Fertility problems can be emotionally and physically draining. It’s often hard to talk about, but keeping your fertility struggles secret can make you feel shameful and hopeless.
Women may experience infertility due to irregular menstrual cycles or gynecological problems such as uterine fibroids, pelvic inflammatory disease (PID) or endometriosis. Medications or hormone therapy can help.
Infertility problems can have many causes. They can affect both men and women of all ages, and they can have both genetic and non-genetic causes. In about half of the cases, infertility is caused by something that happens to both the man and the woman. In the other half, it is due to something that happens only to the woman or only to the man.
For women, the most common cause of infertility is problems with ovulation. This can be because of a problem with the fallopian tubes (such as endometriosis), pelvic infections or uterine fibroids. It can also be because of a condition called polycystic ovary syndrome (PCOS), or because of the way the uterus is shaped, or because of an abnormally long cervix.
Males can have infertility problems because of their low sperm counts, or because they have an abnormal shape of the penis (penetration issues) or because of the cervix not producing enough of the right type of mucus to allow sperm to move through it into the uterus. It can also be because of their health conditions, such as testicular cancer or prostate cancer, or because they have had radiation therapy to the head and neck. It can also be because of their medications, such as sulfasalazine (Azulfidine), which can reduce fertility.
If a woman can’t get pregnant after trying for a year, or if she has multiple miscarriages, she should see her doctor right away. She will want to take her health and family history and do a physical exam. She will probably do a pap test, and she may be asked to use an ovulation predictor kit. This test measures the basal body temperature and other things to find out when a woman is ovulating.
Genetic factors can play a role in about 20% of cases of infertility. These include chromosomal alterations, or mutations in the DNA that codes for specific genes. Some genetic conditions, such as primary ciliary dyskinesia and cystic fibrosis can lead to infertility. Other conditions, such as Klinefelter syndrome, can make it hard for a man to produce a normal sperm count.
Infertility problems may cause symptoms like pain during sex, heavy periods, missed periods, or pelvic pain. Irregular menstrual cycles can be a sign of ovulation issues such as polycystic ovary syndrome (PCOS). Heavy or skipped periods can also indicate uterine fibroids, endometriosis, or other uterine conditions. If you have a pelvic pain problem, talk to your doctor.
Women are diagnosed with infertility when they haven’t gotten pregnant after one year of carefully timed, unprotected sex or six months if they’re over 35. In some cases, doctors diagnose infertility when a woman keeps having miscarriages.
The causes of infertility in women are often different from those in men, though a woman’s age can affect how easy it is to get pregnant. Most cases of female infertility come from problems with ovulation or structural issues in the uterus and fallopian tubes.
Irregular ovulation is a common fertility issue, and it can be caused by hormone imbalances, problems with the uterus or fallopian tubes, or abnormalities in the eggs or sperm. Irregular ovulation can lead to a woman’s inability to conceive, but it can also affect how healthy the fetus might be if she does become pregnant.
Men can have fertility issues too, and they’re more likely to be affected by things that affect sperm production or movement, such as testicular injuries, infections, health problems, and certain medicines. These include some childhood illnesses, inflammatory diseases and conditions like psoriasis and rheumatoid arthritis, and medications such as antibiotics, steroidal drugs, and antidepressants.
Blockages in the genital tract can also cause fertility problems. These can be from birth defects or infections such as chlamydia and gonorrhea. They can also be due to surgery, a hernia, or twisted, swollen veins in the scrotum called varicoceles.
The treatments for infertility depend on what’s causing it. Medicines can help a woman ovulate more regularly, and surgery can repair any problems with the uterus or fallopian tube. In men, treatment can include medicine for erectile dysfunction or problems ejaculating, as well as surgery to repair problems with the tubes that carry semen, such as varicoceles or blockages.
The good news is that with advances in fertility treatment, many couples are able to overcome infertility. Treatment options include drugs and assisted reproductive technology. The treatment recommended for you will depend on the cause of your infertility.
