Male infertility: causes, assessment and treatment
Male infertility is more common than it seems and may be present in up to 50% of cases where there is difficulty achieving pregnancy. At Clínica Fertia we carry out a comprehensive assessment to identify the cause and offer the most appropriate treatment.
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Advanced assessment of the male factor
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What is male infertility?
Male infertility occurs when there is difficulty achieving pregnancy due to factors related to the semen or to the man’s reproductive function.
It may be caused by:
- abnormalities in sperm concentration
- motility problems
- abnormalities in morphology
- damage to the sperm genetic material
In many cases, understanding the cause makes it possible to define a clear strategy and improve the chances of pregnancy.
Talking about fertility is a matter for both partners. Understanding that is the first step forward.
Causes of male infertility
The causes of male infertility can be very varied. Among the most common are:
Abnormalities in sperm production
Varicocele
Genital tract infections
Hormonal problems
Genetic factors
Exposure to toxins or heat
Age and lifestyle
There are also risk factors for male fertility that can negatively affect semen quality, such as smoking, alcohol, stress, obesity, certain medications or prolonged exposure to oxidising agents.
Assessment of male infertility
The assessment of the male factor must be comprehensive, because the cause is not always detected by a single test. At Clínica Fertia we assess each case individually and can complete the diagnosis with various tests.
1. Basic semen analysis
According to the WHO, a sample is considered normal if it has:
- A concentration of at least 15 million sperm per millilitre
- At least 32% of sperm with progressive motility
- 4% of sperm with normal morphology
The findings of the semen analysis may indicate various abnormalities:
- oligozoospermia: low concentration
- asthenozoospermia: impaired motility
- teratozoospermia: abnormal morphology
- necrozoospermia: impaired vitality
- azoospermia: absence of sperm in the ejaculate
2. Semen culture
This makes it possible to detect infections that may affect semen quality.
3. Endocrine assessment
This helps to assess whether there are hormonal abnormalities related to sperm production.
4. Genetic tests
Tests such as:
- karyotype
- cystic fibrosis screening
- Y chromosome microdeletions
may be relevant in identifying the genetic condition responsible for severe abnormalities in the semen analysis.
Sometimes it is not about carrying out more tests, but about carrying out the right ones.
Techniques or tests
Semen analysis
The semen analysis is the basic test for assessing male fertility.
It allows semen quality to be analysed through parameters such as:
- sperm concentration
- motility
- morphology
It is a simple but crucial test for obtaining an initial picture of a man’s reproductive health.
In many cases, it is the first step towards understanding what might be happening.
Sperm DNA fragmentation
Sperm DNA fragmentation assesses the genetic quality of the sperm.
It may be associated with:
- implantation failure
- recurrent miscarriage
- poor embryo quality
It may be abnormal even when the semen analysis is normal.
Sometimes the problem isn’t obvious at first glance, but that doesn’t mean there isn’t a solution.
Genetic analysis of semen (FISH)
The FISH analysis of semen makes it possible to analyse whether there are chromosomal abnormalities in the sperm.
This type of test is useful in cases where:
- there have been several unsuccessful attempts
- there is a history of miscarriage
- a genetic problem is suspected
It helps to make more precise decisions in assisted reproduction treatments.
Urology and andrology in the assessment of male fertility
Urology is the medical and surgical speciality that studies diseases of the urinary tract and the male reproductive system.
Within this field, andrology focuses in particular on:
- erectile dysfunction
- male subfertility
- metabolic syndrome in older men
In addition, urology also treats conditions such as:
- tumours of the prostate, bladder, kidney, testicle or penis
- urinary tract infections
- varicocele
- benign prostatic conditions
- congenital malformations
At Clínica Fertia these cases are managed individually, following up-to-date criteria and using minimally invasive techniques where necessary.
Treatments for male infertility
Treatment will depend on the specific diagnosis.
It may include:
- lifestyle changes
- medical treatment
- antioxidant supplementation
- varicocele surgery
- assisted reproduction techniques such as IVF or ICSI
Varicocele surgery and fertility
In some cases, varicocele surgery can improve semen quality and increase the chances of pregnancy. Whether it is indicated depends on the severity of the condition and on the medical assessment.
A comprehensive approach to male fertility
Male infertility cannot always be resolved with a single test or a single solution. That is why a comprehensive approach is important, combining diagnosis, treatment and follow-up.
At Clínica Fertia we analyse each case individually to offer a clear and realistic strategy.
Because understanding what is happening is the first step towards finding the best solution.
An early diagnosis can change the outcome.
Frequently asked questions about male infertility.
Can male infertility be treated?
Yes. Depending on the cause, it can be addressed through lifestyle changes, medical treatment, surgery or assisted reproduction.
What tests are carried out to investigate male infertility?
The assessment may include a semen analysis, semen culture, hormone tests, genetic testing, DNA fragmentation and FISH analysis of the semen.
How should I prepare for a semen analysis?
It is recommended to abstain from sex for between 2 and 5 days and to collect the sample following specific instructions to ensure the reliability of the result.
Can sperm DNA fragmentation be improved?
In some cases, yes. Lifestyle changes and the use of antioxidants may help to improve sperm DNA quality before starting treatment.
When is a FISH test on semen necessary?
It is mainly recommended in cases of recurrent miscarriage, implantation failure or when there are significant abnormalities in the semen analysis.
When is in vitro fertilisation or ICSI needed?
When the diagnosis requires it or when other measures do not allow pregnancy to be achieved naturally.
Take the first step in investigating male infertility
At Clínica Fertia we analyse your case and help you find the best treatment to move forward with clarity.
Because this journey is travelled together too