In the past, the inability of a couple to conceive a child was attributed primarily to women. Today, however, it is already known that it equally affects men. Whether we are talking about poor quality sperm, genetic disease, high weight or perhaps a urological complication. Although the causes of infertility are numerous, they are still relatively little discussed. Do you know what normospermia means? Where can you find varicocele? Or what obesity does to your hormones?

When to start addressing infertility in men?

We can talk about infertility of a couple at the moment when after a year of regular and unprotected intercourse, pregnancy does not occur. Infertility affects approximately 15% of couples in the Czech Republic, with one third of the cases involving the woman, one third the man and the remaining third involving both parties. Therefore, if a couple is unable to conceive a baby within twelve months with regular intercourse, it is recommended to undergo a comprehensive examination.

“An exception occurs if the woman is over thirty-three years old. There, the examination should be performed after about half a year of unsuccessful efforts,” advises MUDr. Kateřina Veselá, Ph.D., director of the Repromeda Reproductive Clinic. “In men, the age limit is not as crucial as in women, but even in them the years cannot be completely ignored. For example, as the years go by, the proportion of mutated sperm increases, while the volume of healthy, motile sperm gradually decreases,” points out MUDr. Veselá. So what do men most often struggle with in the field of fertility?

What are the most common causes of infertility in men?

Male infertility can be caused by genetic factors and health problems, but also by lifestyle and environmental or hormonal imbalances such as stress.

Poor quality or slow sperm

In the event of difficulties, a man’s first steps lead to a spermogram. Poor quality sperm is in fact one of the most common causes of male infertility. After three days of sexual abstinence, the man will take a sample of ejaculate in a sterile container and hand it in personally. An analysis is then carried out to assess the number, structure, shape and movement of the sperm, the proportion of mature cells, the volume of semen and its pH. If all parameters are in order, the condition is called normospermia.

The good news for men is that they can improve the quality of their ejaculate by their own efforts in some cases. “It is recommended to follow the principles of a proper lifestyle, supplement vitamins E and C, zinc, selenium, folic acid or omega-3 fatty acids,” explains MUDr. Veselá.

A man should limit the opposite:

• alcohol
• smoking
• excessive caffeine intake
• heating in the genital area
• wearing tight underwear
• frequent consumption of soy

Genetic disorders – DNA, spermatogenesis or varicocele

Unfortunately, even a favorable spermogram does not mean that a man is fine. Genetic disorders are another pitfall. Often these are various chromosomal mutations, breaks in the DNA or a disorder of spermatogenesis, i.e. the production of sperm. The basic examination therefore also includes the so-called karyotyping, which is an analysis of a blood sample that monitors possible deviations in a person’s chromosomal make-up. Genetic anomalies can be responsible not only for the inability to conceive at all, but also for repeated miscarriages.

Therefore, if a man is found to have a serious condition, IVF is usually the solution. Based on the problem identified, the doctor will determine a procedure to obtain healthy sperm and, in the case of a hereditary condition, IVF will then select an embryo that does not carry the genetic defect. Varicocele is another complication that is genetic. This is a relatively sensitive male issue – enlargement of the veins of the testicle. Due to the reduced quality of the venous wall, the blood drainage is then impaired, the testicles overheat and the quality of sperm is reduced. However, varicocele can be addressed surgically and the spermiogram will then usually improve.

Obesity – BMI over 30

Although at first glance it may seem that obesity is not directly related to fertility, unfortunately the opposite is true. If your BMI is above 30, you are setting yourself up for problems not only with diabetes, high blood pressure or heart problems, but also in the area of reproduction.

“In an obese man, hormone levels are altered and the fatty tissue subsequently loosens different types of substances into the body than are needed in a healthy man. As a consequence, sperm production may decline,” warns MUDr. Kateřina Veselá from Repromeda Reproductive Clinic.

At the same time, toxins accumulate in the adipose tissue, the temperature in the testicular area increases, and erectile dysfunction occurs. However, the positive news is that a significant weight loss leads to an adjustment of hormone levels and an improvement in spermiogram values in obese men.

Sexual diseases

Another cause of male infertility can be an improperly treated venereal disease. For example, a chlamydial infection carries an increased risk of DNA damage to the sperm, which is then unable to fertilize the egg. In order to conceive an offspring, it is therefore necessary to undergo an ejaculate collection, which is then purified of the damaged sperm and healthy cells are selected for fertilization. Even more severe consequences can be caused by gonorrhea, for example. This often causes inflammation of the testicles and damage to the pathway between the epididymis and urethra, so that the sperm cannot pass through the fallopian tube. The sperm must then be removed surgically under general anesthetic. Although the best option is to think about appropriate prevention of disease transmission, fortunately, even such extensive complications usually have a solution today.

How to diagnose the cause of infertility in men

A spermogram is a basic analysis of the ejaculate. In the treatment of infertility of a couple, it is performed as a complete examination. Spermiogram determines, for example, sperm motility and shape, sperm count, liquefaction, etc.

A comprehensive view is provided by the SpermPacket diagnostic package, which includes:

• Spermiogram,
• halosperm – determines the degree of DNA damage,
• testing the oxidative stress in the ejaculate – i.e. the reproductive capacity of the sperm,
• immasperm – to determine the percentage of mature sperm.

We also offer other types of Spermpackets here. Our experts will be happy to advise you on the appropriate choice.

The examination of a man also includes:

• genetic testing to detect chromosomal defects
• immunological examination
• urological examination

TIP: You can also read about the most common causes of female infertility.

The most common causes of infertility. You can make an appointment in Brno or Ostrava by phone or via the contact form.

However, the important step is an individual approach and consultation with a specialist who can choose the most suitable treatment method according to the specific needs and situation of each patient.