For women, the first step is a medical evaluation by your gynecologist or urologist. Your doctor will review your family history, physical exam and symptoms. A pelvic ultrasound and a hysterosalpingogram may be done to check the condition of your uterus and fallopian tubes. Blood tests can measure your hormone levels. If your doctor suspects you have a problem with ovulation, they may also recommend a semen analysis to look for abnormalities and determine if you’re ovulating regularly.
A few men experience problems getting pregnant that can be cured by hormone therapy, including testosterone replacement therapy. Usually, low testosterone causes the sperm to lose their motility and their ability to attach to an egg. This problem is called oligospermia or male factor infertility. Other treatments that work for men with infertility problems include testosterone injections, intrauterine insemination (IUI) and rectal probe electroejaculation.
In some cases, the cause of a couple’s infertility can’t be identified. When this happens, your health care provider will use his or her experience with different treatments to figure out what might help you. This is called empiric therapy.
For women, some of the most common treatment methods for infertility involve medications or a change to their lifestyle. Medications can reduce menstrual bleeding or stimulate ovulation in women with irregular periods. Hormone therapy — for example, to balance the levels of follicle-stimulating hormone and prolactin, which can interfere with ovulation — can also be used to treat some types of infertility. And if you have a uterine or cervical condition, such as endometriosis or pelvic inflammatory disease, it may be treated with medicine, surgery or both. In addition, a healthy diet and moderate exercise can make a big difference in your ability to conceive. And for both sexes, it’s important to avoid smoking and exposure to radiation and toxins. The risk of infertility increases with age. In general, it’s a good idea for women over 30 to visit a health care provider about fertility problems after one year of trying for a pregnancy. For women over 35, the recommendation is to see a health care professional after six months of trying to conceive.
Pregnancy and fertility problems can have a profoundly negative impact on people’s lives. The inability to become pregnant can put a major strain on relationships, and it is emotionally devastating to see friends, family members and even complete strangers have children while one remains unable to conceive. It can also lead to depression, anxiety and other mental health issues.
Fortunately, infertility is treatable, and many treatments can help women and men who are trying to conceive. For women, the most common causes of infertility are problems with ovulation or blocked tubes. For men, the most common causes are low sperm count or an issue with ejaculation. Many of these issues can be treated using assisted reproductive techniques (ART).
In the majority of cases, however, it is not possible to pinpoint a cause for infertility. This is known as unexplained or other infertility and affects about 15% of infertile couples. Fortunately, today’s high-tech medical procedures are capable of connecting an egg with sperm even when sex cannot naturally occur.
The most common fertility treatment for unexplained infertility is intracytoplasmic sperm injection (ICSI). In this procedure, a single sperm is injected directly into an egg. If this is unsuccessful, the doctor may suggest gamete intrafallopian transfer (GIFT) or zygote intrafallopian transfer (ZIFT). In these procedures, eggs and sperm are fertilized in a lab and then transferred to the fallopian tubes with the use of a fiber-optic laparoscope.
Often, ART is recommended after other treatment options have been tried. However, some of these procedures can cause complications including multiple gestation, chromosomal abnormalities and increased risk of ovarian cancer. In addition, the long-term use of fertility drugs can have serious health consequences, such as heart disease and high blood pressure. In addition, it is important to ensure that everyone has access to affordable and accessible healthcare, including fertility care, and to ensure that these services are included in national universal health coverage benefit packages.
If you are having trouble getting pregnant, it’s important to talk with your primary care doctor or OB-GYN. They can refer you to a specialist for testing and treatment.
Fertility problems can be difficult to diagnose. However, certain symptoms such as pelvic pain, heavy periods or skipped periods could be a sign of an underlying problem.
Irregular periods can make it very difficult to get pregnant, particularly for women 35 and older. A regular menstrual cycle indicates ovulation, which is necessary for pregnancy. If you have irregular or absent periods, it’s important to schedule a visit with a fertility specialist, as this may be a sign of a serious health condition.
