Around one in seven couples have trouble conceiving and the term ‘infertility’ is often used to identify a couple who have not conceived after one year of regular, unprotected sex. However, for some couples, it can take up to two years to conceive naturally and there are multiple solutions to different infertility problems—the following are all targeted towards men.
Causes
According to the NHS, the most common cause of infertility in men is poor-quality semen. Nevertheless, there are multiple factors that can influence male fertility—bad diet, poor overall health and excessive alcohol consumption being a few.
Abnormal semen
Quality sperm is vital for fertilising an egg during conception. Having a low sperm count—fewer than 15 million sperm per millilitre of semen—is quite common and can make it more difficult for conception to occur. Similarly, sperm that does not move properly, or is of an abnormal shape, will have a harder time fertilising an egg. Semen analysis is readily available and can even be done with a home-testing kit.
The testicles
The testicles produce and store sperm. Naturally, if the testicles are damaged, it can have an effect on the semen’s quality. Infection, cancer, surgery or injury to the testicles can all impact sperm quality. In addition to this, undescended testicles or a congenital defect could also play a part. Other symptoms to look out for include pain or prominent veins in the area.
Ejaculation disorders
Ejaculation problems can make it difficult for men to release semen during sex, reducing the opportunities for natural conception. There are a number of practices, therapies and medications available that could help in this instance. Individuals with ejaculation disorders may also notice cloudy urine after sex.
Hormone levels
Rarely, infertility can result from a hormone deficiency. Hypogonadism is when a man has an abnormally low level of testosterone—the male sex hormone involved in making sperm. A tumour, illegal drugs or birth defects can also cause low testosterone levels. Symptoms of the condition include erection difficulties, mood changes, weight gain, lower sex drive and less facial hair.
Treatments
When consulting a doctor about infertility treatments, men may have to relay their medical and sexual history and undergo a physical examination or a semen analysis. Treatment for a fertility problem will largely depend on its cause.
Medicines
Whilst fertility medicine is usually prescribed to women, gonadotrophin hormones can help to stimulate the production of sperm. Pseudoephedrine can also help to treat retrograde ejaculation, and sildenafil (more commonly known as Viagra) may be helpful for those who have trouble getting an erection.
Surgery
Surgery can be undertaken to help treat infertility. For example, surgery to correct the blockage of the epididymis—a coil in the testicles that helps store and transport sperm—can help sperm to be ejaculated normally. Sperm can also be surgically extracted under local anaesthetic, and vasectomies can often be reversed. If a man has varicoceles—swollen veins in the scrotum—surgery can often improve the quality of sperm. However, there is little evidence that this also improves fertility.
Assisted conception
Assisted reproduction treatments, such as in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI) or donor insemination, can help a couple to conceive. These treatments work by fertilising an egg externally, before replanting it back into the womb.
How to improve fertility without outside help
In around a quarter of cases, doctors are unable to find a cause for infertility. If you’re not ready to try IVF, there are certain lifestyle factors that are known to influence fertility in men. Here’s how to boost your chances of conception:
Regular sex. This means two to three times a week, or every two to three days. Tracking your partner’s ovulation cycle can also increase the chances of conceiving.
Sperm temperature. The ideal temperature for sperm production is 34.5C, which is slightly below body temperature. Keep your testicles cool by moving regularly, avoiding tight underwear and removing your laptop from your lap.
Quit smoking, alcohol and drugs. These recreational habits are known to reduce fertility.
Diet, weight and exercise. Eating a balanced diet and maintaining a healthy weight will help to keep sperm in good condition. Being overweight can reduce the quality of sperm and the chances of conception.
Stress. Struggling with fertility problems can be stressful, and this can lower your (and your partner’s) sex drive. Severe stress can also limit sperm production.
Supplements. Whilst the scientific evidence for this isn’t solid, vitamins C and E are supposedly beneficial for boosting fertility. Avoid taking testosterone. You may feel like you should turn to testosterone, but this is likely to do more harm than good. When you take testosterone, you are telling your body that it no longer needs to produce sperm.
This article was originally published in Live to 100 with Dr Hilary Jones. Read the digital edition, here.
