Causes & Treatment
Male fertility – a doctor’s 3-part rundown
Eloise Edington | 20 Jun 2022
June is Men’s Health Month in the U.S., prompting us to focus on causes, treatments and misconceptions surrounding male fertility and treatments.
When male-female couples are struggling to conceive, there’s often a misconception that fertility issues are due to the female partner. However, up to 40% of heterosexual couples trace the cause of their infertility at least partially to the male partner.
Medical Director of Laurel Fertility Care (based in San Francisco), Dr. Collin Smikle, chatted with FHH founder Eloise, answering common questions around male fertility, infertility causes and treatments. Skip back a step before you read up, and catch Dr Smikle’s male fertility Live Q&A.
Q: What causes male infertility?
A: It can be a mixed bag of many things, but smoking, lifestyle choices, genetic predisposition, hormone imbalances, steroid use, sexually transmitted diseases (STDs) and environmental factors can all affect sperm health and potentially cause infertility.
Q: How soon is the male partner’s fertility evaluated, during treatment?
A: Male fertility is evaluated as soon as possible at the start of fertility treatments. We make no presumptions that we’re dealing with normal sperm count. That’s one of the first things we do, in order to ensure we’re optimised for success.
We’re pretty aggressive in terms of doing things simultaneously, usually evaluating both partners right away with heterosexual couples. In the past, it was common to do a lot of exploration into the female partner’s fertility, and then find out later on that it was more of a male factor issue.
Q: Are there different levels of severity when it comes to sperm health and treatment options?
More than 5 million sperm per semen sample is a good number for someone looking to try on their own or conceive through Intrauterine Insemination (IUI). Between 1 and 5 million sperm per sample might indicate that IUI is a good choice, and IVF would be a stronger one.
With less than 1 million, in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) is the only measure that will allow sperm the chance to fertilize because we just wouldn’t have enough sperm to do things naturally.
But, having low sperm count does not necessarily result in poor sperm health, and vice versa. If male factor infertility is suspected, semen can be tested for motility and morphology (movement and shape), with recommendations for next steps.
Q: Does age affect male fertility?
We know that men create sperm throughout most of their lives. But sperm function, morphology, motility and viability does diminish over time. It doesn’t follow the same patterns as female fertility function – for men, we usually see things diminish significantly closer to the ages of 50-70. For example, there have been higher reported incidences of autism in children born to men over 55 years of age.
When it comes to motility and morphology, assisted reproduction allows us to bypass a lot of those effects, but we cannot totally eliminate the effects of age.
