Hey girls just wondering if you think it might be a good idea to have a seperate thread for male factor infertility issues. There seems to be more and more of us with these issues and there are several posts where we have posted useful information. So it might be super useful to have a thread dedicated to it where we can share ideas/information/tests etc. and if anyone new comes along they will no exactly where to go? So what do you think?

Oh elle your a star, this is a great idea, be great to get it made a sticky too. I found it sooooooo hard to get info on male issues when we found out , this would be great for others who have male factor issues.

That would be fantastic. Brilliant idea! Thanks Elle.

Hey girls its great that there is an interst in this. Hopefully a few others will hop on along the way too. I'm going to do a little info. gathering and I will post what I learned tomorrow but for now...

Investigating Infertility

Up to 40% of infertility problems experienced by couples can be caused by a problem in the man. Despite this, however, the focus is generally put on the woman. As soon as a couple begin investigating reasons for their infertility the male partner should be examined, as there are a number of conditions that can make men less fertile.



Causes of Infertility

Low sperm count
If the sperm count is low (less than 20 million per millilitre) then this could definitely reduce your chances of conceiving. A sperm count of 40 million is considered the optimum level.

Poor sperm movement
Even if the sperm count is good, fertility will be affected if the sperm’s motility (capacity to move) is poor. Good motility is necessary if the sperm is to travel up through the cervix and into the uterus to reach and penetrate the egg.

AgglutinationThis happens where the sperm clump together in a circle and don’t move. This may be caused by an infection, or antibodies.

Abnormal sperm
All men have a percentage of abnormal sperm; in fact, it is considered acceptable for up to 70% of sperm to be abnormal. It is only when the amount of abnormal sperm exceeds 70% that fertility be affected. This is because abnormal sperm would find it difficult to penetrate the egg. Some research indicates that a high rate of abnormal sperm is linked with a high rate of miscarriage.

Varioceles
Varioceles are enlarged veins around the testes. Although they may not cause any discomfort and do not affect the man’s health in any way, it is thought that they can overheat the testes, which damages sperm production. In some circumstances, tying these veins has helped to restore fertility in affected men.

Obstructions
Blockages in part of the male reproductive system can affect fertility by preventing sperm from being ejaculated. These blockages can be caused by scarring due to infection, previous surgery, or due to an injury. A severe sports injury — such as a kick in the groin — could stop the testes producing sperm.

Undescended testes
If the testes did not descend properly after birth, then they may not be producing sperm. It is common to correct undecended testes with surgery to bring them down into the scrotum. If undescended testes have not been diagnosed early enough and surgery has been delayed, then fertility may be affected.

Diseases
Glandular conditions such as diabetes or thyroid problems can interfere with hormonal control of sperm production. Infections of the prostate gland and epididymis can interfere with sperm production or block the exit of sperm from the body. Infections such as mumps orchitis (an inflammation of the testicles following mumps) can result in permanent infertility.

Smoking
Smoking can affect a man’s fertility as it decreases the sperm count, makes the sperm more sluggish, increases the number of abnormal sperm and reduces testosterone levels. Furthermore, smoking reduces the level of vitamin C in the bloodstream, a lack of which causes sperm to clump together instead of moving forward to fertilise the egg.

Recreational drugs
Marijuana may lower a man’s level of FSH and LH — two hormones essential to sperm production. It can also lower a man’s libido
Cocaine users will have a lower sperm count, poor motility and a high rate of abnormal sperm
Heroin may cause a decrease in testosterone levels.

Tests for Male Fertility

Semen analysis
Prior to the test, the man will be asked to abstain from sex for a minimum of 48 hours but not longer than seven days before giving the sample. He is asked to produce a sample by masturbating directly into a sterile container. Some clinics may ask him to produce the sample at home and bring it to the laboratory within one hour, and others may ask for the sample to be produced at the clinic. Some men may find this embarrassing and can have difficulty producing a sample, or it may be against their personal beliefs. In these circumstances, a special condom may be provided to collect the semen. Ordinary condoms cannot be used because the type of rubber may affect the sperm.

