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How to treat male infertility

From fertility tests to increasing sperm count, there are many ways to deal with male fertility issues, says Professor Kerryn Phelps.

You have decided the time is right for you to make babies, but things aren’t going to plan. What do you do?

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For many prospective parents, it is the beginning of a long and often physically and emotionally painful process of fertility testing and treatment.

When it comes to problems with fertility, sometimes it is a female factor, sometimes there is a problem with both male and female, and in about a third of cases the problem is with male fertility.

Because most fertility testing and procedures for women are more invasive than those for men, we usually begin by ruling out or treating the male factor fertility issues.

Male infertility refers to being unable to conceive, most commonly due to low sperm count, sperm problems such as poor form or motility, or a blockage in the tubes obstructing the passage of sperm.

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Sperm quality is described in terms of sperm count (the number of sperm in a semen sample), sperm motility (how well the sperm move) and sperm morphology (whether their shape or form is normal).

Addressing male infertility is a process of working out the nature of the problem.

There are many causes of male factor infertility, including hormonal issues, nutritional deficiencies, unhealthy lifestyle, overheated or abnormally formed testes, damaged testes, prostate inflammation and erectile dysfunction.

The man’s GP will arrange initial tests, including a semen analysis to assess sperm quality, blood tests for hormone levels and a general physical examination. He will then be checked for sexually transmissible infections, such as chlamydia.

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If there is a problem with the sperm analysis or a structural problem, he may be referred to a fertility specialist for further investigation, such as testicular biopsy.

Decisions will then need to be made about how best to achieve a pregnancy and this may involve various assisted fertility techniques.

Improving male fertility

Some lifestyle measures can improve your chances of a successful pregnancy.

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Quit smoking tobacco or cannabis: Smoking lowers sperm count and reduces sperm motility. Cannabis lowers sperm count and increases the number of abnormal forms.

Avoid alcohol: Alcohol can reduce the sperm count and increases the numbers of abnormal sperm.

Weight: If overweight or underweight, get into a healthy weight range.

Nutrition: Nutritional quality is important to sperm quality. A study in The Journal Of Nutrition found that men eating a higher amount of oily fish experience a boost in their sperm count. A fish oil supplement may help.

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Avoid processed meats: They reduce sperm quality.

Avoid anabolic steroid injections: They will shrink testes and reduce fertility.

Take supplements: Zinc is needed for hormone production and normal sperm production and motility. Vitamin C avoids “clumping” of sperm and increases sperm motility and viability. Coenzyme Q10 can increase sperm count and motility. Other micronutrients, such as selenium, folate and magnesium, are also essential for optimal fertility.

Avoid toxins: Eliminate environmental and dietary toxins as much as possible. For example, opt for organic foods and products whenever you can.

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Be active: Exercise regularly, but don’t overdo it.

Be cool and comfortable: Wear loose-fitting underwear and stay out of the sauna to avoid heat stress.

This story originally appeared in the October 2015 issue of The Australian Women’s Weekly.

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