Testing, diagnosis, and management for conditions affecting fertility in men and those assigned male at birth.
If you and your partner are trying to have a baby, it can be difficult and frustrating when pregnancy does not happen as expected. Many people are surprised to learn that male fertility plays a role in up to half of all fertility challenges experienced by couples. The good news is that support, testing, and treatment options are available, and many men are able to improve their fertility with the right care.
Good reproductive health in men and individuals with male reproductive organs is determined by several factors, from your overall health, sexual function, anatomy, to the quantity and quality of your sperm.
Sperm are the male reproductive cells. Each sperm cell carries half the genetic material required to form a baby. Fertilisation is the process of a sperm and egg fusing together. For this to happen during natural conception, sperm must swim through the female partner’s reproductive tract to meet the egg waiting in her fallopian tube. Only one sperm will be successful at fertilising the egg, penetrating through the egg’s outer shell and combining its DNA with that of the egg’s.
But conception doesn’t always happen this way. It may be taking longer than you thought to get your partner pregnant, or perhaps you’ve embarked on the journey to fatherhood as a same-sex male couple or as a solo dad. Wherever you’ve come from, your goals and Dr Anna’s are the same – to grow your family.
Male infertility can happen for many different reasons. Sometimes there is a single clear cause, while in other cases several factors may contribute. If a reversible cause is identified, we will treat it to improve fertility outcomes. If there is a non-reversible cause identified, we use IVF/ICSI to try to achieve pregnancy. Some men may be affected by unexplained male infertility, where all fertility tests return normal results yet it is still challenging to conceive. For situations where a cause can be identified, infertility in men can be associated with:
Hormones play an important role in sperm production and sexual function. Conditions affecting your testosterone levels, thyroid, or pituitary gland can interfere with fertility by reducing sperm production or affecting libido and ejaculation. These hormone abnormalities may be acquired or congenital (pre-existing).
Some genetic conditions can affect sperm production or the development of your reproductive system. In certain cases, men may produce very few sperm or no sperm at all (known as azoospermia) due to underlying genetic factors like Klinefelter syndrome or aZFR gene mutations.
Structural issues within the reproductive system can make it difficult for sperm to travel effectively or cause damage to the DNA within the sperm. Examples include genetic conditions like cystic fibrosis, enlarged veins around the testicle (varicocele), and blockages in the reproductive tract from previous injury, surgery (like vasectomy), or previous infections.
Certain health conditions may impact fertility, including high BMI, diabetes, autoimmune conditions, or advancing age. Ongoing illness and chronic health concerns can also affect hormone levels and sperm quality.
Some medications and medical treatments can interfere with sperm production or sexual function. Examples include testosterone therapy, chemotherapy, radiation treatment, and long-term use of anabolic steroids or certain prescription medications.
Everyday habits and environmental exposures can affect fertility over time. Smoking, excessive alcohol use, poor sleep, excessive stress, obesity, recreational drugs, and exposure to heat or chemicals may all reduce sperm health.
Treatment for male infertility starts with a comprehensive fertility assessment. Dr Anna will determine the most appropriate male fertility tests for you based on your medical history, lifestyle, and fertility journey so far, whether you’re a couple facing infertility or a couple or individual looking to conceive through assisted reproduction with your sperm and donor eggs.
A semen analysis is one of the most common fertility tests for men and individuals who produce sperm. Among other parameters, it looks at:
Because sperm levels can vary naturally, Dr Anna may sometimes recommend repeating the test.
A simple blood test with hormone assay can check your levels of vital hormones such as testosterone, follicle-stimulating hormone, prolactin, and luteinising hormone. Genetic testing may also be achieved through a blood test to assess the number and condition of your chromosomes, or to look for inherited genetic conditions.
In some cases, Dr Anna may organise for you to have a testicular ultrasound scan. This non-invasive imaging test provides details about the structure and function of your reproductive organs to look for damage or other abnormalities getting in the way of your fertility.
For some men, improving general health can make a meaningful difference to fertility. Dr Anna may recommend:
Medication or surgery can help to restore fertility that has been impacted by conditions such as hormone disorders, infection, varicocele, or obstruction in the vas deferens tube. In some cases, Dr Anna may coordinate with another specialist, such as urologist or endocrinologist to optimise your care.
Assisted reproduction encompasses several techniques to help you grow your family, including:
If you have an absence of sperm in your semen (azoospermia), it may be possible to obtain sperm for assisted reproduction through surgical sperm retrieval with either testicular sperm aspiration (TESA) or microsurgical testicular sperm extraction (microTESE) surgery.
Dr Anna will talk you through the most suitable options for your individual circumstances and explain each treatment in clear and practical terms.
