"Graeme is one of the most knowledgeable, reliable and empathic clinicians I have known. His practice is evidence based and patient centred, and he is the 'go to' person for difficult clinical cases." WL (UNSW)
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“Many men are surprised to learn how common male fertility problems are. A common cause of infertility is sperm count and quality, and about 40% of my patients some type of sperm problem”
Healthy sperm is needed to conceive a baby, and although a man may appear otherwise healthy he may not produce enough sperm, or they may not be of the quality needed to fertilise an egg during unprotected intercourse.The good news is that it’s relatively easy to diagnose and treat couples where male fertility is an issue. We’re also now able to diagnose many subtle differences in sperm morphology (shape), and this can have a significant impact on its ability to fertilise.
What affects male fertility?
The most common causes of male infertility include:
No sperm cells are produced (Azoospermia)
Few sperm cell are produced (Oligospermia)
High proportion of sperm is abnormally shaped (Teratospermia)
Blockages or absence of vas deferens (due to injury or vasectomy)
Genetic causes, such as cystic fibrosis or a chromosomal abnormality
How do you diagnose the cause of male infertility?
The primary way to assess male fertility is via a semen analysis where we check sperm numbers, motility (ability to swim) and morphology (shape). We also examine the DNA in the head of the sperm to see how potentially fertile it is, using a SCSA (Sperm Chromatin Structure Assay) test.
A semen sample needs to be produced by masturbation, following three days abstinence from ejaculation. You can do this in a private room at one of Associate Professor Hughes’ clinics, or you can collect your own sample at home in a sterile container and bring it to one of IVFAustralia’s andrology labs straight away for analysis. You do need to make an appointment with the lab, so the semen can be examined whilst it is still fresh.
How do you treat male fertility problems?
The treatment for male fertility problems will depend on the issue identified during diagnosis. If you have reduced levels of sperm morphology or DNA damaged sperm, there is a higher than usual risk of miscarriage and a lower chance of pregnancy success.
In mild cases, we can wash the sperm and select the best performing sperm, which are then placed inside the female partner’s uterus using Intra-Uterine Insemination (IUI).
If there are low numbers of sperm but they are of acceptable quality, we can use this sperm for IVF treatment.
If there are a very low numbers of sperm, we use Intracytoplasmic Sperm Injection (ICSI) during an IVF treatment cycle. This means we select the best sperm, and inject it into the egg using a very fine needle.
If there are no sperm present in the semen at all, we may be able to use TESA, which is where sperm are collected during a surgical procedure and then used in an ICSI treatment cycle.
If there are no sperm present in the testes at all, we are able to help couples use a sperm donor, and we have access to a high quality sperm donor bank.
As a Fertility Specialist with IVFAustralia, Associate Professor Hughes has access to advanced male fertility treatment methodology, such as the Digital High Magnification of Sperm. The andrology laboratory can enlarge images of sperm to over 7300x magnification (typical ICSI selection is just 200 to 400x magnification).
This ensures the scientist selects the best possible sperm, defined by size and shape, for injection through ICSI. We’ve managed to significantly increase pregnancy success rates with this technique where male fertility is an issue.