Ten questions about male infertility
The rise of assisted reproductive technology (ART) has led to renewed attention on male infertility problems as it allows some previously ‘infertile’ men to father children.
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Here are Dr Corinne Tutin’s answers to the most frequent questions surrounding male infertility.
1. How many couples are faced with sterility issues?
By and large, it is estimated that between 4 and 5% of couples will never become biological parents. Available data suggests that the percentage of sterile couples hasn’t changed over the past two centuries. Yet we are often misled into believing that infertility is more widespread than it used to be, as couples who have difficulty conceiving seek medical advice more readily and more often than ever before.
Data from the Human Fertilisation and Embryology Authority (HFEA) indicated that 36,648 British women underwent fertility treatment in 2007 – a rise of 5 per cent from the 34,855 in 2006.
2. How long before I should become concerned?
Couples who regularly engage in unprotected sexual intercourse and don’t succeed in conceiving over a period of 2 years and more are said to be infertile. This may seem like a long time to wait: this is because the spontaneous conception rate does not exceed 15 to 20% per ovulation cycle in couples with normal fertility levels. Based on these figures, 60% of couples who wish to conceive will accomplish their goal within 6 months, 80% over the course of one year and 90% in 18 months. However, the time to wait before seeking medical advice can be shortened depending on the woman’s age.
3. How much of overall infertility rates does male sterility account for?
A couple of decades ago, most fertility problems were considered to affect women only, for cultural reasons. To this day, male infertility continues to be poorly perceived and those who seek medical help are mostly women. However, men’s share of responsibility for infertility has increased over the years. According to HFEA data, male infertility accounts for around 30% of the UK couples seekig fertility treatment in 2008. An additional 10% are attributed to a combination of both make and female factors.
4. What are the most common causes of male infertility?
There are many causes of male infertility, the most common being the lack of, or reduced quality of sperm. In some cases, sterility arises from genital duct obstruction or varicocele, which refers to a knot of dilated veins around the testes. In other cases, sperm alteration is caused by an older infection (the mumps), hormonal or genetic disorders. Nevertheless, in 30% to 40% of male infertility cases, no causes can be pinpointed.
5. How is male infertility diagnosed?
The most effective diagnostic test for male infertility is semen analysis, which consists in examining and counting the sperm contained in a male’s semen in a laboratory. A lack of spermatozoa, reduced sperm mobility and abnormal sperm shape are all indicators of fertility problems. Clinical examination can also detect varicocele while clinical investigation sometimes serves to identify causes of infertility such as cancer treatment (radiotherapy, chemotherapy) or infection history. Under certain circumstances, diagnosis can be completed with testicular biopsy, hormone therapy and testicular scan.
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Posted 06.04.2011
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