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Understanding Male Infertility

Male Infertility Contributes to About Half of all Infertility Cases

Male infertility is often overlooked or downplayed as compared to female infertility, when in fact male factors contribute up to 50% of infertility cases! Thus, the evaluation of the male partner is equally essential when a couple faces problems conceiving.

How is Male Fertility Assessed and Managed?

A sperm functional assessment is the main essential test for men. One semen analysis alone is often sufficient to determine subsequent management pathway. Semen analysis is also often complemented with tests for sperm DNA fragmentation to provide greater insight on sperm function.

Should assisted reproduction technique (ART) be deemed necessary, sperm selection will be conducted by identifying highest-potential sperm to be used. New techniques are in the works to improve the live birth rate either by identifying sperm for intracytoplasmic sperm injection (ICSI) based on their functionality, or by further purifying a prepared sperm sample.

Causes of Male Fertility

Causes are numerous and broadly comprise of medical and lifestyle factors.

Medical
  • Low sperm count
    According to the World Health Organization, semen must contain at least 15 million sperms per millilitre for a man – any lower, and he will be considered subfertile.
  • Poor sperm motility
    Sperm must be sufficiently motile in order to make its way to the fallopian tube to meet the egg. Over 50% of the sperm must be motile to be considered normal.
  • Poor sperm DNA integrity
    The more intact the DNA of the sperm, the better its quality and improve the chances of pregnancy. If the DNA fragmentation (DFI) is below 15%, pregnancy should be easily attained provided the woman is fertile.
  • Anatomical defects of the reproductive organs
    There could be an absent vas deferens (they transport sperm to the ejaculatory ducts), or simply a problem with sperm production in itself.
  • Medical conditions
    Certain medications and health issues can affect sperm production or sperm health, or result in scarring that hinders the movement of sperm.
Lifestyle
  • Being overweight or obese
    Obesity has been found to be linked with a lower testosterone level, poorer sperm quality and reduced fertility as compared to men of normal weight.
  • Having an unhealthy diet
    Diet that is heavy on processed meats, full-fat dairy products, alcohol and sugary drinks are associated with poorer semen quality. Try adopting a diet rich in fruits, vegetables, fish and low-fat dairy products instead.
  • Cigarette smoking
    Cigarette smoking has been widely acknowledged to negatively impact semen quality and sperm count.
  • Excessive alcohol consumption
    Habitual alcohol consumption is associated with poorer semen quality and changes in reproductive hormones. Among heavy drinkers, semen volume, sperm count, motility and number of morphologically normal sperm were found to be decreased.
  • High stress levels
    It is reported that psychological stress could lower sperm concentration and progressive motility, as well as increase the amount of sperm with abnormal morphology.
  • Sleep disorders
    Sleep is increasingly acknowledged to affect a range of physiological processes, including fertility-related functions such as testosterone secretion and prolactin secretion (prolactin potentially alters testicular function and semen production).
  • Oxidative stress
    There is evidence to support the role of oxidative stress in sperm dysfunction, which is thought to affect the cell membrane, impair sperm motility and reduce the ability to fertilise the egg, as well as possibly causing sperm DNA damage.

Should you or your partner experience difficulty conceiving, please do not hesitate to consult a fertility specialist, who will assess both partners’ fertility and general health to identify the root cause for treatment.

Delaying an assessment and proper diagnosis can worsen the situation as time is of the essence when it comes to fertility treatments.

Dr Ann Tan
Specialist Obstetrician & Gynaecologist
MBBS (Singapore), FRCOG (London), M Med (O & G) FAM (Singapore)
Supporting Couples For Over Two Decades

Subspecialty trained in fetal and reproductive medicine, Dr Ann Tan is a passionate and experienced advocate for helping couples expand and complete their families.

Speak to Our Obstetrician & Gynaecologist
Contact Information

3 Mount Elizabeth #11-12
Mount Elizabeth Medical Centre,
Singapore 228510

Tel : +65 6734 8188
Fax : +65 6262 0330
Email : mail@dranntan.com
WhatsApp : +65 8318 9757 (for appointment booking)

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