We all know that it takes two to make a baby. That said, when couples struggle with infertility it is often assumed that it is a “female” problem. In fact, about 30 to 50% percent of the time the sperm is either the only problem or is at least one of the problems the couples is having. Therefore, if a couple is having trouble conceiving both the man and the woman should be tested Sperm problems may involve the quantity and or quality of the sperm. All that is needed to assess a man’s basic fertility is a semen analysis. This simply involves asking your family doctor for a test requisition and taking a sperm sample to a local lab for testing. Often men feel embarrassed or stressed about providing the sample. He doesn’t need to worry the sample can be collected at home and discretely dropped off at a laboratory near you.
The semen analysis looks at the sperm in three different ways:
1. Sperm count. This is the most important part of the test and the more sperm there are the better!
2. Sperm motility. This measures the percentage of sperm that are moving in a forward direction. (Sperm needs to be able to travel from the vagina to the fallopian tubes where they meet the egg)
3. Sperm morphology. This measures the shape of the sperm. It is quite common for men to have lot of abnormally shaped sperm. Don’t feel too worried if you get this result as we don’t really know how much impact this has on your overall fertility.
Any abnormality noted on the semen analysis should be followed up by a repeat test to ensure that it wasn’t just a “bad day”. If the abnormality is still there in the second test, your family doctor can go over this result and help outline a plan for management of the problem.
It is important to know that there are some very effective treatments for sperm problems. If the problem is mild, your doctor might recommend “intrauterine insemination. “ In this procedure the man produces a sperm sample which is then prepared in the laboratory and inserted into his partner’s uterus (or womb). This treatment,– known as IUI–is sometimes combined with medication which is given to the female partner at the same time. IUI is a relatively inexpensive procedure and work very well for certain couples.
If the sperm problem is more severe, then a couple may need to undergo an IVF(In vitro fertilization) cycle with ICSI (intracytoplasmic sperm injection). This is when the woman’s eggs are taken out and matched one for one with a single sperm from the man. The single sperm is injected into the egg (which is the “ICSI” part of the treatment). This technology wasn’t available 20 years ago and thankfully, it now offers men with severe sperm problems an excellent chance to have a child.
I often get asked about medications men take to improve their sperm. Except for very rare cases, there really isn’t a medicine that men can take that works to improve the sperm. Many patients find that fact frustrating. There are some male fertility vitamins on the market that can sometimes help. It is best to discuss these vitamins with your family doctor or fertility doctor before taking them. When we do use vitamins, we prefer a product known as Fertil Pro.
In summary, a semen analysis is the easiest way to get a sense of whether there might be a sperm problem contributing to a couple’s difficulty becoming pregnant. Although medicines don’t usually help, there are effective treatments available to help if there is indeed a sperm problem.