Wednesday, 17 September 2014

Male fertility: everything you need to know

When talking about fertility, much of the rhetoric focuses on female fertility. As a result, knowledge about sperm and how to best protect male fertility is often severely lacking. For couples with infertility problems, male infertility is a contributing factor in up to 50% of cases, and actually the sole cause in about 30% of cases. So what do we need to know?

A normal, healthy sperm count is usually considered as about 15 million sperm or more per ml, however it’s not just the number which is important. You also have to assess quality indicators such as motility (speed of movement) and morphology (normal shapes), with normal progressive motility being around 32% or more and normal morphology being around 4% or more. If we take this last stat you can see men may have up to 96% abnormal shaped sperm, yet still be considered to have a normal sperm sample as long as other parameters are within the normal range. As soon as the sperm sample does not meet the above parameters it does not mean the man is infertile, but rather that fertility problems are much more likely to occur and the chances of naturally conceiving are reduced.

So why don’t more men, or women for that matter, usually know these details? I feel the real issue here is that they simply not realise that up to half of infertility issues could be due to sperm problems. Through my experience, when compared to women, men are less likely to talk about fertility problems with family and friends. Women tend to share and talk with each other about fertility issues, and getting pregnant seems to be considered a female issue. In reality, men want to be fathers as much as women want to be mothers, but it’s just not a topic they want to bring up in pubs or offices. If awareness of the issues around infertility were better known, I think men would be more proactive about understanding and improving their fertility. Therefore raising awareness around male fertility and how to protect this is just as important as helping women to improve their fertility.
Once we’ve got prospective fathers aware of the importance of sperm count, what can they do to protect it? When looking at this we must first be aware that there is a fundamental difference between sperm and egg production, one well highlighted in the description:

“Men’s testes are like factories, whereas women’s ovaries are like warehouses”.

Men produce brand new sperm every 2 to 3 months, and so their lifestyle in the preceding months is incredibly important in determining the quality of sperm. Lifestyle issues such as high alcohol intake, smoking and taking recreational drugs, all negatively affect sperm function. Stopping smoking and recreational drug-use is an obvious first step. As regards to alcohol intake, there are no quantitative studies, but we advise to reduce alcohol intake and not drink more than 8 units in 48 hours i.e. no bring drinking! Stress can also have a negative impact on sperm quality, and it is important men look to keep this to a minimum. Other factors include anything that contributes to an intermittent increase in scrotal temperature, such as taking hot baths, sitting at a desk or on a sofa for long periods of time, and long distance driving without taking a break.

If men are worried about any of these issues, or would like to seek help, then the first step should be to seek advice from their GP. If concerned or worried, sperm tests are available at most fertility clinics, and they can offer considered medical advice on receipt of results. At my Create Fertility clinics we run free Open Days for men and women, because in tackling fertility issues both are just as important.