In a third of cases, there is a male factor involved in difficulty in achieving a pregnancy. Sometimes a problem is due to impaired sperm production. Occasionally it is due to obstruction of one of the ducts leaving the testicles. Sometimes the problem is hormonal and occasionally there is a genetic element. Lifestyle changes are important.
We know that ceasing smoking improves sperm counts and reduces erectile dysfunction. Restricting alcohol intake improves sperm quality and avoiding high temperatures for the testicles maximises sperm output. Not being overweight improves fertility in males and having less than two cups of coffee a day may improve sperm counts.
Avoiding medications such as injectable testosterone, which is taken by some bodybuilders, is very important for male fertility. Recreational drugs such as cocaine, heroin and marijuana also have a negative effect on sperm count. Investigations of male infertility include a basic sperm count, chromosome analysis, some hormone levels and sometimes sperm antibodies.
Treatment options depend on what the cause of fertility is. Sometimes hormone problems can be treated by injections, such as luteinising hormone and FSH (follicular stimulating hormone). Surgery is sometimes required e.g. reversing vasectomies. There may be a place for treating varicoceles but this is not entirely certain.
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