Are you man enough?

June is Men’s Health Month, and there can be no better opportunity to highlight the importance of the early detection and treatment of many male-specific diseases.

One health problem that is generally not given much media attention, however, is male infertility and this June, males experiencing difficulties with starting a family are urged to be man enough to accept responsibility for infertility.

Specialist in reproductive medicine, Vitalab’s Dr Merwyn Jacobson says infertility in men is a genuine medical issue which accounts for nearly one half of all infertility cases. In fact, male infertility is the reason up to 40% of South African couples cannot achieve pregnancy.

This is a remarkable statistic considering that infertility still tends to be largely attributed to the woman; a misconception Dr Jacobson says needs to be changed as a matter of urgency:  “Men do tend to interpret being infertile as a blow to their sexual prowess but, for the sake of improving a couple’s chances of conceiving, men must realise that infertility has nothing to do with virility. In fact, they are even manlier if they – and their peers – can accept and deal with their infertility, which has more to do with the absence of healthy sperm in the semen than good looks, a muscular physique and being potent.”

The fact that there are generally no obvious symptoms or warning signs of male infertility helps to further reinforce the notion that infertility is a female problem. “The production of sperm is a very complicated process that begins at puberty and continues, in healthy males, until late in life, so it is not surprising that men can be infertile,” says Dr Jacobson. “There are a number of potential causes of male infertility:


  • Smoking
  • Recreational drugs
  • Alcohol abuse
  • Use of anabolic steroids
  • Tight underwear
  • Exposure to toxic chemicals

Hormonal problems                      

Physical problems:

  • Damaged sperm ducts
  • Varicocele (varicose veins of the testicles)
  • Infection from the likes of mumps and STDs
  • Genetics
  • Retrograde ejaculation
  • Previous vasectomy


The aforementioned conditions may result in anything from thecomplete absence of sperm (azoospermia), low sperm count (oligospermia), abnormal sperm shape (teratozoospermia), or problems with either sperm mobility (asthenozoospermia), or sperm that is completely immobile (necrozoospermia).

However, men can reduce their chances of being infertile by minimizing certain risk factors. Just like women, men do have biological clocks and fertility does gradually decrease in men who are older than 40.

One test to evaluate male fertility isa semen analysis. This will determinethe number, activity and shape of the sperm. This relatively simple test involves the man providing a semen sample for a lab to evaluate. Dr Jacobson says it is the overall evaluation of the ejaculate, not the only the quantity, of sperm that influences a man’s ability to impregnate an egg: “Men with low sperm counts may not have trouble fathering a child, while men with high sperm counts may.  A person’s fertility also depends on the fertility of their partner.”

Fertility can be improved

Fortunately, in a large number of cases, male infertility can be improved either by treating the problem or using fertility treatments. The most straightforward treatment options include a course of antibiotics in cases of infection, medication or fertility drugs to improve sperm production, or surgical correction in order to remove a varicocele, repair a duct obstruction or reverse a vasectomy.

There have also been huge improvements in dealing with more complicated male fertility problems, including reduced sperm mobility. IUI, or intrauterine insemination, is a relatively simple infertility treatment in which a small catheter is used to place specially washed sperm directly into the uterus. Also referred to as artificial insemination, this treatment may beused in cases of low sperm count or quality.

IVF treatment may be suggested if IUI is not successful or appropriate, or if female infertility is a contributing problem.  Today, in even the most difficult of male infertility cases, the direct injection of sperm into eggs in a procedure called Intra Cytoplasmic Sperm Injection (ICSI) can now significantly improve the likelihood of pregnancy. Other treatments include electro-ejaculation for patients with spinal cord injuries, epididymal sperm aspiration for men with absent or blocked ducts, and hormone replacement for individuals with pituitary deficiencies.

This Men’s Health Month, if you and your partner have been trying to unsuccessfully conceive for more than one year, be man enough to admit that you may have a role to play in the fertility stakes. Together with your partner, seek the help of a reputable fertility clinic to help realise your dream of starting a family.

(Press Release, June 2011)

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