Understanding Male Fertility

At Waterstone Clinic, we see men every week who think they are the only one with this problem, but in fact, in at least one third of all cases, sub fertility can be attributed to the male. Men can also be reassured that male factor sub fertility can be overcome through various treatment options.

Male infertility is generally due to low sperm numbers, immobile sperm or the most severe form of male infertility is where there is no sperm in the ejaculate. This may be due to the fact that there is no sperm production or maybe because of a blockage that prevents delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices and other factors can play a role in causing male infertility.

Early fertility assessment in the form of Fertility Check is a self-referral service provided by Waterstone Clinic. It is ideal for those who are thinking of starting a family or have been trying to conceive for a short time and would like an assessment of their reproductive health. After an initial consultation, where an appropriate medical history is taken, a semen analysis will be performed. Semen analysis is the principle investigation used to evaluate male fertility – it measures the number of sperm, the motility of sperm and the morphology of the sperm. If semen quality is sub optimal some lifestyle changes may improve sperm quality before a number of fertility treatment options are considered.

Even when a man is faced with learning that there is no sperm in the ejaculate, the good news is that it is possible for him to still have his own biological child, it does not mean the end of the line. Waterstone Clinic offer Testicular Sperm Extraction (TESE). This involves a testicular biopsy to retrieve sperm from testicular tissue. Waterstone Clinic carry out approximately 40 of these procedures a year and a number of babies have been born by carrying out ICSI (Intracytoplasmic Sperm Injection) using sperm from these biopsies.

For a man, a diagnosis of infertility should not be underestimated. I have co-authored a paper, that has recently been accepted for publication, on the psychological impact of infertility and fertility treatment on the male. The paper explains that fertility investigations and the nature of fertility treatments mean that the male partner may have a relatively minor role compared to the female partner. But this may only add to his feelings of guilt and inadequacy. It is important to realise however, that if a few sperm are present, while it may not be possible to identify the reason for the man’s fertility problems, and while it may not be possible to correct the problem, with the use of ICSI, it may be possible to overcome the problem.

Dr. Tim Dineen, Head of Laboratory services, Waterstone Clinic