Infrequent periods or a missing period completely (amenorrhea) can be caused by hormonal imbalances or structural problems in the uterus, ovaries or fallopian tubes. A gynecologist can diagnose the problem and recommend treatment, which often involves fertility treatments.
An infrequent or missed period can also indicate that you’re in a stage of life called perimenopause, when your hormone levels decline and ovulation stops. This is the final phase of a woman’s reproductive years and can be caused by age, lifestyle or diet.
Women with abnormal bleeding can be diagnosed by a pelvic ultrasound or hysteroscopy, both of which are diagnostic procedures that allow your doctor to see inside your uterus. Abnormal bleeding can be caused by uterine fibroids, endometriosis, side effects from an intrauterine device or health conditions such as blood clotting disorders or cancer.
A couple of irregular periods a year is usually nothing to worry about, but anyone who has missing or infrequent menstrual cycles should see a doctor, regardless of their age. Irregular or infrequent periods can be a sign of a fertility issue that’s getting worse and should be evaluated by a specialist. If left untreated, this can lead to infertility and other health issues. Women with irregular or absent periods can experience many symptoms, such as weight gain and facial hair growth, a deep voice and masculine features (hirsutism). This is called virilization.
Pelvic pain can be a fertility problem in women. If the pain is chronic, or interferes with daily life, you should see a doctor. Pain can be a sign of ovulation problems, or other gynecological issues like pelvic inflammatory disease (PID) and endometriosis. Pelvic pain can also be a symptom of uterine fibroids.
If you have pelvic pain, your doctor will take a detailed history and perform a physical exam. They may order blood tests or a urinalysis to check for infection, or imaging scans such as ultrasound, magnetic resonance imaging (MRI), computerized tomography (CT) or abdominal X-rays. They may also recommend a laparoscopy, which involves inserting a thin tube with a camera into the abdomen.
PID can damage the fallopian tubes that connect the ovaries to the womb, or shorten the neck of the uterus (cervix) and prevent sperm from entering the uterus. It can also cause irreversible scarring to the reproductive organs. Women with PID often have a fever, dull pelvic pain, backache and pain during intercourse or with bowel movements. They may have a heavy vaginal discharge with an unpleasant odor or painful urination.
The CDC says 1 in 8 women who have PID will have trouble getting pregnant. This is because the bacterial infections that cause PID can lead to scarring within the reproductive organs, which can affect ovulation and pregnancy. In some cases, the scarring can make it difficult for the woman to carry a child full term. PID can also lead to miscarriage, a pregnancy that ends in the death of an embryo. A doctor can treat most types of PID, and many patients who get treatment become pregnant.
When a woman becomes pregnant, her body naturally releases the egg for fertilization by the sperm. If this process is not working properly, you might have a fertility problem. Women can experience a variety of symptoms, including irregular menstrual cycles and painful pelvic cramps. A doctor can test for a number of conditions that might be contributing to a woman’s infertility.
One of the most common fertility problems is infrequent ovulation, which means that an egg is not being released each month. This is caused by changes in the release of hormones from the hypothalamus and pituitary gland, which are responsible for ovulation. These hormones are called luteinizing hormone (LH) and follicle-stimulating hormone (FSH). They stimulate the ovaries to develop eggs, but sometimes these eggs do not mature and are released.
A lack of ovulation can be caused by blocked fallopian tubes, endometriosis, polycystic ovary syndrome (PCOS), fibroids and thyroid problems. Medications can also affect fertility. For example, sulfa drugs (such as Azulfidine) and other medications that increase the risk of blood clots can interfere with ovulation.
In males, fertility declines with age, and a man’s chances of becoming fertile are only about 10% per month after the age of 35. Male fertility problems can be due to an abnormal sperm count or a damaged vas deferens, which carries sperm from the epididymis to the ejaculatory duct and the urethra.
