Male infertility treatments

Infertility has traditionally been thought of as a woman's problem, but as it turns out, men don't get off that easily. About one out of every three cases of infertility is due to the man alone, and men are somehow involved in infertility about half the time.

A diagnosis of male infertility can be one of the hardest challenges a man can face. For some, it can be devastating. After all, the necessity of reproduction is one of the few things on which both Darwin and the Bible agree. Not being able to father a child can make a man feel like he’s failing at one of his most primal responsibilities.

Unfortunately, some men have to cope with the reality that nothing can be done about their infertility. For other men, however, advances in male infertility treatment offer real help.

Understanding male infertility: Sex education

To better understand infertility, here's a refresher course.

Sperm are made in the testicles. They're then stored inside metres of “plumbing” called the epididymis, which lies on top of each testicle. Sperm are nourished by semen, which is made by glands along the way. When the magic moment arrives, about 150 million sperm are ejaculated in a half-teaspoon of semen through the penis.

This whole process hinges on there being proper levels of testosterone and other hormones as well as correct signalling from the nervous system.

Women ovulate - send an egg down into the uterus - once a month. This happens about 14 days after menstruation. Sex any time in the five days before ovulation can create a pregnancy. Sex any other time, even the next day after ovulation, will not result in conception.

“We generally advise couples to seek fertility evaluations if they are unable to conceive after 12 months of unprotected intercourse,” says Dr Lawrence Ross, president of an association for urologists (specialists in the urine tract and male genitals). About 85% of couples will have had a pregnancy by that point. “If they are over 30, they should seek evaluation after six months.”

Common causes of male infertility

The “male factor” contributes to infertility around half the time, and about one third of the time, it's the main cause of infertility. Most often, the problem lies in the process of either making or moving the sperm.

Any of the following can cause a man to have a low sperm count or abnormal sperm:

• varicocele - an abnormal collection of bulging veins above the testicle; they’re the most common cause of correctable male infertility, accounting for 38% of cases
• undescended testicle
• infections in the testicle (orchitis), the prostate (prostatitis) or elsewhere in the body that causes a raised temperature
• chemotherapy for cancer
• medicines such as anabolic steroids or anti-seizure medicines
• genetic abnormalities
• hormone problems