15% of couples have trouble getting pregnant. Subfertility can affect both male and female partners. In 40% of cases, the cause is due to abnormal quality sperm.
What are the causes of subfertility in men?
– Low sperm count or quality
– Problem getting an erection or in ejaculation
– Medical treatment such as radiotherapy
– Surgery for undescended testes or twisted testicles
– Medical conditions such as diabetes
– Lifestyle factors such as being overweight or having a job that involves contact with chemicals or radiation.
– Genetic problems
– Age - Male fertility is also thought to decline with age
80% of couples who have regular (ie 3-4 times a week) unprotected intercourse, get pregnant within a year.
What are the tests that can be performed to assess male subfertility?
Semen analysis and semen culture
This is the most commonly performed male fertility test done by fertility clinics to assess the sperm quality with regards to sperm concentration, motility and morphology. Some fertility clinics also perform the MAR test to determine the antisperm antibody (IgG and IgA) levels. We recommend two to three days’ abstinence before producing a semen sample for analysis. The semen culture tests checks for the presence of bacteria in the semen sample.
Sperm DNA fragmentation test
The sperm DNA fragmentation index is an indicator of the fragility or DNA damage within the sperm. Sperm with high DNA fragmentation may fertilise an egg but embryo development may be compromised and there is evidence that there might be an increased risk of miscarriage. Hence, high DNA fragmentation is a predictor of low IVF success rates.
Hormonal assessment is performed in cases of very low sperm counts to determine testicular function.
The chromosome analysis, Y deletion test and the Cystic Fibrosis screening are performed to evaluate a genetic cause of male subfertility.
Ultrasound scan of the testes
An ultrasound scan will help assessment of the testicular size, tubal blocks and presence of a varicocele.