Male Fertility

Fertility involves both partners, and a male factor is a common finding among couples who seek help — sometimes on its own, often alongside a female factor. Assessing both from the start avoids months spent looking in one direction only. There is usually nothing to notice either way, which is why it is assessed by testing rather than by symptoms.

For men the assessment usually begins with a semen analysis and a general health review, because sperm production is sensitive to the rest of the body. Sleep, weight, blood sugar, thyroid function, past infection, heat, medicines and substance use all feed into it.

• Swelling, discomfort or a heavy feeling in the scrotum
• Reduced facial or body hair, or other hormonal changes
• Ongoing difficulty with erection or ejaculation

• Varicocele — enlarged veins in the scrotum
• Past infection, injury or an undescended testis
• Hormonal or thyroid imbalance
• Excess weight, diabetes and disturbed sleep
• Tobacco, alcohol and recreational drug use
• Prolonged heat exposure, and some occupational exposures
• Certain medicines, and past chemotherapy or radiotherapy

1. 1Stopping tobacco is among the changes most consistently advised
2. 2Keep weight and blood sugar within a healthy range
3. 3Avoid prolonged heat — long hot baths, saunas and a laptop resting on the lap
4. 4Keep sleep regular, since hormone rhythm follows it
5. 5Reduce alcohol, and avoid unprescribed hormone or bodybuilding supplements
6. 6Have both partners assessed together rather than one after the other