Dr. Williams Answers Your Most Burning Questions About Male Fertility

Just like women, most men find out about fertility problems only after they’ve been trying to conceive a child. A couple is considered infertile if they cannot achieve pregnancy after a year of unprotected sex. However, it’s important to watch for certain common symptoms of male fertility issues. 

The most frequent signs of mail infertility include problems with sexual function, such as altered sexual desire, erectile dysfunction, or ejaculation issues. Men should also speak to their doctors if they feel pain or bumps in their testicles, experience decreased facial hair, or have a low sperm count. 

A man is considered to have a low sperm count if they have less than 15 million sperm per millilitre of semen. A normal sperm count of conceiving ranges from 15 million sperm to more than 200 million sperm per millilitre (mL) of semen.

Infertility is more common than you might think. One in six couples experiences infertility, meaning they can’t conceive after a year of trying to get pregnant. Men are the cause of infertility in 30 percent of cases, according to Health Canada.

“ In my practice, I see an equal number of instances in which the male partner has an issue as those in which the female partner has an issue,” says Dr. Williams. “Generally, the literature states that ⅓ of the time, it is a female factor, ⅓ of the time it is a male factor, and ⅓ of the time it is both.”

Most cases of male infertility stem from problems with a man’s sperm production or delivery. The International Federation of Gynecology and Obstetrics has found several factors that impact success while trying to conceive. Common factors include obesity, smoking, nutrition, sexually transmitted infections, high testicular temperature, genital injuries and age. Although many men can father children later in life, research shows a man’s reproductive potential drops sharply after 35.  

Dr. Williams recommends the following steps for men to boost their fertility:

• Quit smoking; 

• Reduce alcohol intake to a maximum of 5 or 6 drinks per week; 

• Quit using marijuana as it can reduce sperm production; 

• Maintain a healthy diet – some evidence suggests that the Mediterranean diet may be helpful ; 

• Consider taking antioxidants to improve sperm quality;

• Avoid soy products which contain “phytoestrogens” that are associated with lower semen quality; 

• Exercise with moderate intensity 5-7 days per week for 30 minutes each time; 

• Get enough sleep – 7-8 hours per night; 

• Minimize caffeine – consume no more than  2 caffeinated drinks per day; 
• Minimize stress by practicing self-care, such as yoga, meditation, walking, spending time with your partner and/or friends; and
  
• Have sex with your partner 2 or 3 times per week.  

Studies have shown that long-term exposure to smartphones does reduce a man’s sperm count, motility and viability. Research from the Cleveland Clinic Foundation of Ohio found that keeping your phone in your pocket for more than four hours impacts a man’s testes’ health and the overall sperm quality. So if you’re trying to conceive, it consider keeping your phone out of your pants pocket.

“At our Fertility Clinic, when a couple comes in for consultation, we encourage investigation of both partners,” explains Dr. Williams. “Specifically for the male partner, once a complete history is taken, we recommend bloodwork to look at hormones and viral serology. We request a urine sample to rule out sexually transmitted infections, and 2 semenalyses to look at semen volume, sperm concentration, sperm motility, normal morphology, and sometimes sperm antibodies.”

Dr. Williams adds that “it is important to get more than one sample because semen parameters can change over time, so a comparison of at least 2 samples gives a more accurate assessment.”

 “We also request a sperm chromatin assay to look at sperm DNA fragmentation. This can tell us something about a man’s ability to fertilize an egg.  Depending on risk factors, further tests may also be ordered, including genetic testing, cystic fibrosis screening, scrotal or transrectal ultrasound.”

You can often address most fertility issues in men with medication or surgery. Couples often conceive without any other interventions after these treatments. Additionally, a fertility specialist can assist with conception through various assisted reproductive techniques.

Treatment options include taking antioxidants; using antibiotics for infection; administering hormonal medications to improve testosterone levels and sperm production; receiving a referral for surgery; undergoing artificial insemination (IUI); choosing in vitro fertilization (IVF) with intracytoplasmic injection (ICSI), with or without testicular sperm extraction; opting for donor sperm insemination; and if all of this fails, adoption.