The Less Spoken Aspect of Infertility

For many couples trying to conceive, the thought that it could be an issue with the husband is hard to fathom. Dr. David Robertson, Consultant in Reproductive Endocrinology and Infertility and Group Medical Director at Bourn Hall Fertility Centre answers the most common questions surrounding male infertility.

How common is it for male sperm to be the key reason for a couple’s infertility?

“A male factor is present in about 60 percent of the couples we see who are trying to conceive. In half of those, it is the main problem present and in the remainder, there is a problem with both partners.”

Why is there such a stigma attached with the man’s sperm being “problematic?”

“There is a view that a man is less ‘masculine’ if he has difficulty in impregnating a woman for whatever reason, which is of course not true. Fertility can be quite separate from masculinity or sexual performance but in many more traditional or old-fashioned cultures, the two are seen as the same thing. However, attitudes here have changed greatly over the last few years and male factor infertility is dealt with much more openly than before.”

How is this diagnosed? 

“It really depends on the problem. Minor problems with sperm quality will sometimes resolve with lifestyle changes and medication, particularly if there is a hormone deficiency. In other cases, surgery may be needed, either to repair an abnormality or to retrieve sperm that can then be used for specialized fertility treatment which is something men can do in a fertility clinic. In many cases, treatment such as ICSI, where a single sperm can be injected into a female egg, will allow conception to occur even with very reduced quantity or quality of sperm.”

What are some important lifestyle factors?

“As with other health issues, however, there is still a general reluctance to accept that lifestyle influences fertility. Worldwide, we are seeing an increase in obesity, high blood pressure and diabetes, and these all have an influence on sperm quality. Smoking is also prevalent among men in this region, and again, this has a marked effect, particularly causing an increase in abnormal sperm.”