Fertility and Men - Getting the Full Picture
There’s only one way to get a full picture of your fertility, if you are in a heterosexual relationship. That is to have both partners in the relationship tested.
Much is said on this blog about fertility testing and treatment for women.
Men, it’s up to you too. We know you don’t want to do this. We don’t want to do this either. Believe me. And while we make light of what you actually have to do to be tested, we know it’s not all that much fun to masturbate into a cup and hand it over for testing. There can be performance anxiety, which can be really uncomfortable, as well as emotional anxiety, which can be VERY uncomfortable.
We feel for you. We do. It’s just that without this testing, there’s almost no point. We see couples come in after years of trying because the Obstetrician/Gynecologist or General Practioner has told the woman that everything’s fine, no cause to be concerned about fertility, only to find out there’s a significant problem with the male side of things that would not have been resolved by regular sexual relations (intercourse).
This is not meant to scare you. 40% of problems are male factor infertility issues. This is also not meant to scare you. It’s simply a statistic.
Would you really want to keep on trying and failing to become pregnant and not know why? And not know that there are simple and easy ways to become pregnant, even if male factor problems are found?
Would you want to put your partner or wife through that? Would you want to put yourself through that?
I didn’t think so.
Go for the semen analysis test. Find out if there’s a problem. Because then you can fix the problem and have the baby that you want to have. ~Lisa Rosenthal
The Semen Analysis Test
For men, fertility pretty much hinges on having healthy sperm, so semen analysis is the most important test for the male half of a couple that is experiencing fertility issues. It is an inexpensive test that should be done early in any infertility evaluation.
Usually two or more semen samples, taken at separate intervals, are analyzed because it’s normal for sperm counts to fluctuate. The analysis requires abstinence for two to three days. The specimen is collected directly into a clean container.
The semen sample is examined in a laboratory for quantity, color and the presence of infections or blood. Then a detailed sperm analysis is done to determine the number of sperm present and any abnormalities in their size, shape and structure (morphology) and movement (motility).
Low sperm count is also called oligospermia. Theoretically, it only takes one sperm to fertilize an egg, but the odds of one sperm reaching the egg are very low. Consequently, a low sperm count reduces a man’s chances of fathering a child. An urologist can suggest medical or surgical treatments to increase those odds, and men are advised to avoid smoking, excessive drinking and illegal drugs, maintain a healthy weight, and stay out of sources of excessive heat (like tubs and saunas) that can temporarily reduce sperm count.
Factors in Male Infertility
Both morphology and motility are factors in male infertility because they impair the sperm’s ability to reach and fertilize an egg. Some causes of abnormal morphology are infections, high fever, congenital testicular abnormalities, varicocele (enlarged veins in the scrotum) and illicit drug use. Again, an urologist can recommend treatments that can improve morphology, including treating an infection, varicocele repair and hormone replacement. Pregnancy may still be possible through intrauterine insemination or in vitro fertilization.
If sperm abnormalities are detected, the semen analysis can be repeated in four to six weeks to determine if they are permanent or temporary. If the sperm analysis is normal, your doctor will probably recommend a thorough testing of your female partner before considering additional male infertility tests.
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Men's Health Week
Whether you are a guy reading this or a partner, spouse, even friend reading this that loves or lives with a guy, I know you know most of this stuff. Still, it bears repeating, at least once a year. Since this is Men’s Health Week, here we go. And please, pass this on to the men in our lives.
Basic Men's Health Tips
For overall health, including men's reproductive health, here are the basics of the basics.
- Brush your teeth at least twice a day and floss once a day. See a dentist, twice a year or as directed.
- Have a physical; make sure that everything is in correct working order.
- Work out regularly, five times a week. Cardio is important, so is weight lifting. It all has positive impact on your overall health.
- Avoid recreational drugs. Especially marijuana, which stays in your system and affects your reproductive health for an extended amount of time.
- Don’t smoke cigarettes. If you are a smoker, get some help to stop. There are quite a few methods that can be helpful. Ask your doctor for resources that they trust.
- Sleep a minimum of seven hours a night. Try, as much as possible, to have a regular bedtime and wake up time. Try, as much as possible, to shut off all electronics at least one hour before bedtime.
