I see this all the time: women coming to our clinic assuming something is wrong with their tubes as they are having trouble conceiving. It may be true for some women, yet in about a third of all cases fertility specialists see, the infertility problem is caused by the male partner.

What it means is that one-third of infertility cases are caused by male reproductive problems, one-third by female reproductive problems, and another third by a combination of female and male reproductive problems or by unknown factors.

So if you and your partner have been trying for a baby for over a year and you’re under 35, it is wise to book an appointment with a fertility specialist. If you are over 35 we recommend booking your appointment earlier, after 6 months of trying that is.

Unfortunately, male infertility can not be pinned down to a single cause. Some of the underlying causes of fertility challenges in men are:  

• Lifestyle factors such as drug and alcohol use.
• Being exposed to environmental toxins.
• Semen and sperm issues, such as a lack of sperm in your semen, sperm that are not moving properly and sperm with an abnormal shape, making it harder for them to move around.
• Issues with the testicles; if they are damaged, it may affect the sperm quality
• Ejaculation issues.
• STIs.
• Hormonal issues, for example low testerone levels.
• Medical causes, for example varicocele, infections, antibodies that attack the sperm, tumours.
• Medication use; certain types of drugs may affect your sperm quality.

It’s key to make an appointment at your earliest convenience, as the investigations may take quite a while.

The women’s health GPs will do an initial assessment. Sometimes it turns out you only have to change a few habits such as unhealthy eating, smoking or drinking too much alcohol. In other cases, you will be referred to me or one of our other fertility specialists for fertility treatment.

Either way, you will save time! If you are seeing our GPs first and have done all the necessary fertility testing to then be referred to me or a colleague, you will not have lost time waiting for fertility tests as we have already planned them after our very first consultation.

You will be asked to provide a semen sample which will then be sent off to the lab for analysis. If we cannot find sperm in the semen sample, we may do a testicular biopsy to collect sperm directly from your testicle. 

As part of a fertility analysis, you will also provide a urine sample which will be tested for chlamydia.

We may also do some blood tests to check your general health.

The most common blockage that causes the absence of sperm in semen is when you’ve had  a vasectomy. In some cases, this procedure can be reversed.  Other examples of obstructive azoospermia are retrograde ejaculation (when the ejaculate ends up in your bladder), spinal injuries or infections. 

If you have obstructive azoospermia, you may need a testicular biopsy called TESA. It’s a technique to collect sperm from your testicle. Once we retrieve healthy sperm, you will then embark on an in vitro journey as a couple (ICSI).

This means the lack of sperm in your semen is not caused by a blockage. It means that something else is preventing your testes from creating normal sperm. There are many possible causes:  Varicocele, testicular cancer, some genetic syndromes, undescended testes etc. 

If you have non-obstructive azoospermia, you may need Micro TESE which is a very specific surgical procedure under full anaesthetic.

Even in 2022, infertility is often silenced; some of us won’t talk about it and feel ashamed. That is absolutely a shame, pun intended. Did you know that one in six couples experience fertility problems? You are not alone. So don’t feel embarrassed or guilty. It’s not your fault if you have a medical condition preventing you from falling pregnant. 

So make a booking with me or one of our other male infertility specialists and let’s talk. My team and I have helped hundreds of families and we look forward to helping you.