How common is male infertility?

Infertility is a disease of the reproductive system and it makes a person unable to have children. It can affect a man, a woman, or both. Male infertility means that a man has a problem with his reproductive system and cannot cause a pregnancy with his female partner.

Natural male reproduction depends on several things, including the ability to make healthy sperms that can fertilise the egg, have an erection and ejaculate so the sperm reaches the egg. Problems with either of these may mean that a male may be infertile.

According to Dr Kamali Carroll, embryologist at the Hugh Wynter Fertility Management Unit, Faculty of Medical Sciences at the University of the West Indies, Mona campus, problems with making healthy sperms are the most common causes of male infertility.

“Sperm may be immature, abnormally shaped, or unable to swim. In some cases, you may not have enough sperm, or you may not make any sperm. This problem may be caused by many different conditions, including infections or inflammatory conditions,” Dr Carroll said.

“Anything that blocks the genital tract can stop the flow of semen. This could be a genetic or birth defect. Infection or inflammation from a sexually transmitted disease can also block semen. Other causes include scar tissue from surgery or twisted, swollen veins in the scrotum,” she added.

Other factors of male infertility may include erectile dysfunction or premature ejaculation. Liver or kidney disease, or treatment for seizure disorders are examples of problems that can cause infertility.

To diagnose male infertility, your doctor will review your health history and do a physical examination. Other tests for male infertility may include sperm count (semen analysis) in which at least two semen samples are taken on separate days.

“Your doctor will check the semen and sperm for many things. These include how much semen you make, how uniform it is, and how acidic it is. He or she will also look at how many sperm you make, how well they move, and what shape they are,” Dr Carroll said.

“Your doctor may use blood tests to check hormone levels and rule out other problems. Other tests can be done to find the cause of sperm defects or health problems of the male reproductive system. For instance, imaging tests like an ultrasound may be used to look at your testicles, blood vessels, and structures inside the scrotum,” Dr Carroll added.

If semen analysis shows that you have only a few sperm or no sperm, your doctor may remove a small piece of tissue (biopsy) from each testicle. The sample will be checked under a microscope.

Treatment, she said, depends on what is causing your infertility. Fertility treatment can help, and this treatment involves helping your partner get pregnant. This may be through artificial insemination. This method puts many healthy sperm at the entrance of the cervix or right into the partner’s uterus. The sperm can then make their way to the fallopian tubes.

In vitro fertilisation (IVF) and gamete intra-fallopian transfer work like artificial insemination. Your doctor collects your sperm, then he or she mixes your partner’s eggs with a lot of high-quality sperm. He or she may mix the eggs and sperm in the lab or in your partner’s fallopian tube.

The doctor can also use Intracytoplasmic sperm injection, where he or she injects a single sperm into an egg. Fertilisation then takes place under a microscope. The fertilised egg is then placed in your partner’s uterus.

“Hormone treatment may also help you if you have a hormone disorder causing your infertility. Hormone imbalances can affect how sperm develop. They may be caused by a problem in how the hypothalamus, pituitary gland, and testes interact. Treatment may include gonadotropin therapy or antibiotics,” Dr Carroll said.

You may also use surgery to fix problems that keep sperm from being made, matured, or ejaculated. Surgery to remove twisted, swollen veins in the scrotum (varicocele) can sometimes improve the quality of sperm.

Dr Carroll is also the lab director at the Hugh Wynter Fertility Management Unit. She was guest presenter at the fourth staging of the Medical Disposables Annual Continuing Education Seminar for Pharmacists-MPowered 2023.

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