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Infertility is often seen as a 'woman's' problem. However, male factor infertility is the most common reason for IVF in the UK (HFEA, Trends and Figures 2014-2016), accounting for 37% of IVF cycles. This is followed by unexplained infertility (32%), ovulatory disorders (13%), tubal disease (12%), and endometriosis (6%).
The notion that fertility is a woman's issue is not just incorrect, it's also unhelpful. Men are very much part of the equation, whether they are supporting a partner undergoing treatment, struggling with male infertility, involved in surrogacy journeys, or donating sperm to help someone else, to name a few.
Just because a woman tends to undergo the majority of medical treatment in fertility does not mean that men can or should be excluded. It's time to stop talking about fertility as if that were the case.
This post sheds light on various aspects of men's fertility. How it can be assessed and improved, advice and resources, treatment options, and stories from men who have shared them.
In many cases, there is no clear reason why men have poor sperm or quality. However, in some cases there can be an explanation, such as:
Undescended testes in childhood
Sometimes the sperm may be functioning normally but men have difficulty with erection and/or ejaculation.
When the issue is with the quality of the sperm itself, sperm quality can be improved to a degree. Lifestyle plays a role in the quality of sperm and can affect fertility. Some simple ways to improve sperm quality:
Regular breaks if your job involves working in a hot environment. Avoiding hot baths and saunas. To produce the best-quality sperm, testicles need to be cooler than the rest of your body.
Smoking can harm fertility, so stopping is recommended.
Excessive alcohol can also affect the quality of sperm, so reducing intake is often advised.
Certain recreational drugs are known to damage sperm quality (including cannabis, cocaine and anabolic steroids).
A healthy, balanced diet is also essential for keeping sperm in good condition. Feiby Nassan, a research fellow at Harvard's Department of Environmental Health, found that antioxidants and omega-3 fatty acids are key for good sperm production in a 2020 study. “I believe that it is not only, ‘You are what you eat,’ but it is also ‘Your sperm is what you eat,'” Nassan said.
SDF is quite a grey area in the world of fertility care, and the subject of ongoing investigations and debates. Here's what we know (by one of our fertility doctors, Dr Sotirios Saravelos):
Sperm, like other cells within the human body, contains DNA, the genetic material that ultimately merges with that of the egg to create a healthy embryo. The sperm DNA itself can become damaged, leading to what is called DNA fragmentation.
Some DNA fragmentation is expected to be present, but it is thought that abnormally high DNA fragmentation may be associated with some cases of unexplained infertility, recurrent miscarriage, and failed IVF cycles.
Although abnormal sperm DNA fragmentation can predict poorer outcomes, it is not entirely understood what can be done to improve it. Lifestyle changes such as the ones mentioned above (stopping to smoke, improving diet and taking antioxidants) have been shown to help.
Is Sperm DNA fragmentation (SDF) part of routine examinations?
SDF is not generally a routine examination. The ESHRE guidelines on Recurrent Pregnancy Loss state that you can perform this test for exploratory reasons (i.e. to try to explain miscarriages) but it is not routinely recommended.
It is also not part of the routine parameters evaluated in semen analysis, which is performed under the microscope. This is because it examines a different aspect of the sperm, namely its DNA.
Would a poor result influence fertility treatment?
It may explain some poor results, in terms of infertility and miscarriage. Some interventions for the male partner may be considered to improve future outcomes, but these are being investigated and debated at the moment.
Does Apricity offer SDF?
Yes, Apricity can arrange for SDF to be performed in a partner clinic, and costs around £500.
Sperm DNA testing is not advised for everyone and the decision to test (alongside analysis of results) should be discussed with a fertility doctor. A consultation with a fertility doctor can be arranged by getting in touch via our Contact form or by booking a free call with one of our fertility advisors.
HIMfertility is an initiative set up by comedian Rhod Gilbert (see more below) encouraging men to talk about fertility problems while offering resources and support. Their social media pages share the latest on their virtual meet ups, which men can join with their camera on or off.
Stand Up to Infertility: Comedian Rhod Gilbert takes on the subject of male infertility in the BBC One Wales documentary Stand Up to Infertility, available on iPlayer. Rhod hopes to help men find voices, support and humour through the painful struggle of male infertility.
In Me, My Brother, and Our Balls (available on BBC iPlayer), Love Island star Chris Hughes and brother Ben take on male infertility, a topic so many men struggle with but don't talk about. The program looks at the subject with intimacy, honesty and humour, for an insightful and meaningful watch.
My Wife Let Everyone Assume She Was The One Dealing With Infertility, a beautifully-penned, honest piece by actor, writer and musician, Andrew Burlinson, on Romper. Infertility is so often deemed a woman's problem. It's not just incorrect, it's extremely alienating & unhelpful to men.
In the Invisible Man, Fertility Podcast host Natalie Silverman chats to a range of men on their experiences with male infertility as part of Fertility Fest. The audio episode also features leading fertility specialists.
Apricity have also had the chance to hear stories from some of the wonderful men who have been very open about their journeys with male infertility. These include: Toby Trice, It Takes Three and FortyYearOldDad, to name a few.
We are proud to offer a variety of treatments for male gay couples. From IVF for same-sex couples to adoption, click here to access a page that outlines the main pathways and fertility considerations for gay couples. For men considering using an egg donor, the bottom of the page has an FAQ that might be useful.
You might be wondering how fertility assessments for men work, so we thought we'd make a little guide :
Free call with a fertility advisor: This is the first port of call for all Apricity services. On the call, a trained fertility advisor will chat through your needs, answer any questions you may have, and walk through treatment options. A call is completely non-binding, and can be scheduled using this tool.
Collection: Once the fertility assessment is booked, you'll be given instructions on next steps. Usually, you'll be advised to abstain from sexual activity for 2-7 days. Then the specimen can be collected either at home or at a clinic within a dedicated room.
Analysis: The sample is then analysed under a microscope. The main parameters we test for are volume, concentration (number of sperm), motility (how sperm move) and morphology (sperm appearance).
Virtual consultation with a Fertility Doctor: Your results are then explained in detail by a fertility doctor, who can answer questions and discuss any measures that can be taken to improve the sperm quality. If necessary, the doctor can recommend specific targeted treatment.
This service is included in our Diagnostics Packages:
Written by our group of fertility experts and doctors consultants
Written by our group of fertility experts and doctors consultants
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