Both men and women can have fertility problems, although most of the time it is the woman who has the problem. A couple may be considered infertile if they cannot conceive after 1 year of trying and using birth control. Fertility problems can be caused by a number of things, and they can affect people of all ages.
Men with low sperm counts can still become pregnant, but the chances are much lower than those who have healthy counts. Sperm count is usually lowered by poor hormone levels and structural issues within the body. Low sperm counts are a result of genes, lifestyle and illness and can occur as early as puberty (“congenital”) or later in life. Smoking, alcohol and some medications can lower sperm count as well as childhood infections and long-term illnesses.
Once a man’s sperm are produced in the testicles, they spend two to 10 days passing through the epididymis before entering a tube that transports them down the penis (vas deferens). At this point, muscular contractions force the sperm out of the epididymis and into an ejaculatory duct. It is then mixed with seminal fluid from the prostate gland and ejaculated out of the penis into the urethra. Blockages in this process are the cause of about 25% of infertility problems in men.
If a man finds out he has a low sperm count after a semen analysis at his doctor’s office or at home with an at-home test, he should schedule an appointment with a fertility specialist right away. They will take into account his medical history as well as examine his genitals and ask questions about his lifestyle and habits. They will also check to make sure he doesn’t have an infection or other condition that is interfering with his sperm production. In some cases, if an infection is causing low sperm count, antibiotic treatment can improve the number of sperm. If an infection isn’t the cause, a variety of medications may help increase the number of sperm.
Fertility problems can be caused by a number of factors. Treatment options for both men and women may include medicine or surgery. For women, this includes medicines that stimulate the ovaries and can increase chances of pregnancy.
Radiation can cause fertility problems. For men, erectile dysfunction can also affect fertility.
When a couple is trying to conceive, it may be helpful to have medication available. These medications can help the woman ovulate or stimulate sperm production, and can be prescribed by a fertility specialist (also called a reproductive endocrinologist). Some of these drugs are taken by mouth (clomiphene citrate, Clomid for example), while others are injected (human chorionic gonadotropin [hCG], recombinant human follicle stimulating hormone [rhFSH], metformin).
Before you get fertility treatment, you should make an appointment with your GP, who may refer you to a specialist. You should also have a full medical history for yourself and your partner, including information about previous pregnancies. You should also bring a record of any medications you are taking, including vitamins and herbs.
A doctor will review your medical history and do a physical exam. You will likely have blood tests done to check your hormone levels, which are important in ovulation and conception. You may also have an ultrasound of your uterus and fallopian tubes to find out if they are blocked. An ultrasound of the scrotum can also identify testicular problems, such as varicoceles.
For women who have ovulation problems, medications can be used to encourage the monthly release of an egg (ovulation). These include oral medication (clomiphene citrate, Clomid), and injectable medications (human chorionic gonadotropin, hCG, recombinant human follicle stimulation hormone [rhFSH], and metformin). These drugs have very few side effects. In some cases, if the drugs are used too long, they can cause a condition known as ovarian hyperstimulation syndrome, which causes your ovaries to grow and produce too many eggs.
In some men, low sperm levels can prevent fertilization of an egg. To stimulate sperm, doctors can prescribe male hormones (androstenedione and testosterone) or a drug that blocks the activity of the enzyme that breaks down testosterone, hydroxychloroquine. These drugs are typically taken orally, but some are given intravenously. Infections of the uterus or epididymis can reduce sperm production, so men with fertility problems may be treated with antibiotics.
A number of conditions can cause fertility problems. Some of them can be treated surgically. For example, if a woman is born with an abnormally shaped uterus or vagina, surgery can correct this problem and help her get pregnant. Some surgical procedures can even eliminate the need for fertility drugs or in vitro fertilization (IVF).
