en spend a large part of their lives preventing their partner from getting pregnant and hoping, if any accidents were to happen, that luck would be on their side and an unplanned pregnancy could be avoided. But there is often a little voice whispering quietly at the back of your mind saying, “Maybe you’re just firing blanks.”
Infertility, or sub-fertility, as doctors now refer to it because many of the factors affecting fertility are relative rather than absolute, is a concern for many men. And understandably so, with one in seven couples in the UK reporting difficulties in conceiving in 2013.
How do you know you are fertile?
Is it an assumption that you are until you start trying to make a baby and things don’t happen or is there a test you can have to put your mind at rest? Is there anything you can do to optimise your fertility? Allow GQ to explain.
How common is male infertility?
Although one in seven couples report difficulty in conceiving more than 80 per cent of couples having regular unprotected sex will conceive within a year and 92 per cent within two years (if the female is under 40). Getting your partner pregnant may take time and this doesn’t necessarily mean there is a problem. In my professional experience there are few couples who fell pregnant because the virile stud in the equation “got her on the first go.”
However, there are unfortunately cases where despite time, patience and through no lack of trying, efforts fail to result in a pregnancy and this can be very difficult. Unexplained infertility accounts for 25 per cent of cases. Male infertility accounts for 30 per cent of cases and 45 per cent of cases are from female infertility.
Am I fertile?
Unless you have been trying for a baby unsuccessfully for more than twelve months, have symptoms which may suggest an underlying condition that is associated with fertility issues or have been previously told you have a medical disorder that may affect your fertility it’s safe to assume you are fertile.
What can affect fertility
• Alcohol excess
• Elevated scrotal temperature
• Increasing age
• Infections e.g. mumps and sexually transmitted infections both cause orchitis (inflammation of the testicles), which reduces fertility
• Ejaculatory problems e.g. erectile dysfunction
• Prescription drugs e.g. some antibiotics, immunosuppressants, gout remedies, steroids, anti-sickness medication, antipsychotics
• Recreational drugs e.g. cocaine and cannabis
• Performance enhancing drugs e.g. steroids
• Chemotherapy drugs
• Herbal remedies e.g. root extracts of tripterygium wilfordii and gossypol
• Chronic health conditions e.g. diabetes, thyroid disease, cardiac disease
• Trauma to testicles
• Tumours e.g. testicular, pituitary gland
• Genetic disorders
• Previous surgery to groin e.g. after bladder, scrotal or hernia surgery
What symptoms might suggest an underlying health condition that could affect fertility?
Are you having problems with erections or ejaculation? Is there any blood mixed in with your sperm or do you get pain after ejaculating or passing urine? Do you get pain or swelling in the testicles or do your testicles actually look quite small? Do you have any penile discharge? Are you lacking facial or pubic hair? These symptoms may suggest an underlying problem with the testicles, your hormones levels or an infection that affects fertility and you should see your GP for further assessment and investigation.
Are you anxious or depressed? This may be responsible for fertility issues and you should see a GP for advice.
Will I need to be examined if I go to my GP?
Yes. Your GP will offer to check your blood pressure, Body Mass Index and may suggest an examination of the genital area.
Will I need a test to assess my fertility?
You may be offered a sexual health screen, which involves a urine sample and a swab of the urethra (tip of the penis), if there is concern about an underlying infection.
You may also be offered semen analysis. This is an assessment of a sample of sperm to check for how much ejaculate you produce, how many sperm you make, how motile these sperm are and the proportion of abnormal or deformed sperm. The conditions for doing this test are quite strict so make sure you understand any timing issues especially in terms of getting the sample to the lab within an hour of producing it. Most GP surgeries will provide you with a leaflet giving clear instructions on how to do the test correctly.
What happens if I’m told there is a problem with my fertility?
Fertility issues are usually managed as a couple rather than as two separate individuals, so if there is a problem your GP will suggest you attend with your partner who will also be offered an assessment. Following this you may be referred onto a fertility specialist for input.
At a fertility appointment you may be offered further investigations, treatment and if appropriate access to assisted conception.
Can herbal remedies help fertility?
Herbal remedies aren’t currently recommended.
How can I protect my fertility?
Stop smoking if you are a smoker, avoid drinking excessive amounts of alcohol, stay away from recreational and performance enhancing drugs and keep your Body Mass Index within normal limits. Practice safe sex to avoid sexually transmitted infections by wearing a condom.