Identifying male infertility and where to seek treatment

When it comes to fertility concerns, it's not just about the ladies. Did you know that as many as 40 per cent of couples facing fertility issues have a contributing factor from the man's side? Yep, that's right! So, fellas need to get in on the fertility check too. It's essential to analyse the sperm to assess male fertility.

Male infertility

After marriage, the next step for happy couples is having a precious little baby to complete their family. But trying to conceive is not always as easy as just popping a bun in the oven. Especially when either the wife or even the husband is experiencing fertility issues.

According to KK Women's and Children's Hospital, fertility issues affect approximately 15 per cent of couples in Singapore alone. Not only that, but among this group, 50 per cent are males with fertility issues.

This makes it even more important to know the signs of male fertility that husbands should know about and where to seek treatment. To be more informed about fertility issues in men, theAsianparent reached out to Dr Ee Tat Xin, a consultant with the Department of Reproductive Medicine at KK Women's and Children's Hospital.

Here's what he had to say…

Signs of male infertility

For husbands wondering what exactly are the signs of infertility in males, Dr Ee lists the following to be mindful of:

Unable to have an erection or ejaculate

"If the man cannot have an erection or ejaculate, then these are really obvious signs to seek medical assessment," says Dr Ee.

Inadequate sperm criteria

"Also, if he and his partner have been trying for a while without contraceptives, it may warrant a check as it could mean that the sperm criteria are not adequate," he adds.

"When the man goes for a check, typically, the main test for male fertility will be a semen analysis (SA) test. Further testing will be considered, depending on the results of the SA. A man with a normal SA will rarely have to undergo further testing," Dr Ee tells theAsianparent.

"Generally, the parameters of the components of the SA is wide-ranging. For example, the concentration of the semen may range from zero to hundreds of millions," he continues to explain.

"However, that does not mean that the man with low sperm count will not conceive or that the man with high sperm count will definitely conceive."

What causes infertility in men

When it comes to talking about male infertility, there can be various factors at play that might affect their ability to father a child. Let's take a quick look at some of the common causes:

1. Erectile dysfunction (ED): ED, the inability to get and maintain an erection firm enough for sex, is a common cause of infertility in men. Some natural remedies like DHEA and L-arginine have shown positive results in improving ED, but caution is needed as they may cause side effects and interact with other medications.
2. Hormonal imbalances: Hormonal issues, such as low levels of testosterone, can affect sperm production and lead to infertility. Proper evaluation and treatment by a medical professional are essential.
3. Varicocele: A varicocele is a swelling of the veins that drain the testicle, which can lead to reduced sperm quality and production.
4. Infections: Infections, like sexually transmitted infections (STIs), can damage the reproductive system and cause infertility if left untreated.
5. Genetic factors: Genetic conditions can impact sperm production or function, leading to infertility.
6. Chronic illnesses: Certain chronic conditions, like diabetes and kidney disease, can impair fertility.
7. Medications: Some medications, like certain antidepressants, may have adverse effects on sperm production and fertility.
8. Radiation and chemotherapy: Cancer treatments involving radiation or chemotherapy can harm sperm production and cause temporary or permanent infertility.
9. Age: As men age, sperm count and quality can decline, making conception more challenging.

It's essential for men experiencing infertility issues to consult a healthcare professional for proper evaluation, diagnosis, and personalised treatment options.

Lifestyle factors that affect male infertility

Dr Ee also helpfully breaks down lifestyle factors that are found to be detrimental when it comes to fertility in men:

Smoking

Substances in cigarette smoke are toxic to sperm (and to eggs and to the developing embryo in pregnancy).

Drinking alcohol

Heavy alcohol consumption can affect hormone levels in men (and women) and interfere with sperm production and sperm function.

Drug abuse

Using drugs like heroin, cocaine, anabolics and steroids (used by athletes and bodybuilders) can also affect sperm production.

Being overweight or obese

Obesity is known to result in an alteration of the hormonal regulation in men which can affect the production or quality of sperm, libido or cause erectile dysfunction in men.

Obesity is also associated with depression, which may further adversely affect the sexual health of men. Therefore, obesity has long been postulated to have hormonal, mechanical and psychosocial ill effects on male fertility.

Wearing tight underwear

According to Celia E Dominguez, reproductive endocrinologist, Center for Reproductive Medicine at the Emory University School of Medicine, a male's testes should be at a temperature lower than the core body temperature as "they were made to be out in the breeze."

So if a man wears constraining briefs, this could overheat his testes and reduce sperm production.

Prolonged cycling

While cycling is a great exercise for your overall health, it might not be the best for your little swimmers down there. According to a study shared on BBC, frequent cycling doesn't seem to affect sperm production, but it could lead to lower sperm counts for men who cycle a lot.

The reason behind this could be the pressure from sitting on a bicycle seat, which may affect penile erections and even cause numbness.

"Men who do long-distance cycling may experience numbness of the penis. Some men may also experience erectile dysfunction due to injury to the nerve and the blood vessels within the canal," said Dr Ronny Tan, a consultant urologist and andrologist with Advanced Urology Associates.

Excessive mobile phone use

Are you fond of putting your phone in your jean pocket? You may want to refrain from doing so if you want to increase your chances at conceiving.

According to research, there have been suggestions that mobile phone radiation can have an impact on the quality of a man's sperm. Handphone usage has been associated with increased levels of DNA fragmentation and decreased sperm motility.

In this digital age, it may seem almost impossible to live without our mobile phones or WiFi connections, but for men planning to conceive, it might be worth considering reducing their scrolling time on their phones.

