Male infertility

What is male infertility?

Common male fertility 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.

What causes male infertility ?

Male infertility can be caused by a number of issues. Some of the most common issues affecting men include: 

Semen

• 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 the 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 15 million sperm per millilitre, with over 40% of the sperm active and 4% of normal shape.

Testicles

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
• ejaculation disorders

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 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 – this is known as obstructive azoospermia. This could be causes by a lack of hormonal stimulation from the pituitary gland. Blood tests are carried out to check the hormone levels, and this can be treated with hormone therapy.

Hypogonadism

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, the use of illegal drugs or Kallman’s syndrome (a rare disorder caused by a faulty gene).

Antisperm antibodies

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.

Diagnosing male infertility

Before you undergo fertility testing or treatment, you must have a consultation with a fertility specialist. We understand that starting a family can be exciting, but it can also impact your emotional wellbeing. A consultation helps you prepare for this new stage in your life and gives you the opportunity to ask any questions you may have. We will ask you questions about your medical history and the difficulties you have been experiencing with conceiving.

Whether you’re struggling to conceive or want to understand your fertility potential, a fertility health screening can give you timely reassurance and empower you to make an informed and appropriate fertility planning decision.

Seeing a specialist who has your best interest at heart gives you the reassurance to make the best fertility planning decision. It also allows you to map out a plan of action once you have the results of your fertility test.

Male infertility treatment

Fertility counselling is a key part of all our fertility services. Our experienced team of counsellors provide the emotional support throughout your fertility journey. 

Each person is unique and we understand that providing a personalised treatment can make all the difference. That’s why we offer you a wide range of fertility treatment options. 

Intracytoplasmic sperm injection (ICSI) 

ICSI is a type of IVF treatment and can be particularly useful when treating male infertility. In ICSI, the embryologist injects each egg with live sperm directly to fertilise it. Once fertilised, a specialist can transfer the egg to the uterus for implantation. 

Surgical sperm retrieval for azoospermia 

Azoospermia is where no sperm is present in your ejaculate. When this is causing you fertility problems, surgical sperm retrieval can be a viable option. Surgical sperm retrieval can include techniques such as:  

• percutaneous epididymal sperm aspiration (PESA) 
• testicular sperm aspiration (TESA) 
• testicular sperm extraction (TESE) 
• microsurgical sperm extraction (Micro-TESE) 

Donor treatments 

We offer fertility treatments using donor eggs, sperm and embryos for single people, heterosexual couples and same-sex couples. The treatments we carry out include IUI and IVF/ICSI.  

Our fertility treatments are also available for patients using a surrogate. Our packages include workups for surrogates and intended parents, as well as a range of treatment options. 

Fertility preservation 

Fertility preservation is where you freeze your eggs, sperm or embryos to be used later. Many people choose to undergo fertility preservation, for reasons such as:  

• social reasons like not being ready to begin a family 
• not having found the right partner you want to start a family with  
• being a transgender person about to start transitioning 
• undergoing medical treatment that may harm their future fertility 

We offer various fertility preservation options, including egg freezing and storage, sperm freezing and storage, embryo freezing and storage. 

Once you are ready to start a family, you can access a range of assisted fertility treatments such as a frozen embryo transfer.