Male infertility is a reality. Johannesburg-based Reproductive Medicine Specialist, Dr Merwyn Jacobson from Vitalab explains that infertility in men is a genuine medical issue, and accounts for nearly one-half of all infertility cases. According to Dr Jacobson, male infertility is the reason that up to 40% of South African couples cannot achieve pregnancy. “The production of sperm is a very complicated process that begins at puberty and continues in healthy males until late in life,” says Jacobson.
He points out that the potential causes of male infertility can be attributed to the following:
- Recreational drugs like marijuana, heroin, and cocaine
- Alcohol abuse
- The use of performance-enhancing drugs such as anabolic steroids
- Wearing tight underwear
- Exposure to toxic chemicals
- Hormonal problems
- Damaged sperm ducts, varicocele (varicose veins of the testicles), or infections such as mumps or sexually transmitted diseases
- Retrograde ejaculation (when semen is redirected into the bladder instead of ejaculated through the urethra)
- Having had a previous vasectomy
- Ejaculatory dysfunction, premature ejaculation, and ejaculatory incompetence (inability to ejaculate or constantly struggling to achieve orgasm even though normal sexual desire and stimulation is present)
A word on medical disorders
Dr Jacobson explains that the above-mentioned lifestyle choices, as well as hormonal, physical, and psychological problems, may result in anything from the complete absence of sperm to a low sperm count, abnormal sperm shape, problems with sperm mobility, or sperm that’s completely immobile. Medical disorders can also reduce male fertility.
Dr Jacobson explains that any medical condition that affects the general functioning of the body can play a role in reduced male fertility. “Heart disease and its appropriate treatment; lung disease and the poor oxygen supply associated with it; kidney and liver disease and the fact that many toxins are not removed from the body; diabetes and other conditions which affect the metabolic function, such as thyroid disease, may all have an impact on a man’s fertility.”
Treatment options for sperm disorders
Dr Jacobson says that one test to evaluate male fertility is a semen analysis. He explains that this will determine the number, activity, and shape of the sperm. “This relatively simple test involves the man providing a semen sample which will be evaluated. It’s the overall evaluation of the ejaculate, not only the quantity of sperm that influences a man’s ability to fertilise an egg.” Fortunately, in a large number of cases, male infertility can be improved either by treating the problem or using fertility treatments.
Dr Jacobson explains that the most straightforward treatment options include a course of antibiotics in cases of infection, medication to improve sperm production, or surgical correction to remove varicocele, repair a duct obstruction, or reverse a vasectomy. There have also been huge improvements in overcoming more complicated male fertility problems. “IUI (intra-uterine insemination) is a relatively simple infertility treatment process in which a small, thin, soft catheter is used to place specially prepared sperm directly into the uterus. This procedure is also referred to as artificial insemination and may be used in cases of low sperm count or quality,” explains Dr Jacobson.
He further explains that IVF treatment may be suggested if IUI is not successful or appropriate, or if female infertility is contributing to the problem. “Today, in even the most difficult of male fertility cases, the direct injection of sperm into the eggs via ICSI can now significantly improve the likelihood of pregnancy.” Dr Jacobson adds that other treatments include electro-ejaculation for patients who have spinal cord injuries, epididymal sperm aspiration for men with absent or blocked ducts, and hormone replacement for individuals with pituitary deficiencies.
“Dealing with male fertility problems depends on the cause and severity of the problem,” says Dr Jacobson. He explains that, in many instances, one may not be able to cure a fertility problem, but you might be able to effect some improvement on the sperm quality and function.
Good to know: Although many infertility problems such as genetic, congenital, and mechanical can’t be prevented, maintaining a healthy lifestyle can help men to preserve and improve their fertility.