Mens Health

When couples are trying for a baby for a while, with no result, it’s easy to look to the woman as playing the main factor in problems with conception. However, the latest statistics suggest that about a third of couples having difficulty conceiving will be diagnosed with ‘male-factor infertility’. While woman are predominantly aware of factors relating to or causing their own infertility, men often lag behind. Factors relating to female infertility are easy to identify, for example - age, endometriosis, PCOS, ovulation problems or uterine abnormalities. Men, it seems, are less aware of the causes of their infertility. Unlike women, who are born with every egg they are ever going to have, most men go on making sperm into their eighties - but the quality and quantity deteriorates.

Infertility can be defined as the failure to achieve pregnancy, without the use of any contraception, for at least a year. If a woman doesn’t get pregnant after more than a year of trying, there’s a 30 to 40 percent chance that her partner’s fertility problem may play a role. In another third of cases there will be problems ‘on both sides’, so it’s essential that couples have their fertility investigated together.

Sometimes a man’s hobbies can interfere with infertility. According to a small study conducted in Austria, frequent mountain biking may contribute to a man’s infertility. The study looked at 55 avid mountain bikers and found that nearly 90 percent had low sperm counts and abnormalities in their scrotums. In contrast only 26 percent of 35 non-bike riders had similar damage.

Infertility or subfertility is estimated to affect approximately one in six couples in Ireland. A couple’s G.P. can perform some basic investigations but nowadays it is felt that infertile couples should then be referred to a hospital or clinic that specialises in infertility.

A man will be considered at risk of being infertile if his sperm count is less than 20 million/mL of semen. This level is defined by the World Health Organisation but of course that some men with low sperm counts will still prove fertile whilst others with higher counts can prove infertile. So a measure of sperm count is not a completely reliable method of assessing fertility. While there are many causes of male factor infertility, some are seen more commonly than others. These top causes of male factor infertility account for the majority of cases of infertility in men.

Blockage of sperm
The vas deferens that carries sperm from the testicles to the penis can be blocked for a variety of reasons including prior vasectomy, injury, infection or physical anomaly.

Chronic disease
Diseases that can affect hormonal controls and sperm production, particularly when not controlled are also causes of infertility. Diabetes, hypertension and other problems can all affect the fertility of men.

Erectile Dysfunction (ED)
If you have a problem getting or maintaining an erection then there will be problems getting the sperm out. Sometimes this is caused by a chronic illness like hypertension or heart problems, it can also be caused by paralysis.

Failure to produce sperm
If the body isn’t producing sperm there can be many reasons. Some may be from hormonal issues of testicular failure, while others may be from treatments for certain illnesses and cancer like chemotherapy and radiation therapy.

Exposure to harmful substances
Environmental or work hazards can also lead to problems with fertility. Infected semen can be a cause of infertility. Your doctor can test for this. It was previously thought that mumps could cause sterility in men but in fact it is now known to be extremely rare for mumps to lead to sterility.

Injury
If you have experienced injury to your testicles you may also have issues with sperm production.

Varicocele
This is a varicosity, or varicose vein in the testicle. The varicosity damages the blood flow to the testes, making sperm production slowed or stopped.

Male Infertility Vox Pops - Do you know of any lifestyle factors that can lead to male infertility?

Male factor infertility treatment
Male factor fertility problems can be difficult to treat. Surgery can sometimes help. Occasionally medication may be prescribed. Specialised infertility units at hospitals or urologists will advise in this area.

I.C.S.I. (Intra Cellular Spermatozoa Injection) This treatment is similar to I.V.F. but the main difference is that it can be suitable for men with low sperm counts. Eggs (Ova), having been taken from the woman, can be fertilized in the laboratory each having been injected with just one sperm.

Donor inseminatione Donor insemination has been practiced as a medical treatment in the U.K. and U.S. for over a hundred years. There is also evidence of it being common practice in many cultures throughout the ages. The Morehampton Clinic in Dublin was involved in setting up the first donor insemination (D.I.) unit at the Well Woman Centre in 1979 and has been providing the service for over eleven years. As there is no specific legislation in Ireland concerning donor insemination, they work within the confines of British legislation and also within the guidelines of the Irish Medical Council. Donor sperm is either directly inseminated to the cervix or directly into the womb.

I.U.I.H. (Intrauterine insemination using husbands sperm) This is a procedure whereby a sample of sperm from the husband is prepared by the ‘wash and swim up’ method and is then inseminated into the woman’s womb. Many couples have a couple of months of treatment while waiting to have I.V.F. If the sperm count is slightly lower than optimum or motility reduced, the “wash and swim up” procedure can be of help. Occasionally, though rarely, there can be some hostility to sperm in the mucus at the woman’s cervix (neck of womb) and by inseminating directly to the womb, thereby bypassing the cervix it, can enable the couple to conceive.

Some infertility factors you may not be aware of:
Heat can reduce sperm production. This is why the testicles are outside the body in the scrotum rather than in the abdomen like the ovaries. Medical opinion is divided on how important the role of heat plays in male infertility. For example, some men soak themselves in a bathtub full of scalding water while some obese (overweight) men can become sterile because the sagging layers of fat can overheat the testicles. Some men whose jobs involve long hours of sitting may also have a reduced sperm count because of overheated testicles.
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Very frequent intercourse can lead to a dramatic reduction in sperm count and cause the man to be effectively infertile. If you ejaculate as much as 2-3 times a day you are likely to have a problem. If you want to be at your most fertile you have to wait at least 3 days between each ejaculation!
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Smoking over 20 cigarettes a day has been shown to reduce both the sperm count and the sperm motility. So stop smoking or reduce it to minimal levels.
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Excessive alcohol intake can lead to low sperm counts for a variety of reasons.
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The workaholic man can find that fatigue can have similar effects on his interest in intercourse as well as stimulate a desire for excessive alcohol intake.
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Disposable, plastic-lined nappies keep testicles hotter than core body temperature (and as much as 1.8 degrees F higher than testicles in cloth nappies)! A recent US study speculates that perhaps the significant rise in male infertility over the last 25 years is due to the widespread use of nappies that keep babies too warm.
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According to statistics, about 10% of all men in the United States who are attempting to conceive suffer from infertility.
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It is entirely possibly that, within 10 to 20 years, scientists will be able to take cells from any tissue in a man’s body and induce these cells to fertilize an egg using some future version of ICSI.
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Soya beans may play a role in the problem of male infertility. Soya contains the female hormone oestrogen and too much of it is being linked to poor quality sperm. It is contained in foods such as pizzas, any of those foods that you add hot water to, and some pre-packaged dinners. Some other lifestyle factors that may have an effect on male fertility are traffic pollution, laptops, mobile phones, tight pants and hot tubs, nappies, smoking, overeating, seafood, fast food and driving.
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Recently conducted studies suggest that men may also have a biological clock, which is associated with declining fertility, decreasing hormone levels and increasing risk of genetic defects starting after the age of 30.
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According to a report from the Johns Hopkins Medical Institutes, men have a better than 50/50 chance of fathering a child after a vasectomy reversal. However, the longer a man waits to have a reverse vasectomy, the lower the odds.
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A man’s underwear style is unlikely to significantly affect his fertility. Wearing roomy shorts instead of tight pants probably won’t a major difference to a man fathering a child.