Male Infertility: The Hidden Half of the Story

Chike and Ada had been married for four years. Month after month, they hoped for good news. Friends and relatives whispered, and Ada bore the weight of silent judgment. After months of tests, the doctor finally revealed the truth: Chike had low sperm count. For the first time, they both realized infertility is not only a woman’s burden.

Understanding Male Infertility

Infertility is defined as the inability of a couple to conceive after 12 months of regular, unprotected intercourse. Infertility affects about 15% of couples globally. While women often receive the most attention, male factors contribute for 40-50% of all infertility cases worldwide.

Male infertility usually arises when there are problems with sperm production, sperm function, or sperm delivery.

Health & Semen Parameters

• The WHO 2021 guidelines define normal semen parameters:

  • Sperm concentration ≥15 million/ml

  • Motility ≥40%

  • Morphology ≥4% normal forms

Any deviation can impair fertility.

Common Causes of Male Infertility

1.     Sperm Disorders

• Low sperm count (oligospermia): Having fewer than 15 million sperm per milliliter of semen.

• Poor sperm motility (asthenospermia): Studies show that about 40% of infertile men have sperm motility issues.

• Abnormal sperm shape (teratospermia)

• Complete absence of sperm (azoospermia)

  
  

2.     Hormonal Imbalances

• Low testosterone or problems with hormones that regulate sperm production.

  
  

3.     Varicocele

• Enlarged veins in the scrotum that affect sperm quality and temperature regulation.

  
  

4.     Infections

• Sexually transmitted infections or mumps orchitis can damage sperm-producing cells.

  
  

5.     Lifestyle and Environmental Factors

• Excessive alcohol, smoking, drug use

• Obesity

• Exposure to pesticides, radiation, or heat (e.g., hot baths, laptops on laps).

  
  

6.     Genetic and Structural Issues

• Blockages in sperm transport

• Genetic abnormalities affecting sperm production.

Signs and Symptoms

Most men with infertility have no obvious symptoms beyond the inability to conceive. Sometimes signs may include:

·       Erectile dysfunction

·       Low libido

·       Pain or swelling in the testicles

·       Decreased facial or body hair (linked to hormonal issues).

Diagnosis

Doctors use different tests to evaluate male fertility:

·       Semen analysis to check sperm count, motility, and shape.

·       Blood tests for hormone levels.

·       Ultrasound to detect blockages or varicocele.

·       Genetic testing in select cases.

Early diagnosis is critical. Consulting with a fertility specialist can lead to personalized recommendations based on specific circumstances.

Treatment Options

·       Lifestyle modifications: Weight loss, quitting smoking, reducing alcohol, managing stress.

·       Medical treatments: Hormone therapy, antibiotics for infections, and antioxidant supplements may be prescribed to address specific issues affecting sperm production or function.

·       Surgical options: In cases involving anatomical issues, surgery may be necessary to correct blockages or abnormalities affecting fertility. For example, varicocelectomy (repairing varicocele), and surgical sperm retrieval.

·       Assisted reproductive techniques (ART): Techniques such as in vitro fertilization (IVF), intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI) can help couples conceive when natural methods fail. Research indicates that IVF success rates for men with fertility problems can reach as high as 60% under optimal conditions.

Breaking the Stigma

In many communities, infertility is unfairly blamed on women, leaving men undiagnosed and untreated. Awareness is crucial: fertility is a shared responsibility, and early medical evaluation of both partners can save time, money, and emotional distress.

Final Thoughts

Male infertility is common, but it is often overlooked. With the right medical care, lifestyle changes, and support, many men and couples go on to achieve parenthood. What matters most is breaking the silence, seeking help early, and remembering that infertility is not a woman’s issue but a couple’s journey.

✨ Invitation to Community

Have you or someone you know struggled with infertility? What was the journey like? Share your thoughts in the comments—your story could help another person feel less alone.

You can also join the Men’s Health group.