Male Subfertility

Male Fertility Treatment at a Private Fertility Clinic in London

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What are the causes of subfertility in men?

This is due to low sperm quality or problems with erection or ejaculation. The likely reasons are smoking, vaping, binge drinking, exposure to hot environments (eg steam, sauna), varicocele, diabetes and genetics. Male fertility is also affected by age and declines in mid 40s.

How is male fertility assessed?

Semen Analysis and Culture - determines sperm concentration, motility and shape. The semen culture checks for the presence of microorganisms. Sperm DNA Fragmentation - is an indicator of the fragility or DNA damage within the sperm. High DNA fragmentation is a predictor of low IVF success rates and high miscarriage risk. Hormonal Profile - determines testicular function when sperm count is very low. Genetic Tests - Chromosome analysis, Y deletion and Cystic Fibrosis evaluate genetic causes. Ultrasound Scan - assesses testicular size, tubal blocks and presence of a varicocele.

Meet Dr Koita

Experience personalised fertility solutions under my expert guidance.

I am a fellow of the prestigious Royal College of Obstetricians and Gynaecologists (FRCOG) and trained in Assisted Conception at Kings College Hospital, London. I've also done a Masters in Healthcare Leadership, from Cornell University, USA.

My commitment extends to making comprehensive diagnostic services readily available and financially feasible across the UK. I aim to empower you through IVF Matters, ensuring you have access to a wide range of high quality services.

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Yes. Vaping can negatively impact male fertility and sperm health. Studies have found a negative correlation between nicotine levels and sperm concentration, motility, and morphology in both infertile and fertile men, suggesting a dose-specific effect of nicotine on sperm parameters.

A 2020 Danish study found that men who regularly vaped had lower sperm counts than non-vapers. Another systematic review in 2020 highlighted that the harmful substances in e-cigarettes can disturb the hormonal balance, morphology, and function of the male reproductive organs.

So while more research is still needed, especially on humans, the current evidence from multiple studies suggests that vaping and the chemicals present in e-cigarette liquids may have detrimental effects on various aspects of male fertility and sperm health.

Yes, binge drinking can negatively affect male fertility.

Several studies have shown that heavy or binge drinking can lead to reduced sperm quality and production.

A Danish study found that men who binge drank (5 or more drinks in a few hours) had lower sperm counts and altered reproductive hormone levels compared to non-binge drinkers.

Heavy drinking, defined as 15 or more drinks per week, can lower testosterone levels and reduce sperm production by impacting hormones like follicle-stimulating hormone and luteinizing hormone.

Alcohol abuse and acute intoxication can also cause sexual dysfunction like erectile dysfunction or premature ejaculation, which can hinder conception.

High caffeine intake can negatively impact male fertility and increase the risk of miscarriage in the following ways:

For men, high caffeine intake (over 250 mg/day) is associated with lower odds of achieving clinical pregnancy per initiated cycle compared to men consuming less than 100 mg/day. Caffeine may damage sperm DNA and impair sperm quality.

For women, consuming over 200 mg/day of caffeine before conception was linked to an increased risk of miscarriage compared to those consuming less than 100 mg/day. High caffeine intake in early pregnancy (first 7 weeks) also raised the miscarriage risk.

The study found that both the male and female partner's high pre-conception caffeine intake (over 2 caffeinated drinks per day) was associated with an increased risk of miscarriage.
This suggests paternal caffeine consumption may also play a role in pregnancy loss, potentially by affecting sperm quality.

However, some studies did not find a clear association between moderate caffeine intake and semen parameters or infertility risk. The evidence is mixed, but high doses of caffeine appear detrimental to male fertility and early pregnancy.

In summary, limiting caffeine consumption, especially high doses over 200-300 mg/day, is advisable for both partners when trying to conceive to reduce the risk of miscarriage and optimize fertility potential.

Yes, male fertility does depend on age. As men get older, their fertility declines due to several factors.

Sperm production decreases with age. The number of germline cysts in the final stage of spermatogenesis declines substantially as males age, leading to reduced sperm production. This decline occurs chronologically with age, regardless of mating activity.

Sperm quality diminishes with age. Older men tend to have lower sperm motility, higher rates of abnormal sperm morphology, and more DNA fragmentation in their sperm.

Testosterone levels drop with increasing age, which can impact sperm production and sexual function.

