Male infertility is the cause of about 30% of all infertility cases. Yet, most discussion surrounding fertility is centered on women.

This stigma can prevent men from being proactive about their health and getting treatment. The emotional toll of infertility can also be isolating, leading men to stay silent instead of reaching out for support.

At Dr. Tanya’s Fertility Centre, we think it’s time to invite male fertility into the conception conversation.

About 1 in 6 couples experience infertility in Canada. The problem could be caused by male infertility, female infertility, or both.

Many times, the focus is put on the woman’s health. However, a man’s fertility also plays a large role in conception. Some research suggests that up to 50% of conception problems are caused by male factors but estimates vary. The Public Health Agency of Canada says that out of all infertility cases:

• 3 out of 10 are linked to causes in men
• 4 out of 10 are linked to causes in women
• 2 out of 10 are linked to causes in both men and women
• 1 out of 10 are unexplained

The most common cause of male factor infertility is varicocele—dilated scrotum veins. This affects sperm production. It can cause decreased sperm quantity and quality.  It affects 15% of all men in the general population, and 50% of all infertile men.  It can be repaired surgically or by a procedure called embolization, but improvement only happens about 50 – 70% of the time after this repair procedure.

The average sperm count has also dropped over the decades, which may impact fertility if sperm quality is also low. Given this, couples who are trying to conceive should equally consider male fertility.

Infertility can be a taboo topic. As we continue to raise awareness about the struggles of female infertility, we need to talk about men too.

Even though sperm problems are a common cause, male infertility is often left behind in discussions about conception. This is a problem for two reasons: men struggle in silence and there’s less awareness around their health factors.

Talking about male factor infertility helps us break the stigma surrounding it.

 

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Facebook co-founder Mark Zuckerberg opened up about his struggles with infertility and miscarriage as he was expecting his baby girl.

“You worry your problems will distance you or reflect upon you — as if you’re defective or did something to cause this,” he wrote in a Facebook post.

While women are often portrayed as having “baby fever” and dreaming of a family, many men have the same goals. Although it may not be a typical topic of conversation, many men hope to have a family too. When fertility becomes a concern, they can be equally as devastated.

Singer John Legend and his wife model Chrissy Teigen struggled to start a family until they tried IVF. He said the process, “deepens your love for your partner because you see them in a different light going through, in our case, the trouble of actually having a kid.”

 

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When most people think about male factor infertility, the first thing to come to mind is probably low sperm count. That’s likely because it’s the most discussed cause. However, male infertility is either caused by a defect in sperm production (quantity or quality), a defect in sperm transport, or a problem with sexual function, such as erectile or ejaculatory dysfunction.

Although sperm count could be a reason, there are many factors that determine the overall quality. The WHO defines abnormal sperm parameters as follows:

• Low sperm concentration/count: Fewer than 15 million sperm per milliliter. About 10-15% of infertile men have no sperm.
• Poor sperm motility: < 40% motility; The majority of sperm move slowly and may not reach the egg.
• Abnormal morphology: < 4% normal morphology. A large number of sperm have defects and are misshaped (large head, double tail, etc.).

Any of these problems can lead to suboptimal sperm that are less likely to be able to fertilize an egg—experienced by as many 2% of men. 1 in 100 men in the general population have no sperm production.

To improve or maintain male fertility, there are a few lifestyle changes that may help.

When taking stock of habits, consider these facts:

• Smoking can deteriorate sperm quality
• Alcohol intake affects semen volume, sperm motility, and sperm morphology
• Recreational drugs like cocaine, steroids, and opiates may impair sperm function
• Men who are obese have more sperm with DNA fragmentation and abnormal morphology
• Psychological stress may lower sperm concentration and increase the likelihood of abnormal morphology

Although these factors may not solely cause infertility, they could make conception less likely. Semen quality has been linked to overall health.

Whether a man wants to start a family now or in the future, he can be proactive about his fertility.

Some men can have children into their 70s or later, but like women, a man’s fertility also declines with age. One study showed that semen quality peaked between ages 30 and 35 and the most significant reduction in sperm quality and quantity occurred after 55 years of age.

Men that want children later in life can plan ahead by using a sperm banking service.

Another reason to be proactive is if you’re going through any medical treatments that could affect your fertility later.

Even if you’re young and in good health, you can ask your doctor for a sperm test to be sure. In many cases, if you discover a problem early, you can be proactive about your fertility.

If you suspect fertility issues, you can get a semen analysis. To check for other issues, your doctor may ask you about past testicle injuries, examine for hormone problems, or order genetic testing.

Over half of male infertility cases can be treated. Treatment depends on the cause, which can include surgery to repair damage or medication to improve hormone imbalances and other problems.

When male fertility can’t be corrected, you can consider assistance, like insemination or IVF.

Men tend to have difficulty asking for emotional support, especially if they feel guilty about their fertility being the problem. This can lead to an isolated journey. One way to counteract this is to seek support online.

Studies show that when men use online groups for infertility support, they experience emotional benefits. They reported feeling less isolated, hopeless, and depressed.

To get started, check out these male factor infertility Facebook support groups:

• Fertility Matters – Men’s Support Group by Fertility Matters Canada— Open to all men struggling to build a family.
• Men’s Fertility Support – IVF/IUI/ICSI— A male-only group to talk about journeys with IVF, IUI, ICSI, or miscarriage.
• TTC with Male Factor Infertility— A safe space to share stories and ask questions.

Male Factor Infertility— For those trying to conceive with sperm issues, morphology, volume, etc.

There is less focus on male infertility, but it’s a common cause for couples struggling to conceive. The stigma surrounding male infertility can make it difficult to ask for medical help or emotional support.

If you think you’re experiencing problems, remember that you’re not alone. Fertility specialists at Dr. Tanya Williams Fertility Centre can support you on your journey.

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