- Eat three meals a day and two small snacks. Eat good, healthy foods. Foods that do not come in a box are a good way to start. Foods that are colorful, fresh and vitamin dense. Balance your meals so that you are eating lean protein, a good fat, a healthy carbohydrate, veggies, and a fruit. (See a nutritionist for a check in; Carolyn Gundell is here at RMACT and can help you create a healthier way to eat and live.)
- Moderate your alcohol and caffeine intake. Ask your doctor at your physical what they recommend.
- Talk to your friends. Have a strong support system that you can rely on for those times when you need emotional support.
These are the most basic of the basics. General care of our bodies, minds, hearts and selves.
We all deserve to be healthy. It starts with us.
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Male Factor Infertility Explained for Men's Health Week
Men’s Health Week is this week. A great time to learn how men are affected by infertility as up to 40% of all infertility is caused by male factor problems.
Here is the information that Reproductive Medicine Associates of Connecticut (RMACT) shares on our website about male factor infertility. There will be more this week about men, health and infertility. ~ Lisa Rosenthal
Although infertility research and medical services have traditionally focused on women, fertility issues crop up just as often in men. In fact, it’s estimated that up to 40% of infertile couples are unable to conceive because the man’s sperm production is less than optimal.
The first and most obvious sign of male infertility is the inability for couples to get pregnant. There may be no other symptoms unless the infertility is caused by a hormonal problem, in which case reduced facial and body hair growth or low sex drive may be the tip off.
Male Infertility Information
Male infertility may be due to:
- Genetic abnormalities
- Hormone deficiency or surplus
- Infections of the prostate, testes or epididymis (tubes that store and carry sperm)
- Older age
- Previous chemotherapy
- Previous scarring due to infection (including sexually transmitted diseases), trauma or surgery
- Radiation exposure
- Environmental pollutants
- Exposure to high heat for prolonged periods
- Retrograde ejaculation (dry orgasm)
- Heavy use of alcohol, marijuana or cocaine
- Use of certain prescription drugs
- Poor nutrition
- Being overweight or too thin
Causes of Male Infertility
Male infertility can also be caused by low sperm count (subfertility), reduced sperm movement (motility), or abnormally-shaped sperm (also known as abnormal sperm morphology).
If indicated, men are referred for evaluation to a urologist who specializes in diagnosing and treating infertile men. This evaluation includes a medical history, physical examination, complete semen analysis and, if appropriate, sperm function tests.
Once we determine the most appropriate course of treatment for each couple, alternatives may include:
- medical or surgical procedures to increase sperm counts
- intrauterine inseminations with or without superovulation therapy
- in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) or possibly the use of donated sperm
At Reproductive Medicine Associates of Connecticut, we focus on establishing the correct diagnosis and using advanced treatment techniques to make it possible for many men who are diagnosed with male infertility to become fathers. Contact us for more information.
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Understanding Infertility - Do They Get It?
There's been a lot of conversation lately about how our male partners/husbands just don't get it when it comes to understanding infertility. They don't get the intensity that we feel about fertility treatment and more specifically, they don't get how we feel about not having those babies yet.
There's been a lot of anger as well towards the men about not getting it. The word insensitive has been used a lot to describe them. They want sex at what seems like inappropriate times (in the middle of a cycle or two days after a miscarriage). They don't listen or respond when we talk about the despair we feel when a fertility cycle doesn't work.
That old joke about the duck comes to mind. If it walks like a duck, quacks like a duck, swims like a duck, well then, most likely, it's a duck!
Except when these wonderful women, who are feeling angry, sad, lonely and somewhat (or very) abandoned by their men are asked about whether these men love them, the answer is a resounding yes. Unequivocally yes.
They talk about their marriages being stronger than they were before infertility walked in and took a seat.
I’m wondering if the duck is perhaps not a duck.
Perhaps it’s a tern. Or a loon (kinda like that one). Or a swan. Or a goose.
Infertility Problems: Dealing with the Pain
Maybe insensitivity is a great mask for denial (if I ignore the infertility problems, one day they will be solved and all will be great, etc.). Maybe it is that their beloved’s pain is so deep that they do not know how to touch it gently enough without causing more pain. Perhaps they are worried about drowning in the pain themselves and not being able to be the anchor that they are expected to be. Perhaps their own pain is so bewildering to them that without our help, they are lost and they cannot ask for help while we are in such pain.
It is possible that the only thing they know how to do is to do more of what they know how to do. Work. Fix things. Shelter us the best they know how.