The risk of genetic abnormalities in sperm increases as men get older, potentially affecting embryo development and pregnancy outcomes.

While age-related fertility decline is more pronounced in women, male fertility also decreases steadily after around age 40-45, making it more difficult to conceive naturally with an older male partner.

Therefore, a man's age is an important factor influencing fertility and the ability to achieve a successful pregnancy

High BMI (obesity) can negatively affect male fertility and sperm quality in several ways:

It can reduce sperm count and concentration - obese men are 42% more likely to have a low sperm count compared to men of normal weight

It increases sperm DNA damage and oxidative stress on sperm, which can impair fertilization and embryo development.

Obesity lowers testosterone levels by increasing aromatization of testosterone to estrogen, which is essential for sperm production.

It raises scrotal temperature, negatively affecting sperm health and motility.

High BMI is associated with lower normal sperm morphology (shape), reducing the ability of sperm to fertilize an egg. However, some studies report conflicting results on the effects of obesity on sperm motility and morphology. The negative impacts seem more pronounced with higher degrees of obesity.

Importantly, weight loss through diet and exercise has been shown to improve semen quality, sperm count, and reproductive hormone levels in obese men, potentially reversing obesity-related male infertility.

Finasteride, a commonly used hair loss treatment, can potentially impact male fertility and semen quality. Here are the key points:

Finasteride works by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), which is a hormone linked to male pattern baldness. By reducing DHT levels, it can help slow down hair loss and promote hair regrowth. However, this mechanism of action can also affect the male reproductive system. Studies have shown that finasteride may lead to:

Reduced semen volume
Decreased sperm count and motility.

Altered sperm morphology and increased sperm DNA fragmentation.

These effects are generally mild and reversible after discontinuing finasteride use.
One study reported improvements in semen parameters 4-6 months after stopping the medication.
It's important to note that while finasteride can impact semen quality, its effects on overall male fertility are not conclusively established. Some studies suggest no significant impact on fertility rates.

For men concerned about fertility, alternative hair loss treatments like minoxidil or non-hormonal options may be considered, as they are less likely to affect semen quality.

In summary, finasteride can temporarily reduce semen quality and sperm parameters, but these effects may be reversible upon discontinuation. Men with fertility concerns should discuss the potential risks with their doctor before starting finasteride treatment.

Yes, keeping a mobile device in the front trouser pocket can negatively affect sperm quality. Several studies have found an association between mobile phone use and reduced sperm motility, viability, and increased DNA fragmentation. The main reasons are:

Electromagnetic radiation (EMR) emitted by mobile phones, especially when in talk mode, can damage sperm DNA and reduce motility.

The heat generated by mobile phones kept close to the testes can raise scrotal temperature, which is detrimental to sperm production and quality.

When mobile phones are kept near metal objects like zippers or keys, the radiation absorption in the testes approximately doubles, further increasing the harmful effects.

Studies have found significantly more DNA fragmentation in sperm exposed to mobile phone radiation, even within an hour of exposure.

Long-term exposure to mobile phone EMR has been linked to decreased sperm concentration, motility, viability, and increased oxidative stress.

While some studies have conflicting results, the weight of evidence suggests keeping an active mobile phone away from the groin area, especially for extended periods, may help maintain optimal sperm quality and male fertility.

Exposure to hot environments like saunas, hot tubs, and steam rooms can temporarily impair sperm quality and production, but the effects are typically reversible after stopping the heat exposure.

Here are the key points:
High temperatures (over 100°F/38°C) can cause scrotal hyperthermia, leading to decreased sperm count, motility, and increased sperm DNA damage.

Regular sauna use (e.g. twice a week for 3 months) has been shown to reduce sperm concentration and motility by over 50%, as well as alter sperm DNA integrity. However, these effects were reversed 6 months after stopping sauna exposure.

Even a single 20-minute sauna session can temporarily decrease sperm count, though it returns to normal within 5 weeks.

Hot tub use above 102°F (39°C) for 30 minutes per week for 3 months has been linked to impaired sperm production and increased sperm cell death.

The negative impacts on sperm quality from heat exposure are usually temporary, with parameters returning to baseline several months after discontinuing the heat source.

So in summary, while saunas, hot tubs and steam rooms can adversely affect sperm in the short-term, the effects are reversible once the heat exposure stops, making it a temporary impairment rather than permanent infertility.

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