Why Male Infertility is a Sliding Scale

Why Male Infertility is a Sliding Scale

Guest Post: Harry Gardiner

It’s a worrying commentary on modern life that one in five healthy young men between 18 and 25 now has an abnormal sperm count, and infertility plagues around one in seven couples trying to conceive. These statistics show that infertility is a massive problem, and they’re particularly worrying if you are one of those people trying to conceive, or you are planning to try at some point in the not so distant future.

Because men rarely talk about infertility, most people assume that it’s women who are normally the infertile partner. But in fact infertility strikes both sexes fairly equally. There is a difference, though, in the type of infertility issues each sex suffers from.

Whereas women are born with their lifetime supply of eggs, men produce sperm throughout their lives. In a normal, healthy male, sperm is produced “on-demand”, roughly every three weeks. This difference shapes the causes of infertility affecting each sex. Most female infertility is caused by issues with the fallopian tubes and the uterus rather than the quality of the eggs themselves. Whereas most male infertility is to do with sperm quality, function or count, not the reproductive mechanics.

Why does this matter? Because if a woman isn’t releasing eggs into her uterus, in-vitro fertilization (IVF) can be used as a workaround, fertilizing eggs outside the body and placing them into the uterus to develop into a fetus. But if a man is producing defective sperm, it’s more difficult to find a physical intervention that can help. Either the sperm work or they don’t. If they don’t, natural conception won’t work, and nor will IVF. The best hope of a solution is to find out why defective sperm are being produced, and try to remove the cause. But the causes are varied, and tracking them down may be hard.

Some of the main factors affecting male fertility are sperm motility, viability, morphology and count, along with testosterone levels. Unfortunately, although scientists understand exactly what these factors are, there are a myriad of causes, behaviors and issues that can lie behind them.

Many males suffering from infertility wrongly assume that they are ‘damaged goods’ and there’s nothing they can do about it. However, male fertility is not a switch, but a scale. A highly fertile man will find it easy to conceive, and a male with very low fertility will find it hard or impossible. But in between lie a whole range of cases where fertility is low, but not zero.

Small changes can and do tip the balance either in favor or against conception. This explains why there is so much apparently contradictory evidence out there about what causes male infertility.

Let’s look at an example. Imagine that Jim has 95/100 on our fertility scale and Bob has 55/100. Assume that 50/100 is the tipping point between fertile and infertile. If wearing tight boxers affects fertility by 5/100, Jim would be absolutely fine fertility-wise wearing tight boxers. However, if Bob wears tight boxers, given that he is already teetering on the edge, they may cause him to have problems conceiving.

As our example shows, if you’re having trouble conceiving it’s vital to consider all the relevant factors, and do whatever you can to edge above 50/100. That includes the type of underpants you wear, where you keep your cell phone, and how much coffee you drink!


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