What do men need to know about their fertility?
Mr Marc Lucky, Urologist and Andrological surgeon at Aintree University Hospital NHS Foundation Trust, is one of three consultants sharing the Q&A stage for the All Male Fertility Panel at The Fertility Show Manchester (24 & 25 March 2018). Mr Lucky has extensive experience in male infertility and is one of very few surgeons in the UK specialising in andrological surgery.
Here Mr Lucky explores five of the most important “male fertility factors”:
Growing research into male fertility
The study of male infertility is a very young specialty and it is only in the last 10 years that more research has emerged to help develop our clinical understanding of the issues. It’s fair to say that male fertility has previously been overlooked and the problem has been treated as a predominantly female issue. Prior to that, our knowledge was somewhat limited, primarily focusing on sperm itself – or more importantly, lack of it. Now research has grown and evolved, and we understand that the quality of sperm is equally as important. And, we know that quality of sperm does not just have an effect on fertilisation and implantation but can be a contributing factor to other issues such as recurrent miscarriages. So, the availability of new tests such as DNA fragmentation to identify and assess damage to the sperm will help to progress male fertility treatment in the future.
The damaging effect of free radicals and the benefits of anti-oxidants is well documented. However, while collagen in our skin can be protected with anti-oxidant creams or supplements, sperm is unable to correct any DNA damage. Pollutants in our atmosphere are increasing with factors including; food contamination from plastic-waste, poor air quality and chemicals such as pesticides. Diet, exercise and lifestyle factors are also important and there needs to be more emphasis on educating men about practising “good fertility health”.
Men and women often deal with fertility problems quite differently, with men more likely to find it difficult to open-up and talk about issues.Women tend to take an organisational approach to conception, and some men find it difficult to cope with their sex life becoming regimented. In turn, they feel unable to talk to their partner, family or friends about their unhappiness, due to embarrassment. If the man is found to have a problem, this can lead to mental health issues with feelings of anger, shame, and resentment.Counselling is now widely available for IVF patients, and increasingly, male-focused support groups and closed social media groups can be useful for men to share their experiences and emotions.
For many men in the UK, culturally there is a feeling that the ability to procreate is wrapped up in the male identity. Therefore, the inability to conceive is seen as a slight on manhood and something difficult to share.Some cultural communities and religions also have different views on fertility which can make it difficult for men in particular to seek help. For example, many cultures have traditionally found it difficult to discuss fertility problems openly and some would not be comfortable with procedures like sperm or egg donation. The more people share their experiences openly, the more likely it is that these cultural stereotypes will be broken down and overcome over time.
In recent years, surgical techniques to manage male fertility problems have improved in terms of availability and success rates. If a male patient has zero, or an extremely low number of sperm in their semen due to a sperm production problem (non-obstructive azoospermia), data suggests that the best chance of recovering sperm is microsurgical testicular exploration and sperm extraction: MicroTESE. The problem could be because a man has had chemotherapy or radiotherapy and fertility hasn’t returned to normal, a genetic condition that affects fertility or the patient has had a testicle removed or surgery to bring down undescended testes. The procedure, performed under general anaesthetic, utilises a high magnification operating microscope (x20-x24) to identify the dilated tubules within the testicle that have a higher probability of spermatogenesis (sperm production). The technique has meant that some men previously deemed infertile now have a chance to father their own biological children including those with genetic disorders since Klinefelters Syndrome.
Mr Lucky will be joined by Professor Allan Pacey, Head of Andrology for Sheffield Teaching Hospitals and Mr Oliver Kayes, consultant urologist at Leeds Teaching Hospitals at The Fertility Show Manchester Q&A Male Fertility Session.
For further information or to interview Mr Lucky, please contact Caroline Beswick at Trinity PR on 0020 7112 4905 / 0770 948 7960