Male infertility


Although infertility is often considered a female issue, a male problem can be identified in nearly half of all couples who have difficulty in achieving conception. There are usually no obvious signs or symptoms of an infertility problem. Erections, intercourse and ejaculation will usually happen  normally and the quantity and appearance of the ejaculated semen generally appears normal. Lifestyle factors may impact infertility but for men a low sperm count is the most common cause of infertility.


Low sperm count


One of the most common causes of infertility in the male is damage to the production of the sperm resulting in a low sperm count (oligospermia). This may also be associated with reduced sperm movement and abnormally shaped sperm. In some cases, a pregnancy can be achieved using In Vitro Fertilisation (IVF) when the sperm count is low, or the quality of the sperm is poor. If there are too few sperm for standard IVF, or if fertilisation did not occur in a previous IVF cycle, it may be possible to use Intra-Cytoplasmic Sperm Injection (ICSI) to fertilise eggs in the laboratory and then complete IVF treatment.

Common causes of a low sperm count include:

  • hormonal problems
  • obstruction
  • side effects of drug treatments, e.g. cancer treatment. See our article on Fertility preservation for cancer patients.
  • environmental factors (e.g. smoking, excessive alcohol consumption, frequent hot baths or saunas)
  • infection.

Despite a low sperm count, many men with high-quality sperm (viable and highly motile) may still be fertile.


Poor sperm quality


It is recognised that the usual semen analysis test does not fully assess the potential for sperm to fertilise an egg. Further investigation of sperm quality may involve assessment of chromosome integrity. This can be assessed using a specialised Sperm Chromatin Structure Assay (SCSA) test.


Unexplained infertility


Unexplained infertility is defined as not being able to conceive after a year, even though the cycle is normal, semen is normal, the results of internal examinations are normal and there is normal sperm-mucus penetration.


Related articles


Lifestyle changes


Fertility preservation for cancer patients

Attend a free information seminar
Westmead ButtonWestmead Doctor, IVF clinic
When: Wednesday 28 November 2018
Time: 6pm
Where: Westmead Hospital