Male Fertility

NUH Life offers the following services for the male:

  • Diagnostic semen analysis
  • Diagnostic or trial sperm preparation (test wash)
  • Blood testing for hormonal or genetic causes of infertility
  • Blood testing for infectious disease, including blood borne viruses (BBVs)
  • Fertility preservation (sperm banking)
  • Sperm donation – enquire here

Male fertility status is usually assessed by asemen analysis test. This often tells us all we need to know, and whether there is a good chance of conception or not.

Occasionally, further investigation may be required by physical examination or blood testing and may result in referral elsewhere – for example, a visit to a urologist might be needed to check how well the reproductive system is functioning.

Sperm quality can be a reflection of your general health and wellbeing, although the evidence suggests that a lot of it depends on your genetics. For this reason (and in many cases), there is little that can be done to influence sperm quality.

However there are a number of known external influences which can have a negative affect on sperm number or quality, such as:

  • Medication
  • Chronic illness
  • Scrotal temperature
  • Poor diet, smoking and excessive alcohol
  • Steroid abuse

Apart from being generally aware of these factors, there is often little that can be taken to improve sperm quality in terms of medicines or nutritional supplements. It is always generally acknowledged that a balanced, healthy diet (including vitamins and minerals) will help.

Male factor infertility – interpreting semen analysis

The assessment of male infertility is not a precise science – quite often the answer is not black and white, but a huge grey area. Male factor infertility can therefore range from something quite severe and well-defined (such as there being no sperm present) to something almost insignificant, like one of the semen parameters being slightly low. For more detail about interpreting semen analysis, read below.

Two thirds of men who attend clinic will have sperm characteristics (sperm parameters) in the ‘normal’ reference range, as defined by the World Health Organisation (WHO).

World Health Organisation normal reference values for describing semen analysis:

Semen ParameterReference ValueW.H.O. term if insufficient
Ejaculate volume1.5mls
Sperm concentration15million/mlOligozoospermia
Sperm motility32% progressionAsthenozoospermia
Sperm morphology4% normal formsTeratozoospermia

It’s important to remember:

  • Just because a male has one or two of these ‘semen parameters’ outside of the normal range, it does not mean that the sample cannot still overall be normal. Some of these values are percentages – therefore if the sperm count is 100 million instead of 15 but the sperm motility is only 10%, the count will more than compensate. Likewise, the count could be only 10 million, but the motility could be 75%.
  • Just because a sample is outside of the normal range, it does not mean that the male cannot father a child. It just suggests that his chances are lower.
  • If a male’s first sample is deemed abnormal, it does not mean that the next one will be. It’s important that he follows our instructions for sample collection at the time, as we are looking for trends.
  • To put these reference ranges into perspective, if a male has a vasectomy operation to make him sterile and a single motile sperm is seen in his sample after the operation, the operation will be deemed a failure and would need repeating.

Are there sperm characteristics which definitely result in male infertility?

Yes, these include:

Azoospermia*  – No sperm are seen under the microscope

Teratozoospermia* – If 100% sperm have the same critical defect

Asthenozoospermia* – If none of the sperm are motile (swimming)

*These categories must be diagnosed from at least 2 high quality semen analyses.

Other than these categories, there is little or no evidence to suggest that other potential causes of male infertility can be 100% identified.

Click here for further information on how a ‘semen analysis’ is performed.

Support for male infertility

Extensive support for the male has not been widely available in the past.

However, newer websites like the ‘all about fertility’ site are beginning to provide extensive support information, including facts and figures, review articles and a support forum. Click here for more information.