As we are entering November, Men’s Health Awareness Month, it's time to take a deep dive into a topic that is often not given the necessary attention - the struggles, causes and treatment of male infertility.

Many couples that are ready to start a family with their significant other find themselves struggling to get pregnant. Worldwide this number lies at around 15% which means that almost 50 million people around the globe are struggling with infertility, making it a very prominent subject in our society.

For years, the sector of Assisted Reproduction has tried to help couples with difficulty conceiving, offering many different options for diagnosis and treatment. But it is true that a disproportionately large focus lies in discussions about female fertility only. Something very counterproductive, as we are told by senior embryologist Dr Llanos Medrano from IVF-Spain. She explains that according to international data almost 33% of infertility cases are due to the male factor and that a correct diagnosis of both partners is the key to a successful treatment.

But what should you do when you suspect that the reason you and your partner can't conceive might be due to your sperm quality?

Step 1: See a specialist!

The very first step to knowing if your sperm quality is compromised is to make an appointment with a specialist with the intent of getting a diagnosis. The sooner, the better.

If you feel uncomfortable going by yourself, your partner will most likely be happy to accompany and support you.

Step 2: Diagnosis

There are many different causes for male infertility. Some of the most common are the following:

• Hypothalamus or hypophysis disease (Hormonal or genetic alterations affecting the correct development of sperm)
• Post-testicular defects (i.e. obstruction of the seminal ducts)
• Testicular factors (alterations in the production of sperm in the testicles)
• Idiopathic sterility (the concrete cause is unknown)

When talking specifically about the sperm, the medical field distinguishes between the following pathologies:

• Oligospermia: low sperm concentration.
• Asthenospermia: no or poor sperm motility.
• Teratozoospermia: abnormal morphology of the vast majority of sperm.
• Necrospermia: a high number of dead spermatozoa.
• Azoospermia: the total absence of spermatozoa in the seminal sample.

As most of the time, poor sperm quality does not cause evident symptoms, such as pain, it is necessary to perform a spermiogram to receive a throughout diagnosis.

During such a sperm test the embryologists will examine the spermatozoa sample through a microscope to determine its concentration, motility and morphology.

To go a step further, some clinics like IVF-Spain offer advanced seminograms in which in addition to the before-mentioned tests, embryologists, with the help of artificial intelligence to minimize human error, also examine the Sperm DNA fragmentation and Y chromosome microdeletion, among others.

Step 3: Treatment

In many cases of male infertility, the amazing advances in assisted reproduction can help a couple to still be able to become pregnant with their own gametes, only with a little help from the laboratory.

When sperm quality is poor, reproductive techniques for sperm selection such as PICSI, MACS or Microfluidics are performed to obtain the best quality spermatozoa out of the semen sample. This sperm is then used to perform artificial insemination on the female partner, in which the selected sperm are placed directly into the uterus, thus facilitating fertilisation.

Only in cases of severe sperm alteration or additional factors, a couple may have to resort to using a sperm donor to conceive.

As we have discussed in today’s blog post, male infertility, similar to female infertility, can have many different reasons. That is why experts like Dr Llanos Medrano from IVF-Spain insist on the importance of a thorough diagnosis, not only for their female patients but also for their male patients. She mentions that in many cases of couples that have not been able to get pregnant after a year of unprotected intercourse, the male factor has not been analysed or even considered yet.

That’s why, during this year’s Men’s Health Awareness Month, we want to tell you: There is no shame in getting help and finding the right diagnosis! There is also no shame in making use of Assisted Reproduction to make your dream of becoming a parent come true.

If anything, it is a sign of strength and love for your partner!
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