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Natural Conception All things fertility Male fertility 101

Male Fertility

How to increase sperm count

Sweeping generalisation here but many blokes we know are solutions oriented and will take a good bullet point list over the essay version any day. So, here’s the summary and we promise there won’t be a quiz on the finer points … or will there be? You can scroll down to read more.

40%25 of infertility issues come from male infertility

Male infertility is behind 40% of infertility.
Healthy sperm is key to creating a pregnancy.
The sperm needs to be able to get out of the man’s body and into the woman’s body and make it to her eggs.
A sperm test is a quick and easy way to check your fertility.
Simple lifestyle changes might be all that’s needed to get you back on track if things aren’t working.
If there’s a bigger issue, we’ve got treatments that can help.

Are you keen to know more? Here are our top tips for sperm health.

Here’s your 101 on how the male reproductive system works

Most of a man’s reproductive system is located on the outside of the pelvis. This includes the penis, the scrotum and the testicles. The important bits inside are the epididymis, the vas deferens and the urethra.

For a couple to get pregnant naturally, the penis needs to ejaculate semen into the woman’s vagina. Semen is a viscous, creamy, slightly yellowish or greyish substance made in the testicles (also known as the testes) which is usually made up of spermatozoa - commonly known as sperm – plus a fluid called seminal plasma which is designed to help the sperm survive.

When the sperm is produced in the testes it is still immature and not yet ready to fertilise any eggs it meets. So, it travels slowly through the coiled channels of the epididymis on the way to the penis, maturing and growing as it goes. Once it is mature, the sperm moves into the vas deferens, a tube which connects the epididymis to the ejaculatory ducts just behind the bladder.

During sex sperm move to the urethra – a tube running from the bottom of the bladder to the tip of the penis - in readiness to be ejaculated. At this point, urine is blocked from the urethra so only semen is ejaculated.

From that run down, you can see that there are a few areas which could cause a problem with fertility and getting pregnant.

When it comes to conception, if there is a problem, many assume there is an issue with the woman’s reproductive system. But male infertility is real, and it is more common than you might think.

In about 40% of cases where couples have trouble conceiving, the problem lies with the man – usually the quality or quantity of sperm.

When the difficulty getting pregnant is due to male infertility, the problem could be:

Obstruction or absent vas deferens (tubes)
Low sperm count and/or poor sperm production
High numbers of abnormally shaped sperm
Absent sperm production
Anti-sperm antibodies
Sperm DNA fragmentation
Genetic diseases such as cystic fibrosis or a chromosomal abnormality
Previous vasectomy

Sperm health

Top tips for improving sperm health

Maintain a healthy BMI as being overweight can affect sperm quality.
Don’t smoke or take recreational drugs, both can affect sperm health and can impair sex drive. Partners of male smokers also have an increased risk of miscarriage.
No more than eight standard alcoholic drinks per week.
Some prescription medications can affect sperm health, check with a GP.
Eat well. A healthy balanced diet will provide the body with all the essential vitamins and minerals it needs to encourage healthy sperm production.
Regular ejaculation helps increase the quality of sperm. Have sex two to three times a week.
Warm temperatures might affect the testis' ability to make sperm. For safety, avoid spas, saunas, hot baths and putting a laptop on your lap.

^*Applicable for Medicare eligible patients. No-out-of-pocket Fertility Assessment is for an initial virtual consultation with our Fertility GP. Additional costs may be incurred for fertility investigations.

Yep, it’s that awkward moment that we’re talking about. When you provide a sample to our scientists, this is what we’re looking for:

Number and movement (aka concentration and motility). A healthy ejaculate has over 40million swimmers with at least half of them moving normally. If a man isn’t producing enough sperm, it significantly lowers the chance of conception.
Shape (aka morphology). A healthy sperm has an oval head and a long tail to help it swim like a champion. Sperm with abnormal shaped heads or curled/double tails are less likely to fertilise an egg.

A more detailed look at sperm can also include testing DNA:

The genetic information (DNA) carried in the sperm head needs to be healthy. If there’s DNA damage, the embryo might not develop properly, and there’s a risk of miscarriage. A regular turnover of sperm leads to less DNA damage, regular ejaculation is important so, in this case, thinking sexy thoughts can help.

