Infertility is when a couple cannot conceive or become pregnant despite having regular unprotected sex.
Infertility can be an issue for the man, the woman or both partners.
Infertility is fairly common with around one in six couples having difficulty getting pregnant.
A person who has infertility has a reduced ability to have a child. It usually doesn't mean a person is sterile - that is, physically unable ever to have a child.
For many couples, infertility is a crisis. Fertility problems often come with feelings of guilt or inadequacy, but a diagnosis of infertility is not necessarily a verdict of sterility.
Men and women are equally likely to have a fertility problem. In about one in five infertile couples, both partners have contributing problems, and in about 15% of couples, no cause is found after all tests have been done, called 'unexplained infertility'.
Seek medical advice if you've been trying for a baby for a year without getting pregnant.
What causes fertility problems in men?
In men, the most common reasons for infertility are sperm disorders. These problems include:
- Low sperm count. This means there are too few or no spermatozoa in the semen.
- Low sperm motility. This means that the sperm don't move as well as they should.
- Malformation of the sperm.
- Blocked sperm ducts.
Another common problem is a temporary drop in sperm production. This happens when the testicles have been injured, such as when the testicles have been too hot for too long or the man has been exposed to chemicals or medications that affect sperm production.
Spending a long time in a hot tub, for example, or wearing pants that hold the testicles too close to the body can increase the testicular temperatures and impair sperm production. Sometimes there is a physical reason. In the relatively common condition called varicocele, veins around the vas deferens (the duct that carries sperm from testicle to urethra) becomes dilated - similar to a varicose vein in the leg. The pooling of blood in these veins keeps the temperature inside the scrotum too high.
Certain lifestyles such as increased alcohol intake and smoking can also have a negative effect on sperm count. Men who are 40 or older often have decreased fertility.