Infertility Isn’t One-Sided: How Male Health Matters

Infertility is primarily, if not exclusively looked upon as a female condition, after all, it is the woman who carries the baby. But we know that conceiving takes two, and we have seen couples where the problem has been with the mail.

Young couple embracing warmly.

Typically the male is investigated much later down the road, if he shows up at all. I would say that the bigger issue really is investigating the couple together. But how much of the problem is from the male, and what can we do about it?

So, what do statistics tell us? About 35% of couples will have both a male and female issue as the cause, and another 20% of the cause at the center of the infertility is exclusively of male origin.

So given what we know, it would make sense to perhaps eliminate the 20% first off and then concentrate on figuring out what the other issues might be.

Couple admires Matisse painting of dancing figures.

The specific male investigation to pursue can be summarized in one test, and that is semen analysis. And within semen analysis, there are quantitative test results and interpretation that will be the subject of another discussion.

But as will be made clear a “normal” semen analysis in practice confirms male potency. But as stated, one of our biggest obstacle to getting the answers that we seek is persuading the male partner to get tested. Frequently the response is that the partner already has many children or children by a previous partner or partners. Again, that’s another subject for discussion at a later date.

Broadly, without getting into the numbers in these tests, semen analysis looks at the sperm count, movement of sperm, and the shape of sperm. It also looks at the color of the ejaculate, viscosity, that is the “thickness” or otherwise, and the pH of the semen. It also checks for unusual findings such as white blood cell counts, which could be indicative of an infection.

Pregnant woman in maroon dress embraced by partner, both hands on belly.

What the infertility experts focus on, however, are the count, the movement and shape of the sperm. If the count is low, intuitively, it indicates that the chances of fertilization will be correspondingly less than optimal. And if this person are not moving, that is the motility of the sperm, the chances the sperms would move from the vagina, through the birth canal, through the cavity of the uterus into the fallopian tube to fertilize the egg released by the female is also much reduced. And finally, if the sperm had a lot of abnormal forms such as abnormal heads, this abnormality could also reduce the chances of fertilization.

Overall, to recap, I would say that the most important thing of these three is sperm motility or movement. Even if the count is low, because it only takes one sperm to fertilize an egg, if the sperm can move, the chances are low, but not zero. And if there is a large count, but abnormal forms are plentiful, the few normal forms could still do the job. But if sperm are not able to move from the vagina then regardless of their numbers, the chances of pregnancy become much worse.

The leading sperms travel from the vagina to the fallopian tubes in just a few minutes, meaning 5 to 10 minutes. However, the functional process that leads to fertilization take much longer. And the sperm have to get there to do the job.