Male fertility
Male fertility is a complex issue that is affected by many factors. With the right knowledge and support, it is possible to maintain and even improve fertility, regardless of age.
Male fertility plays an important role in infertility and family planning, although the general discussion often focuses on female fertility. In men, fertility is based on the ability to produce sperm that can fertilise an egg. Sperm must be healthy, sufficiently motile and have the right shape.
Men usually produce sperm throughout their entire life. Male fertility is typically at its highest just after the age of 20, after which it decreases with age. Fertility can also be impaired by various sperm production issues, such as reduced or absent sperm production or sperm with poor motility.
Fertility can vary for many reasons, including lifestyle, health and genetic factors. You can often also influence your own fertility. It is also possible to cryopreserve semen proactively to preserve fertility.
Male fertility also decreases with age
Compared to women, men are usually fertile even at an older age. However, fertility in men also decreases due to a number of biological changes that affect the quality and quantity of sperm.
- Decreased sperm production. Decreased sperm production begins to affect fertility around the age of 35–40.
- Decreased sperm quality. Sperm motility and morphology, or the sperm’s ability to travel to the egg and fertilise it, may decrease with age.
- Increased genetic changes. Older men have a higher risk of producing genetically defective sperm, which can affect fertilisation, miscarriages and the health of offspring.
Smoking, alcohol, stress and obesity can cause poor male fertility
Smoking and other nicotine products reduce the sperm count and motility and decrease the quality of sperm. The results of fertility treatments are also poorer if the man smokes regularly. Heavy alcohol consumption directly affects the testes and reduces sperm production.
Intense, prolonged stress is accompanied by many hormonal changes that affect metabolism. Consequently, prolonged stress can impair sperm production. In overweight men, abundant adipose tissue forms excess oestrogen, which in turn can inhibit sperm production. In addition, excess weight increases the temperature of the testes, which can contribute to poor sperm production.
Learn more: Effect of lifestyles on fertility
Lifestyle changes improve male fertility in 2–3 months
Even a small improvement in the quantity and quality of sperm can improve the success of fertility treatment. Even if the reduced quantity or quality of sperm is an indication for micro-injection therapy (ICSI), it is a good idea to prepare for the treatment by adjusting your lifestyles. Some sperm may have DNA damage that leads to poor male fertility. Corrective treatments are being developed, and one of them is antioxidant therapy, which has shown promising results in some cases. With regard to the formation of semen, results can be expected in the case of both lifestyle changes and corrective treatments within 2–3 months, at the earliest. This corresponds to the time it takes for sperm to mature in the testes.
The effect of medications on fertility
It is important to tell your doctor about the medications you are taking, as certain substances can impair fertility. Anabolic steroids (such as testosterone) used in bodybuilding form a separate group as they inhibit testicular sperm formation very strongly and with long-lasting effects. Long-term use of anabolic steroids may lead to a temporary suppression of sperm production, in which case medication may be required to restore it. Despite this, it is still possible that sperm production may never return to normal.
How is male fertility examined?
Semen analysis shows the fertility of the semen.
The investigation of male infertility usually begins with a semen analysis from a semen sample aimed at determining the man’s ability to conceive. Felicitas Mehiläinen’s sperm laboratory analyses the sperm count, sperm motility, structure and possible antibodies from the sample. Special tests may also be performed as part of semen analysis.
A man’s fertility has started to decline if there are fewer than 15 million sperm per millilitre of semen. In some men, the semen contains no sperm. If there are fewer than 10 million sperm per millilitre, additional examinations are carried out.
Semen disorders may be temporary, permanent or congenital. Sometimes the issue may be caused by blocked or absent seminiferous tubules.
A variety of factors affect sperm production
Chronic illnesses, obesity, genital infections or operations, varicocele, certain medications, alcohol or drug use, and severe stress can all affect sperm production.
If a temporary factor such as fever is suspected to affect the quality of the semen, the result is usually checked (retested) before further examinations (e.g. blood tests).
Sperm antibodies can also affect the fertility of semen. They may occur as a result of, for example, trauma, surgery or inflammation.
Clinical examination, ultrasound examination and hormone tests
A decreased sperm count is examined through blood tests to determine pituitary hormone and testosterone levels that control sperm production in the testes. In addition, the testes and epididymis are palpated, and an ultrasound examination of the scrotum is performed.
If the semen contains no sperm, they may still be found in a testicular tissue sample.
Male infertility can also be caused by hormonal imbalance. Low hormone levels may be caused by congenital factors, but an explanation is not always found. In some cases, hormone levels can be corrected with medication, thereby increasing sperm production.
Genetic testing
Sperm DNA fragmentation test
The integrity of sperm DNA significantly affects sperm fertility. Integrity can be examined using a DNA fragmentation test. The DNA fragmentation index indicates the level and quality of sperm DNA fragmentation.
Learn more about DNA fragmentation testing
Chromosome analysis and Y deletion
Abnormalities in the Y chromosome
If the sperm count is low or the semen contains no sperm, rare abnormalities in the chromosome arrangement or the Y chromosome should also be ruled out.
The Y chromosome contains several gene regions that regulate sperm production (the AZF region, or azoospermia factor), the deficiency (deletion) of which is associated with a strong decline in or complete absence of sperm production.
There are smaller regions within the AZF region (AZFa, AZFb and AZFc) where the deletions affect sperm production differently.
Klinefelter syndrome
In Klinefelter syndrome, the man has an extra X chromosome. Thus, he has 47 chromosomes, including two X chromosomes and one Y chromosome (47, XXY).
Klinefelter syndrome is often accompanied by a reduced testicular volume, due to which the testes do not produce a normal amount of testosterone and sperm production is impaired. For this reason, most XXY men suffer from infertility. In some cases, however, it is possible that sperm is formed in the testicles and the semen is fertile.
Most XXY men do not know about the existence of an extra chromosome until they start thinking about having a child. Based on the abnormal result of a semen sample analysis, the infertility specialist may order chromosome studies for the patient, in which case the presence of an additional X chromosome can be detected in a cell culture sample. Even if no sperm are detected in the semen sample, in some cases it is possible to look for them in the testicular tissue samples for fertility treatment.
MiOXSYS test
The MiOXSYS test is used to examine the oxygen radical level in semen. Learn more about the test here
Do you want to have your fertility checked?
We are here for you if you have concerns about your fertility or are considering having children.
We offer comprehensive services and support for men who want to understand and improve their fertility. Our services include:
- Fertility tests: We use modern and state-of-the-art methods to assess the quality of semen and sperm, providing a clear overview of the current situation and possible issues.
- Counselling and guidance: Our specialists offer individual counselling and guidance on lifestyle changes that can improve fertility.
- Treatments and methods: Our clinics offer a variety of treatments, including hormone therapy and other methods that can improve sperm quality and quantity.
- Cryopreserving Semen to Preserve Fertility: If desired, you can cryopreserve semen for potential future use.
- Therapist’s appointments to discuss your situation.
Book an appointment for semen analysis
Book an appointment with a specialist (remote or at a clinic)