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It takes two to tango - Why Infertility isn't just a women's problem.

It might come as a major surprise, that men actually contribute about 50% to infertility challenges in a couple. To be more specific, 40% of infertility is female factor, 40% male factor and 20% is combined or idiopathic (hard word for ‘no understandable reason’).

The amount of information and push towards fixing infertility as a ‘woman problem’ is actually dumbfounding and extremely lopsided because realistically speaking it has always taken two to tango! It is however true that female factors in infertility are generally a tad more complicated to fix ( granted by the fact that the woman is the one who carries the baby in utero for 9 months). While most male factor issues can be easily treated, it is time we begin to speak up more about male infertility and how it can be treated, because as I always say, there is hope and there is healing!

So what exactly is infertility?

Allow me to get just a bit sciencey here. The WHO defines infertility as when the male or female reproductive system fails to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. In women over 35 this period is shortened to 6 months. This definition is rather broad and in some ways excludes some important factors in fertility like:

  • This unprotected intercourse needs to be occurring within the woman’s fertile window otherwise you may have regular unprotected sex until the cows come home but still not achieve a pregnancy simply because the timing in relation to ovulation is off.

  • There is also a difference between the term infertility and subfertility. Infertility concludes that the couple ‘cannot conceive naturally’ and subfertility means that chances of conceiving are simply below optimum. In my experience, most couples aren't actually infertile but are subfertile - that is, given time and opportunity to prime their bodies for conception, they would be able to conceive naturally. Research on subfertility shows that 50% of couples after trying to conceive unsuccessfully for 6 months, go on to conceive spontaneously within the next 6 months. Of those who have tried for 12 months, 50% again go on to conceive spontaneously within the next 36 months


The Billings Ovulation Method informs that a man cannot be considered truly infertile unless he produces no sperm at all! Remember it only takes one sperm to fertilize an egg, only one little guy to win mother nature’s hardest triathlon!. A complete lack of sperm (azoospermia) is the cause of infertility in about 15% of men who are infertile and 1% of all men. This condition is caused by a hormone imbalance or a blockage of sperm movement.

In cases where the man produces less sperm than normal, it is called oligospermia or a low sperm count. The most common cause of oligospermia is varicocele, an enlarged vein in the testicle.

A normal ejaculate contains about 280 million sperm ( yes, you read right!). A man may produce a normal amount of sperm but the sperm is abnormal or malformed.

Problems with the sperm can be caused by issues like:

  • Chromosome defects and disorders

  • Diabetes

  • Hyperprolactinemia : an overproduction of a hormone called prolactin

  • Injury to the testicle

  • Insensitivity to male hormones called androgens, which include testosterone

  • Swelling of the testicles from infections such as mumps, gonorrhea, or chlamydia

  • Thyroid problems

  • Mal-descended testes: The testes did not descend from the scrotum as a newborn or young boy.

  • Varicocele, which is the enlargement of veins in the scrotum; enlarged veins disrupt the blood flow in the testicle and cause an increase in temperature, which negatively affects sperm production. This condition is present in about 40% of men with fertility problems.

  • Cystic Fibrosis- Many men with cystic fibrosis lack the tubes that carry the sperm out of the testicles.

Lifestyle, environmental, and age-related factors can also play a major role in male infertility.

  • Smoking

  • Marijuana

  • Street drugs

  • Steroid use

  • Being overweight

  • Certain occupations (e.g. transport drivers, cooks) in which scrotum temperature is raised leading to low sperm counts;

  • Chronic fatigue;

  • Erectile Dysfunction

  • Exposure to toxins such as chemicals, pesticides, radiation or lead, especially on a regular basis

  • Age & age men unlike women never lose their fertility entirely, men can continue producing sperm throughout their life cycle, but the quality of this sperm deteriorates with age.

There are factors and conditions that affect sperm motility ( movement) even if the man is producing enough viable sperm. Sperm may move too slowly or not move at all and thus die before reaching the egg. Sometimes the seminal fluid, which contains the sperm can be too thick for the sperm to wiggle around properly. This inability to transport sperm properly causes about 10-20% of cases in men who are subfertile. It can be caused by natural blockages in the tubes that transport sperm from testicles to the penis. A man who has had a vasectomy has had these tubes cut and sealed so proper sperm transportation cannot occur.

There is hope and there is healing!

The beauty about male subfertility is that the majority of the problems are correctable most with just an outpatient visit to the doctor and of course going about things holistically with treatments such as; acupuncture, Chinese herbs, lifestyle changes and nutrition advice. I encourage men and the ladies in their lives to be open and speak up about issues of fertility. Early diagnosis and earlier treatments often means a greater chance of achieving your dream of a little one.

As always, remember to be kind to yourself and to the one you love. After all, fertility is a couple phenomenon!


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