Understanding Men's Infertility Diagnosis And What To Expect Physically and Emotionally

What Percentage of Men Are Infertile?

While being diagnosed with infertility is devastating, you are far from alone. Globally, around 1 in 6 people experience infertility at some point in their life. Furthermore, male infertility has been steadily increasing over the last 30 years. As of 2019, over 56 million men suffer from infertility globally — an increase of almost 77% since 1990. In particular, male infertility more than doubled in Southeast Asia during the same time period.

Unfortunately, male infertility is still highly stigmatised in Southeast Asia, leading it to be underreported. Because of this, there is not enough information to estimate the rate of infertility amongst Southeast Asian men. Overall, the percentage of men who suffer from infertility can range from 2.5% to 12%. The Central Asia and Oceania regions had the highest rates at 9% to 12%. This begs the question: how much of a role does male infertility have when it comes to conceiving a baby?

Even though most infertility information is for women, globally, male infertility accounts for 50% of fertility problems amongst couples. About one-third of infertility is due solely to male factors. And another one-third is due to a combination of male and female factors. While fertility impacts men and women equally, the underlying causes vary significantly between genders.

Common Causes of Male Infertility

Conceiving is complicated. Even during people’s most fertile years, couples only have about a 30% chance of getting pregnant in the first month of trying (based on European data). This number is greatly influenced by the sperm’s ability to get to and penetrate an egg. As a man suffering from infertility, it’s important to understand your specific issues, which may include:

• Low sperm count: Your testes may be having difficulty producing a high enough quantity of sperm. As your sperm count decreases, the chances of getting your partner pregnant also decrease. Your sperm count is considered low (oligospermia) if you have fewer than 15 million sperm in each milliliter of semen or under 39 million sperm per ejaculate. Around 10% to 15% of men diagnosed with infertility have no sperm (azoospermia).

Keep in mind: your sperm count can vary. So don’t be surprised if your results are different if you have multiple semen analyses.

Poor sperm quality: Even if your body makes enough sperm, they need to be able to reach and penetrate an egg. This is where sperm motility and morphology (shape) come in.

• Sperm motility is how well your sperm can move. Most men have some percentage of immobile sperm. But this only becomes a problem if at least 32% of your sperm are not actively moving.
• Sperm morphology is the shape and size of your sperm. This is important for the sperm to be able to penetrate an egg. Most sperm are not perfect. So to be considered fertile, at least 4% of your sperm must be appropriately sized and shaped.

Blockage: A blockage in your reproductive tract could prevent sperm from getting into your semen. This is called obstructive azoospermia. There are several locations where sperm can be blocked, including in your:

• Epididymis: This is located behind your testes and is where sperm is stored to mature.
• Vas deferens: This is the tube that transports sperm from your epididymis to your ejaculatory duct.
• Ejaculatory duct: This is the tube that allows sperm to enter your semen and leave your body.

For many, blockages can be surgically fixed, which can restore fertility. But this is not the case for everyone.

There are numerous reasons why you may have low sperm count, poor sperm quality, or a blockage. These include genetics, hormonal imbalance, infection, trauma, medications, exposure to chemicals, age, excess body weight, diet, alcohol/drug consumption, life stressors, other lifestyle choices, and certain medical conditions. Unfortunately, studies estimate that the cause of infertility remains unknown (idiopathic) in about 40% of infertile men, ultimately amplifying the emotional toll infertility has.

What Is the Emotional Toll of Male Infertility?

For many, the emotional toll of infertility is far greater than the physical one. It can leave you feeling angry, embarrassed, and ashamed. It can make you question your own manhood and adequacy as a husband or partner. You may feel guilty for not being able to give your wife or significant other a child. You may also feel responsible for your partner going through the challenges of fertility treatment. You may even grieve the person you thought you were and the children you do not have.

But it’s important to know these feelings are common amongst men facing infertility. Some studies show that almost 1 in 5 men with infertility have depression symptoms. But this could be as high as 1 in 3. Beyond depression, about 60% of men suffering from infertility also have anxiety. Infertility can impact your mental health so much that you may experience an overall decrease in your personal and sexual quality of life.

While men have the same desires to have children as women, they often face more stigma and social isolation when it comes to infertility, especially in Asia. Historically, infertility has been seen as a female problem. So men are often taught they can have children whenever they choose to. To make matters worse, male fertility is often wrongfully associated with masculinity and sexual prowess.

These stigmas can cause men who are diagnosed with infertility to have an identity crisis and withdrawal from their family and friends. Almost half of men suffering from infertility have not spoken about their condition with anyone except their wife. The immense shame and need to preserve ‘face’ can cause men to isolate themselves, leading to significantly less social support than women. So, what can you do to get the support you need?

 By: Julz Richterman, PharmD, MBA, BCGP

Steps You Can Take to Manage Your Infertility

Being diagnosed with male infertility does not mean all hope is lost. Here are some steps to help you navigate your fertility journey and live a happier life:

• Speak to your fertility specialist to learn more about your options to achieve fatherhood and the IVF process in Singapore
• Eat a healthy diet. Avoid sugary drinks and junk food. Eat lots of vegetables
• Participate in physical activity
• Manage stress
  
• Lose excess body weight.
• Quit smoking.
• Limit or stop alcohol and recreational drug use
  
• Avoid long exposures to extreme heat
• Seek support from family, friends, or professionals to better manage and cope with your infertility
  

Conclusion

Being diagnosed with infertility is scary and filled with unknowns. There are many reasons for male infertility, including low sperm count, poor quality sperm, or a blockage in your reproductive tract. But now that you know what percentage of men are infertile, you can feel confident there’s an entire community of support behind you.

You do not need to face infertility alone. If you are experiencing guilt, anger, depression, anxiety, or any other infertility-related distress, we can help. Don’t let your infertility control you! Book a consultation now!

FAQs: Male Infertility

How can you tell if a man is infertile?

• Usually, the only symptom of male infertility is the inability to conceive a baby after trying for at least a year. Once this happens, a urologist or fertility specialist can further evaluate the reasons for your fertility issues. In some cases, there are symptoms men experience that can lead to or be a sign of infertility. Be sure to seek medical attention if you are experiencing pain after ejaculation, testicular pain or swelling, low sex drive, or inability to maintain an erection.
  

Can a man be permanently infertile?

• Yes, but not always. There are many different causes of infertility. Some infections, trauma, heat exposure, or medications may only temporarily affect your fertility. But the damage can be permanent. There could also be other factors, like genetics and age, that could lead to long-term infertility problems. But this does not necessarily mean you cannot have a biological child. Speak with your doctor about your specific case and what you may be able to do to help improve your fertility.
  

Can you fix male infertility?

• Sometimes. If you have a blockage in your reproductive tract, this can often be surgically fixed. There are other changes you can make that can potentially improve your fertility, like diet, exercise, and stress management. But some risk factors are out of your control. These include age, genetics, other medical conditions, infections, and previous exposure to chemicals or medications. In these cases, you may not be able to improve your fertility or chances of conceiving naturally. In this case, speak with your fertility doctor about your options! There are several medical procedures available to you that can retrieve sperm directly from different parts of your scrotum. From there, your sperm can be used to fertilize an egg through IVF.

How does my age affect my fertility?

• Unlike women who are born with a set number of eggs, men can continue to produce sperm for their entire lives. But their sperm count and quality tend to start decreasing around 40 years old. This can potentially reduce your chances of having a child. In addition, if a child is conceived by a father over 40 years old, the baby has a greater chance of having genetic or health issues, being born early, or having a low birth weight.15 Nonetheless, men can successfully have a healthy baby at any age of adulthood.

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