Signs and Symptoms of Infertility in Men

Infertility in men is most often the result of a medical issue that can only be determined by medical tests and is not readily evident from physical signs or symptoms. However, there are medical conditions, treatments or physical injuries that may result in infertility and should raise concern.

Signs of infertility in men

There are few obvious or tell-tale signs of infertility in men. In fact, erections, ejaculation and the sperm itself may appear normal and reveal no signs of infertility or an underlying medical condition.

However, there might be obvious reason for male infertility, such as a vasectomy or a spinal cord injury. There could also be medical conditions or medication that is affecting sexual performance and fertility, as well as a range of lifestyle factors and the use of steroids or testosterone.

Symptoms of infertility in men

The term “infertility” is used in the medical field to describe a couple’s inability to conceive after a year of unprotected intercourse where the female partner is younger than 35, or after six months where the female partner is older than 35, or the inability to carry a pregnancy to term.

It is important to know that you are not alone in facing infertility. The incidence of infertility worldwide is high. In fact, the World Health Organization (WHO) estimates that approximately 8-10% of couples experience some form of infertility problem. However, the incidence of infertility may vary from region to region.

The truth is that male infertility is far more common than many people realise. In around 30% to 40% of the infertility cases that we work with at Cape Fertility, there is a male infertility factor involved – meaning that the cause of a couple’s infertility is due to, or partly due to, a medical problem experienced by the male partner.

It is also important to realise that “infertility” does not mean that you are unable to have a child, but rather that you will require medical assistance to achieve a pregnancy. Infertility is a medical disorder, which often needs appropriate medical treatment.

Fortunately, it is also true that there are a range of male infertility treatments available for the many possible causes of male infertility.

Causes of infertility in men

There are many factors that can cause male infertility.

Some are obvious, such as male sterilization or vasectomies, or spinal cord injuries, or erection or ejaculatory dysfunction. Other possible causes may be more difficult to pinpoint, such as previous mumps infection, any STDs (sexually transmitted diseases), previous surgery or old injuries especially in the groin area such as a torsion.

A range of lifestyle factors such as being overweight, smoking and drinking, or the use of steroids or testosterone can also affect the quality of the sperm.

Male fertility levels can also decline due to several causes such as age, stress, a compromised immune system, environmental factors like working with chemicals and heat caused by tight briefs, hot tubs and saunas.

There could be medical conditions or medication that is affecting sexual performance and fertility.

Problems with sperm production or the quality of the sperm are the top cause of infertility in men. In fact, male fertility is defined by the “sperm quality”, which refers to semen volume, sperm count, sperm motility (movement) and sperm morphology (shape).

For this reason, after a thorough medical review, the first male infertility test that is done is a sperm test.

How to identify infertility in men

Today’s advanced male infertility tests allow us to pinpoint the medical problem that is causing infertility, and also to recommend the best treatment for it.

The first test that we do at Cape Fertility is a semen analysis.

First, we look at the volume of the sperm. A normal volume is at least 1.5ml. If the volume is much lower than this, it raises the concern of a possible obstruction between where the sperm is produced and ejaculation.

Next, we consider the concentration of the sperm. One measurement of this is to look at how much sperm there is per millilitre of sample. We also look at how much sperm is in the entire sample.

We then move on to motility. General motility refers to what percentage of the sperm are moving, even if they are just twitching or swimming in circles. Progressive motility refers to the percentage of the sperm that are not just moving, but also actually making progress in its movement. We consider 42% for total motility to be within normal range and 32% for rapidly progressive sperm or sperm that is moving from point A to point B.

The next thing we look at is morphology, which refers to how the sperm looks. Men are often appalled to hear they have only got 4% or 5% normal-looking sperm. However, we only expect 4% of the sperm to look normal, because that is what is usually the case.

We also look at the pH of the sperm. This can give us information about what’s happening with the ejaculatory ducts that make the fluid to support the sperm. We can also see how many of the sperm are alive. We check for antibodies, because if you have had a previous vasectomy and a reversal, there can sometimes be antibodies that might hinder the sperm from moving normally.

This is the routine sperm test that we do at Cape Fertility. But thanks to our advanced facilities and technology, we are also able to do more advanced male infertility tests when necessary, such as DNA fragmentation, which looks at the DNA integrity of the sperm; and a whole spectrum of sperm function tests.

Where to get male infertility treatment

Fortunately, whatever challenge there may be related to the production of sperm or the quality thereof, there are advanced treatments available. For example, if there’s a severe limitation on the amount of sperm, there are other alternatives such as IVF or ICSI, during which the sperm is actually injected into the egg in a lab. Even if there is absolutely no sperm in the sample, there are medical and surgical options available to address this, and if those options are not suitable, there is always the option of a sperm donation.

The treatment or combination of treatments are often highly individual and obviously depend on what is revealed by the semen analysis report.

We offer many advanced treatments at our purpose-built premises in the beautiful city of Cape Town, with procedure rooms and a modern sophisticated laboratory adjacent to our Main Reception and Staff Offices. These facilities, along with our experienced team, ensure all the latest fertility treatments are used with great success at Cape Fertility.

If you are concerned about your fertility, we would like to invite you to set up an initial consultation with one of our fertility experts at Cape Fertility. It is as simple as contacting us here

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our custom-designed premises in the Claremont Medical Village under the eaves of the picturesque Constantia Mountains and the back of Table Mountain.