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Extraordinary Conceptions

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[Mar. 28th, 2007|10:43 am]
Extraordinary Conceptions
Boy Story

YOU may be surprised to know that when it comes to infertility, men and women are pretty equal. So why is talk about male infertility so rare?
When you're a woman and you hit your 30s, IVF suddenly seems to turn from the stuff magazine articles are made of to a regular conversation among your girlfriends.
The fact is, once you reach a certain age, most women know someone who's doing IVF, has done it or considering giving it a try.
Blame it on not yet meeting Mr Right, even blame it on your bank balance, but more of us are not in a situation where we can consider having children until later in life, and often it's just too late.
It's a fact that's put infertility on the radar for many women. But can the same be said for the men in our lives?
How many men do you know who even think about their fertility, much less feel concerned about it?
The Fertility Society of Australia conducted a national survey last year on fertility.
It discovered that only two per cent of the people interviewed thought that male infertility was the reason behind couples seeking medical help to conceive.
Put that another way and it sounds more dire; 98 per cent of us think that female, or gynaecological, problems are always at the heart of conception difficulties. "I think it's a very common misconception," says Professor Gab Kovacs, the Monash IVF national medical director. "You wouldn't believe the number of couples who, once they've investigated everything from the female side of things, putting her through all of the tests and practically making her jump through hoops, discover that the problem lies with the male. "Most people just assume that infertility is predominantly a female problem. It's partly because men assume that if all other aspects of their masculinity are in place, then there's no way there could be a problem with their sperm.
"Men just don't want to acknowledge that their fertility might be in question." Dr Moira O'Bryan, a scientist from the Monash Institute of Medical Research who was recently awarded an accolade from the Society of Reproductive Biology for her work in the area, agrees:
"People just don't talk about male infertility. It's my experience that people think it's more socially acceptable for a woman to be infertile than it is for a man. Somehow it does make them feel less manly. Unfortunately I also think it's true that not enough is being said about it - as a problem it seems relatively low on the agenda." The facts and figures In truth, male infertility is almost as prevalent as female infertility. According to figures compiled by Andrology Australia, an organisation dedicated to promoting male reproductive health, around one in eight couples are considered infertile and for about one in five affected couples the problem lies with the male partner.
In fact, it's estimated that one in 20 Australian men has some kind of fertility problem. They're figures that Kovacs has experienced first-hand. "In about one-third of the couples who visit me the problem lies with the female, another third with the male, another third due to a bit of both and the remaining 10 per cent is unknown." In line with this is the fact that male infertility is the underlying reason behind 40 per cent of the IVF and other assisted reproductive technologies that occur each year in this country. Once you consider the figures, it's obvious that infertility is far from being just a female concern. Cause and effect So what are the leading causes of male infertility? While there are a number of factors at play, a big piece of the puzzle comes down to age.
While a 20-something woman has a 20 per cent chance of falling pregnant each month, fertility starts to decline at around age 31, so that by the time we celebrate our 35th birthday, the average woman's fertility has already dropped by about 50 per cent.
At 40, our fertility is around 10 per cent of what it was when we were 25, and for most women there's only a one per cent chance of falling pregnant each month when you're 44. But what about men? Does one more candle on the cake each year reduce their ability to conceive?
According to some studies the answer is yes. Collaborative research from Columbia University's Mailman School of Public Health and Jerusalem's Hebrew University Hadassah Medical School found that women with partners aged 35 and older were three times as likely to miscarry than those with a partner under 25.
Meanwhile, a study from the French national health institute INSERM found that among couples undergoing fertility treatment, regardless of the women's age, pregnancy attempts were 70 per cent more likely to fail when the man was 40 or older than if he were younger than 30. Neither Kovacs nor O'Bryan believe that age is the main cause of male infertility.
"There is a slight decrease in a male's fertility with age, but it's nowhere near as significant as it is for women," says Kovacs.
"Probably the most common cause of male infertility is a problem with sperm production - so the testes either aren't making enough sperm or the sperm that is being produced, doesn't work properly. This can be caused by a number of things." Another common cause is an obstruction in the flow of sperm, something that affects about 15 per cent of infertile men.
"That is a very common cause of male infertility these days, and, as obvious as it sounds, it often occurs because men have had vasectomies. They then decide that they'd like to have more children, so opt for a reversal which may not be successful." Taking action If you've been actively trying to conceive for a year, but still haven't hit the jackpot, O'Bryan suggests getting tested.
"And in line with what we've been talking about, it's a good idea to start with getting the male tested, or at least do it at the same time. Male tests are much less invasive, so before a female starts the process, it's a good idea to rule out the male as a possible cause." According to Andrology Australia, the good news is that one in eight infertile men will have a treatable condition that can be completely overcome, paving the way for a natural pregnancy.
In addition, 75 per cent of affected men have sperm present in their semen, but at lower rates than normal, and while IVF can often be the answer in these cases, natural pregnancies are still possible; it can just take longer to conceive. In fact, only one in nine infertile men will have untreatable male sterility. And as for whether you can take measures to protect your bloke's fertility, Kovacs has this to say.
"If you're going to have a vasectomy, make sure you store some sperm beforehand. And likewise if you have to have a cancer treatment like chemotherapy or radiotherapy, both of which can affect sperm production. It's a simple process and is inexpensive to store." Kovacs also recommends avoiding sexually transmitted infections, which can create blockages in the tubes leading sperm away from the testes.
"And look after your general health. There's good research to show that men who drink heavily can compromise their sperm count, as do heavy smokers and men who frequently use recreational drugs." For more information, visit Andrology Australia at www.andrologyaustralia.org or call 1300 303 878. Secret sperm business If you're trying to fall pregnant, and regularly use a personal lubricant during sex, then you might want to reconsider. According to some experts, lubricants act as a temporary but instant fertility killer for many couples.
Researchers from the Cleveland Clinic in the US found that after just 30 minutes of exposure, common lubricants impaired sperm mobility, by up to 98 per cent, leaving only two per cent of sperm okay and able to swim the distance.
The study also found that after a more lengthy exposure to lubricant, it wasn't just mobility that was affected - sperm DNA was also damaged.

Fertility myth ... a woman's reprodcutive systems is readily scrutinised when a couple has difficulty conceiving, but quite often problems stem from the man's sperm. / The Daily Telegraph

source: http://www.news.com.au/dailytelegraph/story/0,22049,21385846-5006012,00.html