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29th Sep 2020

An expert says we have to talk about male fertility too – and here is why

Trine Jensen-Burke

There is a lot of talk and attention and column inches dedicated to female fertility.

However, why aren’t we all talking more about the fact that it does indeed take two to tango? And the fact that there needs to be more focus on male fertility and issues surrounding it too?

The Road to Parenthood is tough on would-be dads, says Dr Hans Arce, Medical Director at ReproMed, when asked about the challenges faced fathers when the focus is always on female fertility.

Every year, between 5000 and 6000 people undergo fertility treatment in Ireland. It is estimated that male infertility accounts for 50 percent of all cases and 20-30 percent of cases with both male and female issues.

A major problem? Since the 1970s, there has been a 59 percent decrease in normal sperm counts and this rate of decline is not slowing.

When one of the most natural things to happen isn’t happening, it’s an extremely tough time, emotionally and psychologically. But, says Arce,  it’s important not to apportion blame.

“Men often don’t want to talk about something so personal, worried about their male ego and heaping too much emotional pressure on themselves with huge feelings of shame,” he explains. “But it is important to discuss fertility and break down the taboo surrounding it. It is no-one’s fault, it is just something that is happening and should be tackled head-on with open conversations.”

According to Arce, causes of male infertility can be hard to diagnose but the problems are most often with sperm production and delivery.

“If you are worried, you can obtain a semen analysis test, a straight- forward lab test which can determine causes of male infertility. The test is most often done twice and can determine sperm volume, count and concentration.”

AIt should be pointed out that around a 20-30 perccent of infertility is also considered caused by male and female together, so as you can see there is an overlap in the causes.

When a man ejaculates, nearly 100ml sperm are released with each ejaculation but, as we all know, it only takes one to be successful.

However, sperm have to survive and thrive in a hostile obstacle course environment – it’s a marathon trying to navigate the cervix, the uterus, the fallopian tubes and onwards to success, so producing the healthiest sperm possible, should be a focus as it is the most common cause of male infertility.

Sperm can be low in number, not as mobile (good at swimming up-stream) or may be abnormal with unusual heads or tails making getting inside the egg harder. The main reasons for low sperm count are being overweight, excessive alcohol consumption, smoking or drug-taking and Arce has some advice for men which will help in making sperm as healthy as possible and help with getting pregnant.

1. Have sex. It sounds obvious but you need to be having a good amount of sex! Sperm live for 5-7 days after intercourse so it makes sense, if you are having more sex, the chances of a healthy sperm making the journey to success will increase.

2. Delete the fertility app. It is very easy to become too focused on these apps and focus all your attention on having timed sex coinciding with ovulation thereby forgetting that you need to have sex all the time to really increase chances.

3. Use your common sense – Infertility rates are higher in smokers than non-smokers and the risk for fertility problems increases with the number of cigarettes smoked daily, so try to cut back or cut out the cigarettes altogether.

4. Vaping? Although there is not a huge body of evidence, the full impact of vaping on reproductive function is currently undergoing evaluation in multiple ongoing studies but they so far suggest that vaping may be detrimental to fertility and can negatively impact sperm.

5. Carrying a few extra pounds – Obesity can have a negative effect on sperm health. Men who are overweight have an increased body temperature but sperm thrive in 35 degrees so any prolonged increase in body heat can see a decrease in healthy sperm. Change your diet and try to lose some weight.

All in all, Arce advises patients to stay positive and not to panic or lose hope. Make the diet and lifestyle changes, cut out the cigarettes and continue to have sex as often as you can. The road a sperm must take is a long one filled with difficulties so give them as much a chance as possible.