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18 July, 2017

Causes of male infertility

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A common scene in the majority of specialist fertility clinics…

Men are increasingly attending assisted reproduction clinics with their partners to see whether the problem is a male or female one. “Alongside an increase in the causes of infertility in men, we are seeing more and more cases where it is a male problem, nearly always related to semen quality,” explains Dr. Juan Manuel Marín García, Gynaecologist at HC Fertility – The fertility centre in Marbella.


We cannot get pregnant, which one of us has a problem?

As discussed in our previous article, although fertility problems have traditionally been associated with women, the reality is very different, and infertility affects men and women more or less equally. In 55% of cases female factor is involved, with the remainder being male. It is however often a combination of both, “A minor problem with the man such as a sperm motility problem may occur in a couple where the woman is older. The result is a couple who suffer from subfertility, meaning their fertility is reduced,” adds Dr. Marin.


Studying male fertility

If a couple already knows that the problem is not related to the woman then a study of the man’s fertility is required. Male infertility is usually as a result of a physical problem such as poor testicular function, however it can also be due to an anatomical or urological problem. When due to poor testicular function, it can result in a lower sperm count than usual, production of sperm which function abnormally (such as low sperm motility), or even no sperm at all.

There is also a percentage of men who have psychological problems preventing, or causing difficulties with, normal sexual function (for example erectile dysfunction).


How is male infertility treated?

There are two alternatives: infertility medication or assisted reproduction techniques.

The only condition which can be treated with medication is a condition known as secondary hypogonadism, which occurs when the hypothalamus or the pituitary gland do not function correctly, the resulting hormonal changes affect the normal production of testosterone and sperm. Men with this condition produce little or no sperm, only 2% of infertile men are infertile for this reason. In all other cases assisted reproduction techniques are required

“There are those who have poor sperm motility, and others who are not able to ejaculate, producing sperm but inside the testicle,” explains Dr. Marin. At HC Fertility we have used a procedure known as ICSI (intracytoplasmic sperm injection) in these cases for several years. This, in conjunction with in vitro fertilisation, makes it “virtually impossible” for a man not to become a biological father, as Dr Devroey, the “father” of this technique explained. With ICSI the best sperm are selected and individually inserted (through a pipette) into the egg.


HC Fertility thoughts and recommendations:

• If you had mumps as a child, inform your doctor. Mumps is a contagious, viral disease affecting the parotid or salivary glands. In general the condition causes life-long immunity, it can also be prevented by the MMR vaccine. Mumps can affect other glands in the body, the central nervous system and the testicles. The most frequent complications are meningitis and testicular inflammation which can result in infertility.

• Emotional strength is an important factor in the success of assisted reproduction techniques. You and your partner should be as prepared as possible when you enter into the process and try to maintain a positive frame of mind. It is proven that the likelihood of treatment success is higher in couples with good mental health says Dr. Marin, HC Fertility – The fertility centre in Marbella.

Dr. Juan Manuel Marín

Specialist in Human Assisted Reproduction at HC Fertility.

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