Fertility problems often lead to much stress and anxiety to couples. These problems also increase for both genders as we age. General risk factors for fertility issues include advanced age, diabetes, stress, smoking, excessive alcohol intake and a sedentary lifestyle. A detailed workup including a history, physical examination and investigations of both the female and male partner is required to ascertain the cause of infertility.

When a couple is unable to conceive a child, the cause is often attributed to the female partner. However, up to half of infertility cases are due to male infertility issues. Men with infertility often do not present with any signs or symptoms though occasionally some men would notice erectile dysfunction or pain and swelling around the testes.

There are numerous causes of male infertility, most of which reduce the amount of sperm or the quality of sperm produced. Conditions affecting the testes like varicoceles, growths and infections can lead to low sperm count and poor sperm quality. Hormonal issues with low testosterone production can also adversely affect sperm production. Men with chronic illnesses on long term medications like steroids and painkillers can also have problems with fertility. Rarely, genetic diseases and undescended testes can also result in male infertility.

Investigations for men would usually include blood tests for hormone levels are general health, STI screening to look for infections, imaging scans like ultrasounds of the testes and semen analysis to look for issues with the sperm.

Treatment would again largely depend on the findings during the work up for male infertility. However, first and foremost is that the individual should lead a healthy lifestyle free of smoking and excessive alcohol drinking together with regular exercise. Any infections found must be treated with the appropriate antibiotics or antiviral medications. Endocrine problems with hormone imbalances would need to be corrected with hormone replacement or medications. Erectile dysfunction must not be neglected as well even if semen analysis is normal. Sometimes surgery is indicated for treatment for example varicocele surgery or the removal of testes tumours.

Do consider speaking to our doctors for more information on this topic.