The lab will examine the sample and measure the following factors:

Number of sperm per millilitre (the sperm count)
Percentage of sperm moving (sperm motility)
Quality of the movement, or progression (graded from 1-4, with 1 being the highest)
Volume of semen.
According to World Health Organisation recommendations, there should be more than 20 million sperm, more than 30% of which should be normal, and more than 50% moving actively. However, if the female partner is fertile it is still possible for her to conceive with a man whose sperm count is less than 20 million.

Medical Terms
Doctors use certain terms when talking about sperm count:

• Oligozospermia: This means that there are too few sperm
• Azoospermia: This means that there are no sperm at all
• Teratozoospermia: This is when there are high levels of abnormal sperm
• Astenozoospermia: This is when the sperm has low motility.
If either of the latter two of these conditions is diagnosed, further tests will be offered to see if there is a reason for these results.

Seminal Volume
Normally, the volume of seminal fluid is approximately 2-6mls. This level may vary, however, depending on how long the man has abstained from sexual intercourse or masturbation. If the volume is low this may interfere with transportation of the sperm and they may not reach the cervix. High volume can also be a problem as it may dilute the density of the sperm and affect their motion.

If the first semen analysis reveals a problem it is often repeated, as periods of stress or illness can produce unusual sperm samples.


Why are so many sperm required?

It is estimated that only a small fraction of sperm (as few as 100) will actually reach the egg. This is because the sperm have to swim up the vagina, through the cervix and up the fallopian tubes. When they finally meet the egg a number of sperm will surround it. On the front of the sperm’s head is is the acrosomial head cap, which ontains enzymes to help dissolve the cells surrounding the egg. The combined action of all the sperm help with this dissolving process, but only one sperm actually gets through the next layer. As soon as the egg is penetrated, rapid changes take place in the outer layer and no other sperm can get through.




Other Tests

Fructose test
If there are no sperm in the semen analysis it may mean that the testes are not producing any, or they are being produced but a blockage is preventing them getting through and they cannot be ejaculated. Fructose is a sugar normally found in semem. If no fructose is found in the semen this can mean that the seminal vesicles are blocked, preventing both sperm and fructose from getting through. Surgical correction of the blockage may be possible. However the absence of fructose can also mean that the man does not have any seminal vesicles. If fructose is present but there is no sperm in the sample further investigations need to be done.

Anti-sperm antibody test
This test is to determine if the man is producing substances that are causing the sperm to clump together, or lose motility, or that could prevent fertilisation. These substances or antibodies would make the man’s immune system identify his own sperm as foreign and try to destroy them. Sperm antibodies may develop in response to an infection. 70% of men will develop these antibodies after a vasectomy. This is because during the procedure some sperm may leak out and because they have previously been kept within the reproductive system the body sees them as foreign substances that need to be destroyed. Treatment for anti-sperm antibodies may involve steroids, which have a number of side effects such as weight gain, gastric bleeding, or depression. In some circumstances, the woman may produce antibodies to her partner’s sperm and this can be diagnosed by a blood test.

Best of luck tomorrow

great thread.
just to add something I found out about abnormal forms..on a stricter criteria they consider 14% rather than 30 to be acceptable so it is worth checking which scale they are using to test against.

Just wanted to post to say thanks Ellewood for all that helpful information.

It's great to be able to come here and get all the help and useful information from everyone here.

June06

Great sticky Elle. Really useful info and a great help.

Hey girls sorry I didn't post yesterday as promised we had our viral bloods at HARI yesterday and DH was super sick after so I had to mind him. Then I got to excited about Djdee's news so I'm a naughty girl who didn't do any research and I'm putting myself in a cyber corner!

Thanks to all the girls who showed interest in this post, hopefully we can help each other through this as there is def. not as much info. out there for male factor infertility.

I'm going to start by telling our experience. I came off the pill in Aug. 2006 we got married and started TTC in Aug. 2007. In Jan. 2008 I visited my GP for a smear and she commeted on how it had been over a year since I came off the pill and nothing had happened so just in case she was referring us to Dr. Rishi in the Rotunda. Dr. Rishi did day 3/21 bloods and HSG on me ~ all fine.

