What is male infertility?

Male infertility arises when a couple cannot conceive because of a physical or hormonal problem that lies only with the male partner. The woman in the partnership has no infertility issues and could become pregnant with a different male partner.

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Male infertility accounts for around a quarter of all cases of infertility. Another 25 % are due to female infertility while the remaining 50 % are due either to a combination of female and male infertility, or to unexplained infertility.

The factors that cause male infertility fall into several broad categories:

  • The inability to have an erection or to have one that lasts long enough to have penetrative sex. This can be due to the man’s age;  erectile dysfunction is common over the age of 40. It can also be due to injury or disability.
  • The inability to ejaculate: many men experience delayed ejaculation, which may have an emotional cause. Some ejaculate, and instead of the semen going forwards into the penis and into the female partner, it travels backwards and ends up in the bladder. This is retrograde ejaculation. Fortunately, sperm can be retrieved from the bladder fairly easily for use in intrauterine insemination (IUI), in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI).
  • Problems with sperm production: sperm may be absent completely, in short supply or poor swimmers.
  • Physical abnormalities: the tubes that carry sperm from their site of production into the penis, where they mix with the secretions that form semen, can be blocked. This can be due to a condition present from birth, such as cystic fibrosis, or can be caused by infection, or something pressing against the tube, such as a tumour or a swollen varicose vein.

Male infertility, also called male factor infertility should be investigated by an andrologist, a specialist in male reproduction. However, some of the infertility treatments that can overcome male infertility can only be offered by IVF specialists, who are usually gynaecologists who specialise in treating female reproductive problems. So, male infertility is unusual in that it can require an andrologist and a gynaecologist to work together in a multidisciplinary team to solve the infertility problem.

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