Fertility in men

Women are born with a certain number of eggs, which decreases each year. The male body, on the other hand, constantly produces new sperm - approximately 1,500 sperm are produced every second.

In terms of fertility, both partners play a crucial role in conception. While female fertility is often the priority subject, male fertility is equally important. Studies show that the male factor is responsible for 50% of conception problems. Male fertility is affected by various factors such as sperm health, hormone levels, and the anatomy of the reproductive organs.

Unlike female infertility, male infertility often does not present obvious signs, meaning many men are unaware of their fertility issues until they have difficulty getting their partner pregnant. This is why the quality and quantity of sperm are crucial factors for conception.

Diagnosing male fertility

One of the first steps in family planning is a comprehensive health examination of the man. The spermogram is a key element in diagnosing male fertility.

This test evaluates several parameters, each providing important information about sperm health and fertility potential:

• Total sperm count in the semen sample - the higher the number of sperm, the greater the chances of pregnancy.
• Sperm concentration - measures the number of sperm per milliliter of semen, which is an important indicator of fertility.
• Volume - indicates the amount of fluid produced during ejaculation necessary to transport sperm to the egg.
• Motility - assesses the ability of sperm to move to reach and fertilize the egg.
• Morphology - examines the size and shape of sperm; abnormalities may indicate fertility issues.

Causes of male fertility deterioration

Hormonal imbalances, such as low testosterone levels or thyroid disease, can interfere with sperm production and fertility in general. Genetic problems, such as chromosomal abnormalities or mutations, can also affect sperm quality and reduce fertility function.

Poor diet, sedentary lifestyle, smoking, and alcohol consumption negatively impact reproductive health. However, sperm renews itself every 60 to 90 days, so adopting healthy habits can lead to significant improvements.

Among the diseases and conditions that harm male fertility are

• Varicocele: swelling of the veins draining the testicle, which leads to decreased quality and quantity of sperm due to disrupted normal blood circulation.
• Infections: sexually transmitted infections can affect sperm production or block the passage of sperm.
• Anti-sperm antibodies: antibodies synthesized in the man's body in response to sperm.
• Tumors: cancer or tumors affecting the reproductive organs can harm fertility.
• Undescended testicles: when the testicles do not descend into the scrotum during fetal development, it can reduce fertility.
• Chromosomal abnormalities: genetic disorders such as Klinefelter syndrome or cystic fibrosis lead to abnormal development of the reproductive organs and can result in infertility.
• Testosterone replacement therapy, steroids, or chemotherapy can also negatively affect sperm production.

When should a man seek help?

A man should make an appointment with a specialist if he and his partner have been trying unsuccessfully to conceive for a year despite regular unprotected intercourse. If the man is over 35, this period is reduced to six months. A healthy lifestyle can increase fertility, but if no pregnancy has occurred after 12 months, it is necessary to consult a specialist for a fertility assessment.

How to increase male fertility?

To answer the question "How to increase fertility?", reproductive specialists recommend the following:

• Eat well: consume fruits, vegetables, whole grain products, lean proteins, and healthy fats, and add zinc, selenium, and vitamin C to your diet. Don't forget to drink plenty of clean, non-carbonated water every day.
• Engage in physical activity: moderate physical activity helps improve overall health and supports fertility.
• Manage stress: practice meditation, deep breathing, or yoga to reduce stress levels.
• Avoid bad habits: quit smoking, reduce alcohol consumption, and stop using drugs.
• Maintain a normal weight: both underweight and overweight can harm sperm quality.
• Have regular medical check-ups: timely detection and treatment of health problems can improve fertility.

Treatment of male infertility

Treating male infertility can be challenging, but modern methods help many couples realize their dream of becoming parents.

A common approach is ICSI (intracytoplasmic sperm injection), a form of IVF where a single sperm is injected directly into the egg to promote fertilization. This method is considered the best for men with low sperm counts or poor sperm motility.

TESE and micro-TESE are two surgical techniques used to treat male infertility in cases of spermatogenesis problems, including azoospermia (absence of sperm in the ejaculate). These techniques can be effective as part of an in vitro fertilization (IVF) or ICSI program:

• TESE (testicular sperm extraction) is a procedure in which testicular tissue is surgically removed to search for sperm. The procedure is performed under general or local anesthesia. Samples of testicular tissue are examined under a microscope for motile sperm that can be used for ICSI.
• Micro-TESE (microsurgical testicular sperm extraction) is a more advanced version of TESE that uses a microsurgical approach to more accurately identify sperm in testicular tissue. Using a microscope, the surgeon can more precisely identify areas of the testicle likely to contain sperm.

If male infertility is related to lifestyle factors or diseases, it may be recommended to modify lifestyle by improving diet, increasing physical activity, avoiding bad habits, and managing stress. Improving diet, reducing caffeine and alcohol consumption, engaging in regular physical exercise, managing stress, and avoiding bad habits such as smoking and vaping can enhance sperm quality and overall fertility.