Why men need fertility tests

After my article that was published in this newspaper recently, one ardent reader of this publication emailed me. His concern was about men who refuse to go for fertility checkups irrespective of the years spent in a childless marriage. His argument was that such men believe infertility is solely a woman’s problem. He cited an anecdote from the novel Burden Of Failure, in which a couple resolved for a divorce following failure to have children despite the woman’s strenuous efforts to have the husband undergo medical tests. Instead, the husband excused himself, claiming that a certain powerful man had assured him that it was his wife’s problem, even when he failed to impregnate another woman he secretly consorted with. This is a situation most women face, especially those who endeavour to seek fertility treatment from the available fertility hospitals and clinics. 

According to Dr Vasudeo Ridhorkar, male infertility factors may be present in 50 per cent couples seeking treatment for infertility. About a year ago, one woman, whose identity I will shield, called me to inquire about fertility services offered at my workplace. She said she had been married for three years without a child. When I told her to seek treatment with her husband, she said she had previously told him about the same, but he insisted the problem lay with her, even when there was no scientific evidence. Determined, she met the doctor who took her medical history and did the multiple required examinations. Surprisingly, however, her entire fertility condition was found to be normal after all the tests. This implied that the underlying cause of her failure to conceive was most probably with her husband who has adamantly refused to visit the fertility clinic. From this experience, you may realise that most men, especially in our African communities, will hardly accept the fact that a man can be infertile. To many, having an erection and the ability to ejaculate is a guarantee that they can have children. 

But this is wrong because the male infertility factor mostly lies with issues to do with the sperm, abnormal coital habits and lifestyle such as smoking, alcoholism and psychological stress, among others. Meanwhile, available research reveals that rapid advances in the field of infertility management have put the evaluation of male infertility in the back seat. Text from Infertility Management Made Easy divulges that a complete evaluation of the male partner is important for two reasons: 

First, many causes are easily treatable without costly measures; second, other significant diseases of the male like testicular malignancies, pituitary tumors and neurologic disorders can be diagnosed, which otherwise may be overlooked. With continuous advancement in assisted reproductive technologies and treatments, there is no need to entirely rely on natural factors to have children, especially after a minimum of one year in a childless marriage. Thus, the man will be required to see a fertility doctor who will take his medical history and do the ideal tests. 

Your past history may be about congenital abnormalities of urinary tract; surgical history resulting in scrotal trauma, spinal cord injury, bladder neck surgery and testicular torsion. He may also intend to find out as to whether you have had urinary infections, sexually transmitted diseases, viral orchitis, renal diseases, recent febrile illness, epididymitis, and other chronic diseases such as diabetes. The doctor will also ask about your complete list of past and present medications since some drugs interfere with spermatogenesis, erection and/or ejaculation. Exposure to radiation such as chemotherapy is also a risk factor to male infertility. 

In Male Infertility Made Easy: the African Experience, Dr Edward Tamale-Sali argues that the patient’s age, type of chemotherapy drugs and the doses may affect a man’s ability to impregnate a woman. For example, he says the higher the doses of chemotherapy, the longer it takes for sperm production to get back to normal after treatment, and the higher the chances that sperm production will stop altogether. 

Thus, he recommends that before exposure to chemotherapy, the patient should visit a fertility hospital and have his sperm stored. Meanwhile, semen analysis is believed to be the best predictor for male infertility. A semen analysis measures how much semen a man produces. It also shows the quality and quantity of sperm in the semen sample. It is recommended that men with fertility issues should have at least two to three semen analyses for satisfactory results. All said, there is no need to worry because all the causes of male infertility are treatable. If a man fails to have children naturally, there are other technologies that may be used to achieve the most desired goal. These may include In Vitro Fertilisation (IVF), Intra Cytoplasmic Sperm Injection and IVF, Open Testicular Biopsy, Testicular Sperm Extraction, and sperm donation, among others.

 Arthur Matsiko is communications officer, Women’s Hospital International and Fertility Centre, Bukoto-Kampala.