While there were a few names flying around describing these men that were not duck or goose or loon, there was also general consensus that these men love us. And that their best wasn’t good enough. That’s a hard concept to face, that our best isn’t good enough. We know about that one, don’t we? Because that’s the one we face when it comes to failed fertility cycles.
Infertility Support - Is Something Getting In The Way?
Perhaps they need more help and direction than we can give them about how to support us.
Or, maybe they are the ones who need the support and help themselves and have no idea how to dig deeply enough to ask for it.
I don’t know. I just suspect that if there is love there and it’s not being expressed then something is getting in the way. Going a step further, I would suspect that the culprit getting in the way is our pain.
Not making excuses or apologies for them or us. Just trying to figure out the odd phenomena of our men not showing up in ways that are helpful or supportive even when we all agree that they love us.
Maybe it’s time for us to look past the obvious. Maybe it’s not a duck at all.
Maybe it’s the swan we see struggling under the weight of not knowing the right thing to do or say. Or being too afraid to say it.
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What to blog about first. Some weeks, some days, I can’t think of a single thing to write about. That’s a little scary. Other days, I have 49 million ideas floating around in my head and it’s all I can do to stay focused on one idea about infertility and life.
Here’s a head’s up for this week, as long as we’re on the subject of topics. Sex. Sexuality. Dualism. Birth control. Spring (you know how much I love the weather), events coming up at Reproductive Medicine Associates of CT, pre-natal vitamins. Those days with 49 million ideas can be a little scary too.
Today, I’m going with sex. And it wasn’t really my idea. Not exactly, anyway. I did bring it up in the blog last week and then the conversation continued this week end in the peer support group. Interesting twist, perhaps predictable for infertility challenges, sex on demand.
There are times, while in fertility treatment, that you are asked to abstain from sex. Seems a little ironic. Want a baby? Don’t have sex. Ok, but it you’re in treatment, you know that things are timed very carefully, very methodically. Now, if you are laughing, don’t worry, I am too.
Yes, everything’s timed very carefully. And then your blood levels go up, go down, follicles appear, get larger, more of them, some blood levels go down, test results come back differently then expected and so on and so forth. The best laid plans of mice and men. Everything’s timed perfectly, except that each of us unique beings react differently to medication and stimulation, as well as having our own private rhythm. It is amazing how the body, mind and heart can override even the most powerful medications. So just when you think you have it all figured out, what to tell your co-workers about absences, planning your time off, it all changes.
How does this relate to sex? Don’t have sex. Do have sex. Don’t have sex now. Do have sex now. Plan having sex around work, travel, meals, etc. Turns out that this is not the most sexy, romantic, heart throbbing way to have sex.
I don’t say enough about men in this blog. One, I’m not a man. Two, I’m married to a man who doesn’t say a lot, doesn’t complain a lot and is very cooperative. (Most of the time.) But how about if your partner or husband isn’t like that? What if he would prefer that his sexual relationship with his partner not be dictated by someone else?
What about the pressure to have sex when the last thing that you’re in the mood for is sex? Again, not a man, but this pressure makes me, a woman, wince. How about a note of sympathy for the guys who manage the erection under pressure? How about a round of applause for all of us who manage to have sex and even enjoy it, even when spontaneity and desire are not even remotely involved?
It didn’t occur to me just how much men might not only resent being told when, but also might not be able to. Is there anyone out there, man or woman, who can’t get what a blow to the ego that might be? Even more than a blog to the ego, the sense of self and manhood that already probably feels under attack, has got to take a huge hit if, when under pressure, getting and maintaining an erection is impossible.
Sex on demand. Infertility and fertility treatment being it’s most invasive.
As usual, I have no answers. There are many simple answers that I can give you. This is not a simple problem and probably requires the two individuals in the situation working it out together.
I will tell you that my solution was to go to a therapist. My husband and I went for two years while we were in fertility treatment and I am quite sure that it not only saved my marriage, but quite possibly his life!
It’s not necessary to wait until you are on the verge of divorce or murder to seek help. Our two mental health professionals provide just the type of support that can help this type of situation, as well as address the other stresses that infertility challenges bring. Dr. Lisa Tuttle and Jane Elisofon LCSW, both have the experience and compassion to help. You do not have to do this alone.
Thanks for reading today. Comments? Suggestions?