Does stress have something to do with men's infertility?

Stress can indeed have an impact on male infertility. Research has shown that psychological stress can affect sperm quality and fertility. Stress may lead to hormonal changes and increased levels of glucocorticoids, which can negatively influence testicular function and sperm production.

Studies have indicated that psychological stress may lead to reduced sperm motility, altered sperm morphology, and lower sperm concentration. Additionally, stress-induced oxidative stress can damage sperm DNA integrity, potentially leading to poor embryo quality and an increased risk of pregnancy loss.

While stress alone may not be the sole cause of male infertility, it can certainly play a contributing role. Therefore, it's essential for couples experiencing fertility concerns to address and manage stress levels as part of their overall approach to improving fertility.

Does age affect male fertility?

While the quality of the sperm is not as affected by a person's age, as compared to the quality of eggs, there is increasing evidence to show a slight decline in sperm quality with age.

"Try to conceive early as men aged older than 40 years contribute to reduced fertility and fecundity (maximum potential reproductive ability) of a couple, especially when the female partner is also of advanced age," advises Dr Ee.

"There are also observations that sperm DNA damage is significantly higher in older men and that it is detrimental to reproductive outcomes. In addition, there may be an increased incidence of sexual dysfunction in older men," he adds.

Where to seek treatment for fertility issues

A wife and a husband can both seek help from a fertility specialist. For instance, KKH offers a comprehensive range of fertility treatments for couples wanting to start a family.

According to Dr Ee, treatment of infertility in males largely depends on the cause. He says,

"Should the infertility be due to causes like previous vasectomy (male sterilisation) or recent hormonal or steroid usage, these causes can be reversed."

Men with poor sperm due to chronic diseases such as obesity or diabetes may also often see their sperm improving after optimising their chronic diseases.

"However, causes such as testicular failure, genetic disorders or congenital absence of the vas deferens (long muscular tube that propels sperm into the urethra during ejaculation) are not reversible.

Men with these conditions will likely be recommended to look towards in-vitro fertilisation (IVF) for their best chance at conception," the doctor makes sure to add.

Male fertility test in Singapore

Male fertility tests in Singapore usually include a semen analysis which looks at sperm number, motility (ability to move), morphology (size and shape) and other aspects of your sample.

Another test to consider is Sperm Chromatin Dispersion (SCD) assay, which is designed to detect problems with sperm DNA fragmentation.

Apart from its primary role in fertilising the egg, sperm also has a significant influence on embryo quality, implantation, and successful pregnancies. When sperm DNA integrity is compromised, it can lead to the production of embryos of poor quality and result in pregnancy loss.

Importance of fertility health checks for couples

As we may all know, Dr Ee says age is a very important factor in determining the success of fertility treatment.

For females, fertility potential is highest before 30 years old, states Dr Ee. But it will steadily decline with age, especially after women turn 35 years old.

"After 40 years of age, only 10 to 15 per cent will be able to conceive, even with assisted reproductive technology (ART)," Dr Ee says.

"Therefore, the success rate of a woman at or over 40, having a baby through natural conception is even lower."

The doctor stresses how time is really crucial if you're trying to conceive.

"It is important for couples to seek a fertility health check because couples who are healthy may not mean that they have good fertility health," he shares.

"Instead of waiting till it is too late, just in case there are underlying issues causing fertility conditions, the couple should seek help early," adds Dr Ee.

It is also advised that couples seek specialised medical attention if they do not conceive after one year of regular intercourse without the use of contraceptives.

"Couples above 35 years of age who have not been able to conceive after six months, even though they have been having regular intercourse without the use of contraceptives, may want to seek specialised medical attention," concludes Dr Ee.

How to increase sperm count and improve male fertility

Aside from knowing the early signs of male infertility, it would be helpful to know how you can avoid it from the get-go. When asked what husbands can change in their daily lives to avoid fertility issues, Dr Ee gave the following tips:

Avoid smoking, alcohol consumption and taking drugs

Quitting smoking and drug abuse, and reducing alcohol consumption or abstaining from it altogether can positively impact sperm health.

Ensure you have a healthy body mass index

To optimise sperm quality and improve fertility, it is essential for men to maintain a healthy body weight through a balanced diet and regular physical activity. By doing so, men can increase their chances of successful conception and contribute to the overall well-being of their future offspring.

If you're looking to improve your sperm count naturally, here are additional steps you can take:

Exercise regularly

Engage in moderate exercise to promote overall health and hormone balance, which can positively influence fertility.

Eat a balanced diet

Consume a diet rich in fruits, vegetables, whole grains, and lean proteins to provide essential nutrients for sperm health.

Be mindful of your choice of clothing

Avoid wearing tight trousers or underwear, as sperm production is optimised at a slightly lower temperature than the body's normal temperature. So, give your scrotum some breathing room.

Manage stress

Practice stress-reduction techniques such as meditation, yoga, or spending time outdoors, as excessive stress can affect sperm production.

Take antioxidant supplements

Consider taking antioxidant vitamins such as vitamin C, vitamin E, and CoQ10, which may improve male fertility by reducing free radicals that can damage sperm cells.

Remember, it's always essential to consult with a healthcare professional before starting any new supplements or making significant lifestyle changes to ensure they are appropriate for your individual health needs.

If you and your partner are seeking assistance to conceive a baby in Singapore, you can explore the various fertility treatment options available. There are specialised fertility centres that diagnose, treat, and support couples dealing with fertility issues.

ALSO READ: Basic ovulation test kits: All you need to know about using OPKs

This article was first published in theAsianparent.