Medical Monday - An Introduction to Male Factor Infertility
Male Factor Infertility: An Introduction for All
This is a layperson's explanation of male factor infertility problems. I’m giving a disclaimer here; I am not a doctor or clinician.
This is my understanding that has come from having been in the field of infertility for almost twenty-five years and having spoken to doctors, nurses and lab directors so that I could understand things a little better. I tried to write this in plain English as that is how most of us non-clinicians would have a shot at understanding things.
Hopefully you all know how important it is if you are not conceiving and are in a heterosexual, sexual relationship to have both partners tested. We assume, wrongly, that infertility is a “woman’s” problem. In fact, as you will read below, it can often be a male problem and even more frequently, it can be a problem in both male and female that creates the infertility.
So here goes, everything I know, (sort of) about male infertility, semen and sperm.
About Male Infertility and Testing
Male infertility accounts for fully 35% and more of all infertility. Semen analysis is the first and most comprehensive test and is also the most basic; checking the sperm to see its shape, size, count and how it moves.
When giving a sperm sample, it’s vital that you pay attention to the when and how of giving a sample. Some labs ask that you produce (masturbate and ejaculate) on their premises, following their protocols and using their materials (sterile cup, sterile wipe, etc.).
This is not fun. See, I’m not a clinician. It’s not fun. In fact, it can feel humiliating to have to go to the facility, go into a room and have to masturbate into a cup. Some facilities have material (pornography) to help and some facilities give the option (if you live close enough) to produce the sample at home and bring it in. Some men find this tremendously difficult; most men do not. There is the emotional facet as well; the anxiety around whether their sperm is contributing to the problems of becoming pregnant.
Semen Analysis: What Can Be Learned
The amount of information that can be learned from a semen analysis sample is tremendous. An andrology lab looks at the sample under a microscope and can give answers based on the following aspects of the sample.
An andrology lab looks at many different facets of the semen, including color, odor, volume and thickness. They go farther and look carefully at the size and shape of the head and the tail.
The head of the sperm should be a certain size and shape as should the tail. Sperm with too large, too small, tapered or a crooked head may cause a problem. Sperm should also have only one head. Likewise with the tail, it needs to be without any kind of curls or spirals.
Sometimes the lab will see no sperm at all in the semen (Azoospermia). The sperm are in the semen and this can come as a shock to the man/couple that there is no sperm as there is still fluid in the ejaculation. At least one common cause of this is incorrectly providing a sample. Please be very careful about following the directions for providing and transporting the sample. Also, if there is an appointment that needs to be scheduled for the semen to be received at the lab, make sure that you take care of that as well.
If you have done everything correctly in giving the sample to the lab and they find no sperm, please don’t panic.
I repeat, do not panic. This does not mean that conception is impossible or that donor sperm is necessarily needed. It means that you have identified a problem for which there are medical techniques and procedures that can help.
Work with your doctor or doctors and they will help you find the causes of Azoospermia, whether it is a blockage or an infection or even a lifestyle choice.
Sperm is made constantly and sperm counts can be improved.
This is a time to work together and support one another.
There are solutions out there and you can find them.
We’re here to help. If you have any questions, please let me know. I will direct them to the right clinician at RMACT and get the answer.
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About Lisa Rosenthal
Lisa has over thirty years of experience in the fertility field. After her personal infertility journey, she felt dissatisfied with the lack of comprehensive services available to support her. She was determined to help others undergoing fertility treatment. Lisa has been with RMACT for eleven years and serves as Patient Advocate and the Strategic Content Lead.
Lisa is the teacher and founder of Fertile Yoga, a program designed to support men and women on their quest for their families through gentle movement and meditation.
Lisa’s true passion is supporting patients getting into treatment, being able to stay in treatment and staying whole and complete throughout the process. Lisa is also a Certified Grief Recovery Specialist, which is helpful in her work with fertility patients.
Her experience also includes working with RESOLVE: The National Infertility Association and The American Fertility Association (now Path2Parenthood), where she was Educational Coordinator, Conference Director and Assistant Executive Director.