Surgically treating some pelvic conditions can enhance the effectiveness of medications and in vitro fertilization. For example, a hysteroscopy can identify and surgically remove fibroids, polyps, scar tissue from the uterine cavity, or an abnormal septum that could be blocking sperm from entering the fallopian tubes. Surgery can also treat endometriosis and pelvic inflammatory disease, which can make it difficult to conceive.
The first step in finding the cause of fertility problems is for the couple to see a gynecologist or urologist who specialises in infertility treatment. A thorough medical evaluation will be performed, including a physical exam and blood tests to check hormone levels. The doctor will also examine the ovaries and uterus with ultrasound or X-rays. In some cases, the doctor will inject the ovaries with medication to stimulate them. However, these medicines are not proven to increase the chance of getting pregnant.
In 80% of couples with unexplained infertility, doctors can determine what is causing the problem by testing the ovaries, fallopian tubes or sperm. For example, a simple surgery called laparoscopic ovarian drilling may be used to test for polycystic ovary syndrome (PCOS). In this procedure, the doctor uses heat or a laser to destroy the cysts that cause PCOS.
In the last 15% of cases, doctors cannot determine what is causing infertility. This category includes couples who are unable to get pregnant after a year of unprotected sex and women with irregular, painful or no periods. Couples with this problem might choose IVF using a gestational carrier, where the mother’s embryo is implanted in another woman’s uterus. This method can have multiple births, which introduces health and emotional complications that can be severe.
IVF (in vitro fertilization) is the most advanced fertility treatment. It’s used for patients who have failed to achieve pregnancy with more basic treatments such as intrauterine insemination (IUI). Patients with severe male factor infertility are also candidates for IVF, which uses an advanced form of fertilization called Intracytoplasmic Sperm Injection or ICSI (pronounced “ick-see”). During ICSI, just one healthy sperm is injected into each egg, increasing the chance of successful fertilization. After fertilization the resulting embryos are placed in the woman’s uterus.
IVF has been found to be effective in many women with unexplained infertility as well as those who have had previous miscarriages, a history of tubal disease or tubal ligation and some patients with endometriosis. Women who have a history of endometriosis are more likely to achieve a clinical pregnancy with IVF, but routine resection of endometriomas prior to beginning IVF does not increase pregnancy rates or improve the chances for success of IVF.
Other treatments that may be used in conjunction with IVF include a minor surgical procedure called laparoscopic ovarian drilling for women with polycystic ovary syndrome, or a surgery called laparoscopic epididymectomy to remove a coil-like structure in the testicles that sometimes blocks sperm from being released normally. Both of these procedures are performed under local anesthesia as outpatient operations.
Women who have serious medical conditions that would make it unsafe to carry a baby to term, such as Marfan syndrome, New York Heart Association class 3 or 4 heart failure, Eisenmenger syndrome or pulmonary hypertension, can still undergo IVF with the use of a gestational carrier. The oocytes (egg cells) are fertilized with the partner’s sperm but then transferred to a woman who will carry the child to term.
Access to fertility services varies widely across the country, with some states requiring private health insurance plans and Medicaid, the national health coverage program for low-income individuals and families, to cover infertility diagnosis and treatment. However, even among those states with mandates, a number of factors influence who receives help and who doesn’t. For example, a higher share of Black and Hispanic women seek fertility care, but many have limited private insurance coverage or no health coverage at all.
Many people use complementary therapies when trying to have a baby, including herbal medicines and manual therapies such as massage and reflexology. However, there is little evidence that these improve fertility in women or men or increase the chance of a successful pregnancy for people having IVF treatment. It’s important to speak to your GP or fertility doctor before starting any complementary therapy.
Fertility problems can be stressful for both women and men, and chronic stress can cause a physical chain reaction that makes it even harder to get pregnant. Some fertility practitioners believe that complementary therapies like yoga and acupuncture can help reduce stress and restore the body’s balance, which may improve a woman’s chances of becoming pregnant.