Sometimes the number, movement, shape and DNA are all healthy, but the man’s immune system accidentally makes anti-sperm antibodies which prevent the natural binding between sperm and eggs (doh). We can test for that too.

Look, we know this isn’t going to be the top of your Christmas wish list, but a physical examination is pretty important to check for physical issues such as:

Undescended testis - This is when the testis has not reached its normal position in the scrotum which stops it from functioning properly and may stop it from producing sperm.
Testicular size – testes that can only hold a small volume are associated with poor sperm production.
Whether the tubes that carry sperm from the testes to the outside world are present or not.

Book a sperm test

If you and your partner have experienced recurrent miscarriage  or one or both of you have a genetic condition in your family, your Fertility Specialist may review both partners for chromosome abnormalities. If the blood tests detect abnormalities, your Fertility Specialist might discuss with you our genetic screening and testing options - Pre-implantation Genetic Diagnosis or Pre-implantation Genetic Screening.

Even without any obvious family history, anyone planning pregnancy should consider having testing to ensure that you don’t carry the same quiet genetic (recessive) condition as the person you plan to get pregnant with. Many of us carry one recessive condition which in itself doesn’t cause disease, however, if both people carry the same recessive gene (examples include cystic fibrosis and spinal muscular atrophy) – then you have a 1 in 4 chance of having a baby with a serious medical disorder. Your Fertility Specialist will offer this testing which is undertaken by an external pathology company.

Your Fertility Specialist or GP may order an ultrasound to check for:

Obstructions – which prevent the sperm from leaving the male reproductive system.
Scrotal varicocele - large veins (aka varicose veins) wrapping around one or both of the testicles which may impair the ability of the scrotum to cool down. This can seriously affect sperm quality.
Any pre-cancerous change in the testes – men with very low sperm counts have a higher risk for this.

Download andrology costs (PDF)

Genea Fertility Specialist Dr Derek Lok on male factor infertility

Check out our award winning Modern Babies podcast.

FAQ

Causes of male infertility

When we test sperm to see if it is normal or abnormal, here’s what we’re looking for:

Number and movement (aka concentration and motility)

A healthy ejaculate has over 40 million swimmers with at least half of them moving normally – in the right direction and at the right speed. If a man isn’t producing enough sperm, it significantly lowers the chance of conception.

Shape (aka morphology)

A healthy sperm has an oval head and a long tail to help it swim like a champion. Sperm with abnormally shaped heads or curled/double tails are less likely to fertilise an egg.

Quality

The genetic information (DNA) carried in the sperm head needs to be healthy. If there’s DNA damage, the embryo might not develop properly and there’s a risk of miscarriage. A regular turnover of sperm leads to less DNA damage, regular ejaculation is important so, in this case, thinking sexy thoughts can help.

Occasionally an ejaculation sample will be normal but the immune system – belonging to either the man or woman - makes anti-sperm antibodies which block the natural binding between sperm and eggs (doh) We can test for that too.

Other issues that can come up are:

Obstruction

Sometimes, sperm hit a proverbial brick wall on their way out of a man’s body. In this case, no sperm will be seen in a semen sample. Some men are born without the tubes (vas deferens) that carry sperm from the testicles while others might have a blockage because of an infection or surgery.

Absent sperm production

In some men, the amount of sperm produced by the testicles is so low that none appears in the ejaculation at all. This is commonly a genetic issue but sometimes we can find sperm using a minor surgical procedure on the testicles. That sperm can then be used in IVF to fertilise the partner’s eggs.

Unexplained

For many men the reason for changes to a normal sperm test cannot be explained. Some of the possible baby-making meddlers are genetic disorders, undescended testis, infections, heat, drugs or radiation damage are known to disrupt the production of healthy sperm. While some of these issues can be reversed, in many cases there are no treatments to correct poor sperm production so the man and his partner will need to have fertility treatment to achieve a pregnancy.

In about 40% of cases where couples have trouble conceiving, the problem lies with the man.

Regular ejaculation can help improve the quality of sperm. Have sex two to three times a week.

Doctors suggest no more than eight standard alcoholic drinks per week.