for about a third of couples who attend fertility clinics, the underlying fertility problem is related solely to the male.
In our clinic, we always recommend that couples are assessed as a couple first because, while some patients may have an idea that they have a fertility issue, male fertility issues can be asymptomatic. The reasons for male fertility issues can be very varied: some men are born with a fertility issue (such as undescended testicles) or they may have had an injury during childhood or adulthood. Or, the fertility problem could be hormonal or genetic in origin. For many men, however, the reason is just unknown.
Men also tend to be slower than women to seek help with their fertility, and sometimes can feel embarrassed about having a fertility test. It’s important for them to know that the test is simple, non-invasive and inexpensive, so there is no need to stay in the dark about their reproductive health. A semen analysis test will identify if their is an issue, and if there is a problem, it will help tailor the treatment to overcome it.
How does the test work? A semen analysis will test a sample of semen under a high powered microscope for a number of things: the number of sperm that are present per millilitre of the sample (sperm count), what percentage of them are moving as they should (motility), and what percentage of them have a normal shape (morphology). The semen analysis result sheet will detail what the normal range for each of these measures are, and what the specialist’s recommendations are.
Sometimes there may be no sperm at all and this can be due to a blockage in the reproductive tract, a hormonal imbalance, a varicocele, or even lifestyle factors. Lifestyle choices can have a considerable impact on fertility. Things such as smoking or vaping, regular pints, poor food choices and taking anabolic steroids can all lead to suboptimal semen parameters. If the results are poor, we will give some recommendations or we may need some further investigations.
The good news is that it only takes around 12 weeks for the body to produce new sperm cells. If you improve your nutrition, exercise in moderation, reduce caffeine and alcohol, and quit smoking or vaping, then the quality of your sperm (and your overall health) can improve. Researchers have also seen improvements when men take zinc, vitamin E, folic acid and selenium supplements, and included whole nuts, spinach and lentils to their diet. If you make these positive changes to your lifestyle, you could see improvements in your fertility in just three months.
Also, patients find it very reassuring to know that there are a number of treatments to help get around even the most complicated of male fertility issues (such as ICSI, a form of IVF treatment), and a high percentage of patients with a male factor issue will go on to have a biological child. Getting the information by having a simple male fertility check will help you and your partner be in the best place to start your journey to parenthood.
Continue to follow us here to hear from Ireland’s leading experts in our IMAGE talks Fertility series in partnership with Waterstone Clinic.