Acupuncture is believed to boost blood flow to the uterus, making it a more hospitable environment for a fertilised egg and also reduce men’s issues with low sperm count or quality. But while acupuncture and other complementary therapies have been used to treat fertility problems, there is little evidence that they do so and more high-quality studies need to be done to support these claims.
One study, published in the journal Human Reproduction, found that women who had a healthy diet and took a course of acupuncture, massage or yoga were more likely to have a successful pregnancy than women who didn’t take these measures. But researchers conceded that the study was too small to determine whether the complementary therapies actually made a difference and more research needs to be done.
It is important to remember that many complementary medicines are not regulated and may contain ingredients that could be harmful, especially in young children or those who are pregnant or breastfeeding. They may also interact with some conventional medications.
There are simple and effective lifestyle changes that you can make to improve your health and wellbeing, find out more on the NHS website. In addition, some complementary therapies can be expensive, but there may be free or low-cost options in your area. There is a growing body of evidence that suggests that mindfulness, meditation and yoga can be useful for people who are struggling with fertility issues.
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Infertility is a complex medical condition that can happen for many reasons. In 20 percent of cases, it can’t be explained. Female fertility declines significantly after age 35, and men may also experience problems.
The most common fertility problem in women is that they don’t ovulate (release an egg) regularly. This can be due to hormone imbalances, a condition called polycystic ovary syndrome, or scar tissue in the fallopian tubes caused by surgery. Women can also develop a lack of ovulation due to a low number or poor quality of eggs, a condition called premature ovarian insufficiency (POI).
Menstrual cycles are controlled by many glands, and for women to ovulate, the pituitary gland secretes hormones that signal the ovaries to release an egg. If these signals are disrupted, it can lead to irregular or absent periods, a condition called amenorrhea.
If a woman doesn’t ovulate, she can’t get pregnant, even with healthy sperm. In fact, it is estimated that ovulation problems account for about half of all infertility in women.
When a woman is ovulating, the cervix (neck of the womb) makes thin mucus that sperm can swim through to reach the egg. But if the cervix is swollen or irritated, it may be hard for sperm to swim through.
A woman’s ovaries can be affected by a lot of things, including the way she moves or lifts heavy objects. Certain medications, like birth control pills and hormone replacement therapy, can interfere with the normal ovulation process. A woman can also lose her ability to ovulate if she experiences severe stress, an eating disorder, or certain thyroid conditions.
Sometimes, no reason is found for unexplained infertility. However, it is important for women under 35 to see a doctor after trying to conceive for a year or for those over 40 to visit a doctor after six months of unsuccessful attempts. The sooner a woman seeks treatment for ovulation issues, the more likely she is to have successful pregnancy outcomes. Treatment options include medicines, fertility treatments such as artificial insemination or in vitro fertilization, and surgical procedures. These may be used alone or in combination with other therapies. Many couples treated for infertility go on to have healthy babies. But, in about a third of all cases, the cause can’t be found and there is no effective treatment.
Blocked fallopian tubes are one of the most common causes of female infertility. When a woman ovulates, her egg travels down the fallopian tube to the uterus where it can be fertilized by sperm. In around 35 percent of cases, one or both of the fallopian tubes are blocked, preventing an egg from reaching the uterus and fertilizing.
The fallopian tubes are located in the pelvic cavity, connected to the ovaries and uterus by the cervix. Each month during ovulation, the ovaries release an egg that then travels down one of the fallopian tubes to be fertilized by sperm. When the egg is fertilized it then implants in the uterus, where it becomes a zygote. The other fallopian tube can also be blocked, which is known as tubal factor infertility.
Many women who have blocked fallopian tubes don’t have any symptoms and are unaware of this problem until they begin to struggle to conceive. Infection is the most common cause of blocked fallopian tubes, particularly a previous chlamydia infection (85 percent of women who have this infection don’t know they have it). Other causes include inflammation from endosalpingiosis or endometriosis and enlarged fibroids that can put pressure on the fallopian tube.
