Male Infertility FAQs

It’s often difficult for men to talk about infertility, so here’s the answers to some of your most common worries.

Male infertility is not widely understood. Some men are told they will never be biological fathers, but the reason for their infertility may be treatable, according to Mr Oliver Wiseman, Consultant Urologist at Bourn Hall. You can hear Mr Wiseman talk about male infertility on our video.

Below are some common questions about male infertility. You might want to consider a consultation with one of our specialists, or to book a fertility health + wellbeing check – after a few quick tests at our clinic, you’ll be much better informed.

Low sperm count

Making sure you’re in the best of health will boost your fertility as stress and lack of sleep  can affect your hormone levels. Being overweight will reduce sperm production, while smoking harms sperm and can reduce your sex drive.

Regular exercise and eating a healthy, balanced diet helps maintain an ideal body weight, improves the health of the reproductive system and boosts the male fertility hormone testosterone. Foods that are rich in antioxidants, vitamins C and E, and minerals such as zinc are particularly good, as they increase sperm count and motility (movement). These nutrients can be found in nuts, seeds, citrus fruits and green, leafy vegetables.

Very few sperm are required for IVF with ICSI, the procedure in which a single sperm is injected directly into an egg to fertilise it. This would save on cost and patient inconvenience, and should be discussed with your consultant.

Cycling

Yes. Regular and prolonged cycling on hard bike seats can affect the nerves and blood vessels to the genitals by putting pressure on the perineum, so it’s best to use a gel seat to cushion this part of the body. Also, overheated testicles can temporarily lower sperm counts, so try to avoid tight underwear, saunas and  hot baths when trying to conceive.

Cystic Fibrosis

Male infertility in an otherwise healthy person needs to be properly investigated, as it may be the result of an underlying health condition that needs treatment. Sometimes a healthy carrier of cystic fibrosis may have a blockage or absence of the vas deferens – the muscular tubes that transport sperm from the testes towards the penis – which prevents sperm from exiting the body. In this case, sperm can be collected surgically,  but the patient’s female partner should also be tested for the disease so that the chances of the couple having a baby with cystic fibrosis can be discussed.

Swollen testicle veins

This condition is called a varicocoele and it could affect fertility, as it may reduce sperm production. However, often all that is needed is a small operation to correct it, which may improve the sperm count and potentially restore natural fertility.

Blood tests

If no sperm is being produced by the testes, a blood test could show whether that’s a result of a genetic condition or hormonal imbalance.

The most widely known genetic test is karyotype analysis. This looks at the size, number and shape of the chromosomes to rule out conditions such as Klinefelters syndrome, which is caused by an extra X chromosome.

We would also recommend a Y chromosome microdeletion blood test. If a problem is detected with this chromosome, there is a chance it will be transferred to any male baby you may have, and this needs to be discussed. Both tests can be done at the same time.

No sperm in ejaculate

In many cases, yes. For men with no sperm, for example those who have had chemotherapy, have small testes or abnormal hormone levels, it may be possible to retrieve sperm surgically.

If the cause of no sperm in the ejaculate is a blockage, a procedure called PESA (percutaneous sperm aspiration) may be performed. This involves inserting a needle into the scrotum to remove liquid from inside the epididymis where sperm are stored. It takes about 20 minutes under local anaesthetic and can retrieve immature but viable sperm.

A more invasive form of surgical sperm retrieval, required when there is poor production of sperm, called micro-TESE involves removing small pieces of testicular tissue under general anaesthetic, which is then inspected for the presence of sperm. This is possible even when each testis is very small. Bourn Hall is one of the only clinics in the country to offer this treatment.

We can find sperm in 50% of patients for whom the micro-TESE operation is applicable.

Vasectomy

Around 90% of obstructions seen at the clinic are a result of a vasectomy or an unsuccessful vasectomy reversal.

We recommend that sperm is collected during the vasectomy reversal operation so there is an option for IVF if the reversal is not successful. If the man’s partner is in her late 30s, the chances of natural conception are diminished even if the reversal is successful. In these cases, it might be best to aspirate the sperm in a procedure called a PESA, as described above, and proceed with IVF without reversing the vasectomy.

Very few sperm are required for IVF with ICSI, the procedure in which a single sperm is injected directly into an egg to fertilise it. This would save on cost and patient inconvenience, and should be discussed with your consultant.

Men in a same-sex relationship

Yes we can. However, This is a little more complex in that – apart from needing donated eggs – male same-sex couples also need a surrogate to carry the pregnancy for them.
The Human Fertilisation and Embryology Authority (HFEA) requires that couples who seek surrogacy in the UK (the commissioning couple) must be married or in a stable, long-term relationship. The introduction of civil partnerships has made it easier for gay couples to demonstrate that they comply with this requirement.

Although we can find an egg donor and can advise on the criteria for a suitable surrogate, we are not allowed by the HFEA to locate a surrogate for any couple.

There are a number of surrogacy agencies we work with in the UK that might be able to help, but it could also be someone from your own circle of friends or family.

Your first steps to becoming a parent could be to get in touch with us.