DH's first SA came back with double the count, volume grand and no abnormalities but with Astenozoospermia: This is when the sperm has low motility ~ 15%

Dr. Rishi reccomended taking "Fertility Plus for Men". He also said the usual things: no baths, loose underwear, not too much cycling....
DH also gave up caffine. After 2 months DH had 2nd SA appointment where he had to produce sample on site in HARI clinic. This was a more detailed SA. The results of this was motility ~ 16%. The doc. said we def. would get PG naturally but he couldn't say when.

We were rccomended for IVF and our waiting to have our appointment to start on the 26th September.

Now the cost: We both have VHI but none of this was covered. We went private:
1st Consultation: €150
Following consultation: €100
Bloods: €19.95
1st SA: €15
2nd SA: €100
Viral Bloods €100 each total €200
Fertility Plus: €33 per 90 (3 a day: 1 month supply)

Thats all I can think of for now. Maybe we could all tell our experiences? See what stage that we are all at?

Morning ladies

Hope Mr Woods is ok now, do you mind me asking what the viral bloods are??

Well my story so far is...................
We started ttc nov07, got wed dec 07 so after 6 months of no joy i persuaded dh to see gp, i also went to mine. Dh gp was very good and referred him for SA in rotunda, so about 3 weeks later got results, motility and count are both low We were soooooooooo shocked, really thought it would be a problem with me. During this time i had my day 3 and 21 bloods done, day 3 fine but progestorone on day 21 was only 33 which means i do ovulate but not necessarily every month. Am starting clomid when af arrives please god fri or sat, never thought i'd be glad to see af
So in a nutshell after all these tests came back were got referred to HARI , we wre very lucky as we got a cancellation for about 6 weeks later.

So the day arrived for the appt, was both nervous and excited if that makes sense, saw Mr M, lovely man, so basicly our story is we will get pregnant naturally but when is the big question
He reckons IVF/ICSI will be our best option.
Dh has been for bloods since appt, one to check hormonal imbalance and the other for a genetic problem, doc said we should find out possibly cause for dh problem from these. Dh brother had problems conceiving too so doc feels there may be a genitic problem so time will tell.

Back to hospital in October for post coital test and dh blood results so should find out our treatment route then.

So in a nutshell thats our story, so its so long

Great idea having this thread,
Thanks elle

Mrs. Kia thanks for sharing pet. I def. think we underestimate the effect it has on the boys self esteem. Like you I always aaumed it was me.

Mr. woods is fine now, just mortified that I was so brave and he wasn't it. In fairness I'm so used to blood tests at this stage its easy to be brave.

Viral blood tests have to be done according to EU before every round of IVF. They screen for HIV/Hep. I'm not sure what else


How are all the other girls?

Hey girls,

Great thread elle. I just wnated to share too things i have read recently in my research into trying to help myself ovulate. Don't know if DH has probs but we trying to follow some of the advice for him anyway to be safe until the time when/if he has to have sa

see below:

Male Infertility

Low sperm counts have been linked to low carnitine levels in men. Several studies suggest that L-carnitine supplementation may increase sperm count and mobility.

Dehydration has been linked to slow sperm - so make sure your man drinks plenty of water !

Hi,
My story is as follows, got married in June 2006 and went off pill. Starting ttc but not temping etc. Got BFP in Oct 07 but lost it at 4 weeks. I was then referred to gynae. In April had lap done and found I have endometriosis and cysts but had all removed. In July went for 21 day blood tests and dh went for sa in the rotunda. My tests came back fine but dh had low sa but with a few good motility. Met with doc last tues and have now been sent off to ttc on our own following his charting etc. If we don't succeed by Dec then we will be referred for ivf in the new year.

Thats my story so far!!

Wishing you all the best in your journey and thanks for starting this thread
June06

Hey thanks fat frog, DH never drinks enough water. I tell you if this is all because he doesn't drink enough bloody water he will be on the naughty step until santa comes!

Hey June06 thanks for sharing, sorry you have been through so much. I really hope you get a BFP before Christmas. I'll prob. be going through IVF before you so I can keep you posted and we have DJdee to inspire us.

Thanks Ellewood.

It's great news for Djdee and hopefully you will have a bfp soon too

June06