In some cases, a blocked tube can be fixed with medication or surgery. The best treatment depends on the type of blockage, the severity and location of the scarring as well as whether one or both tubes are blocked.
Male fertility problems can be caused by many different things including a low testosterone level, abnormal sperm production and a condition called oligospermia. A man with oligospermia only produces a few sperm each month which makes it very difficult for him to become pregnant.
Men who are suffering from a low testosterone level can benefit from medications and surgical procedures such as testicular biopsy to diagnose the cause of their infertility. A low testosterone level is often caused by infections or an underlying disorder of the pituitary and hypothalamus glands. In some cases, a lack of natural testosterone is caused by testicular trauma or a birth defect that occurs during fetal development such as cryptorchidism.
When you want to get pregnant, your body needs to have a few things in place. The man must make healthy sperm, and the woman must produce eggs that can be fertilized. To conceive, the egg and the sperm must meet inside the woman’s uterus, where it will implant and develop into a healthy baby. Infertility can be caused by a problem in the woman’s reproductive system, a problem in the man’s, or both.
If you are having trouble getting pregnant, talk to your doctor early on about what may be causing it. Infertility can lead to stress and emotional problems in a couple, so early diagnosis and treatment is important. If you have tried to conceive for a year and aren’t successful, or if you have had two or more miscarriages, it’s time to see a specialist.
Endometriosis is a condition where tissue resembling the uterus grows in other parts of your body, including the pelvic area. This causes pain and interferes with fertility. There is no cure for endometriosis, but surgery can help with symptoms and improve your chances of conceiving. Yale Medicine offers laparoscopy, a minimally invasive technique that allows doctors to look for and remove the endometrial cells. In some cases, your doctor may need to perform a full surgical procedure called a laparotomy.
Male infertility accounts for over a third of all cases of infertility. It can be caused by problems with sperm production, with the way sperm travel from the testicles to the fallopian tubes, or with the delivery of the sperm to the egg.
If your doctor thinks you might have male infertility, he or she will ask about your health history and do an exam of your vagina and cervix. The doctor will also do an ultrasound of your abdomen to check for blocked or scarred tubes or for cysts behind your uterus. A sperm sample will also be tested for signs of abnormalities that might cause infertility. Treatment for male infertility includes medications and surgery. In some cases, a man may need to have his fallopian tubes opened or removed, in order to increase the chances of his partner becoming pregnant.
In most cases of male infertility, there’s a problem with the sperm. The sperm needs to be able to fertilise the egg, so a low count or problems with the shape and movement (motility) of the sperm can cause infertility. Men with this type of fertility problem can get treatment on the NHS or privately.
Some home-testing kits claim to tell if the sperm is normal, but these are not very accurate and it’s best to see your GP instead. Your GP will arrange for a semen analysis, where a sample of your semen is tested to check the number and quality of the sperm. Other tests can also be done, including hormone tests and a test for the presence of antibodies that attack and kill sperm as it passes through the body. These are often caused by certain illnesses, injuries or medications, such as mumps, diabetes, steroids and exposure to radiation or toxic chemicals.
If the sperm test results are abnormal, your doctor will try to find out what’s causing it. This can include a blood test to measure levels of testosterone and follicle-stimulating hormone, which are both important in the production of healthy sperm cells. A swab may be taken from the inside of your penis to check for blockages in the tubes, or a test to look at the sperm cells themselves to see if there are any signs of an abnormal shape. If you have no sperm in your semen (azoospermia), your doctor may examine your testicles for problems, such as small testicles or a missing vas deferens, or carry out genetic testing.
If the sperm tests are abnormal, you may be prescribed medication to increase the sperm count. Clomiphene is a commonly used drug for this purpose, but assisted reproductive technologies can also be considered. Other treatments include surgery to repair any abnormalities, such as varicoceles, or sperm donation. Genetic disorders that prevent sperm production can’t be cured, but in vitro fertilization with intracytoplasmic sperm injection can help men father a child.