Common male infertility problems are usually identified either in the physical abnormalities of the reproductive tract or abnormalities of the sperm itself. In many cases the causes of male infertility are unknown. During investigations, we conduct a semen analysis to check the number, activity and shape of the sperm. Here are some of the most common issues affecting men:
- decreased number of sperm – you may have a very low sperm count, or no sperm at all
- decreased sperm mobility – if you have decreased sperm mobility, it will be harder for your sperm to swim to the egg
- abnormal sperm – sometimes sperm can be an abnormal shape, making it harder for them to move and fertilise an egg
- many cases of abnormal semen are unexplained, but there are several factors that can affect semen and sperm.
A normal analysis of semen should show a sperm count of more than 20 million sperm per millilitre, with 50% of the sperm active and 30% of normal shape.
Your testicles are responsible for producing and storing sperm. If they are damaged it can seriously affect the quality of your semen. This may occur if you have, or have had in the past, any of the following:
- an infection of your testicles
- testicular cancer
- testicular surgery
- A congenital defect (a problem with your testicles that you were born with)
- Undescended testicles (when one or both of your testicles has not descended into the scrotum)
- trauma (injury) to your testicles.
Absence of sperm
Your testicles may produce sperm, but it may not reach your semen. The absence of sperm in your semen is known as obstructive azoospermia. This could be due to a blockage in one of the tiny tubes that make up your reproductive system, which may have been caused by an infection or surgery. The cause could be lack of hormonal stimulation of the testes by the pituitary gland. Blood tests are done to check the hormone levels and this can be treated with hormone therapy.
Hypogonadism is an abnormally low level of testosterone, the male sex hormone that is involved in making sperm. It could be due to a tumour, taking illegal drugs or Kallman’s syndrome (a rare disorder caused by a faulty gene).
Once antisperm antibodies form, they can affect the sperm’s ability to penetrate and fertilise an egg. This can occur following a vasectomy, previous infections or injuries. The success rates for male infertility have improved since intra-cytoplasmic sperm injection has been introduced.
Investigations to help find the right treatment for you
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