Advertisement
Men's health

Male fertility. Improving sperm health and chance of pregnancy

SHANNON H.K. KIM, VICTORIA NISENBLAT
OPEN ACCESS

Figures

© SCIENCEPICTURE.CO/MEDICAL IMAGES.COM
© SCIENCEPICTURE.CO/MEDICAL IMAGES.COM

Abstract

Male factor infertility is common. There is insufficient knowledge in the general population of how to optimise fertility in men, and preconception counselling often focuses on female factors. This article provides advice on preconception care for men and discusses strategies that may be implemented to optimise male fertility based on the existing evidence base.

About one in six couples experience infertility and 50% of cases are due to male factors, either as a sole cause or as a contributing factor.1 Although there is increasing awareness about optimisation of general and reproductive health before pregnancy, preconception counselling primarily targets women. Male partners often receive less attention and less is known about preconception care for men.2

Preconception care aims to improve general and reproductive health and should be offered to both partners. Preconception counselling is recommended for all couples who are aiming to conceive. Preconception advice can be divided into four domains:

Advertisement
Advertisement

  • advice based on the person’s medical history and a fertility assessment
  • educating couples about coital practices
  • recognising and eliminating modifiable risk behaviours and exposures 
  • recommending treatments that may improve fertility.

History and fertility assessment

Early and appropriate recognition of reproductive risks is important and helps to identify people who would benefit from early assessment and targeted interventions. In addition to taking a general medical history, basic fertility assessment of a male partner should cover the following:

Advertisement
Advertisement

  • coital frequency and timing and any difficulty with erections or ejaculations
  • previous fertility
  • childhood conditions (e.g. mumps orchitis, undescended testes or testicular torsion)
  • previous genitourinary tract infections
  • adverse lifestyle exposures, including past or current use of anabolic steroids.

Early semen analysis and referral to a specialist in male reproduction or urology are warranted if the history is abnormal.

Advertisement
Advertisement

Pages

Figures

© SCIENCEPICTURE.CO/MEDICAL IMAGES.COM
© SCIENCEPICTURE.CO/MEDICAL IMAGES.COM
Dr Kim is a Urologist at IVF Australia, Westmead Fertility Centre and the Royal Hospital for Women, Sydney; and Conjoint Lecturer at UNSW Sydney, Sydney. Professor Nisenblat is a Clinical Senior Lecturer and Visiting Research Fellow in the Discipline of Obstetrics and Gynaecology at The Robinson Research Institute, University of Adelaide, Adelaide, SA; and a gynaecologist at Westmead Fertility Centre, Sydney, NSW.