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15% of couples experience fertility problems and therefore have difficulty conceiving, i.e. 1 couple in 6 who will be referred for fertility treatment.
Infertility is defined as the absence of pregnancy after 24 months of regular unprotected sexual intercourse in couples of childbearing age (WHO definition).
A male factor predominates in 30% of cases of infertility in couples. Studies have shown a deterioration in sperm parameters over a number of years, leading to a downward revision of the standards defined by the WHO for the various parameters.
Factors affecting male fertility
What can affect male fertility comes from factors linked to his quality of life. Here are some examples:
Age: A decline in male fertility with age has been established, with a decrease in sperm volume, sperm mobility, and the percentage of normal forms. Changes in sperm concentration are more controversial.
The effect of your history on your fertility
Your past history may also have an impact on your fertility, leading to infertility:
* Fertility preservation should be discussed before certain treatments are started. This consists of freezing spermatozoa in a CECOS (egg and sperm conservation centre) before the introduction of medication.
Medical history: urogenital infection, particularly sexually transmitted infections (gonorrhoea, chlamydia), diabetes, hypertension, testicular trauma, dental problems, mumps, sexual dysfunction (reduced libido, erection unsatisfactory for intercourse, absence of ejaculation), urogenital malformation (cryptorchidism, hypospadias), orchitis, hypogonadotropic hypogonadism, etc.
Fertility tests: the next step?
The medical check-up carried out during military service used to detect risk factors for infertility. Now that military service has been abolished, certain pathologies can be detected later in a man's life, particularly during the fertility check-up.
Technical advances in fertility, and in particular the introduction of micro-injection (ICSI) in 1992, have meant that the andrological aspect of fertility care is all too often neglected, and the focus is simply on finding the sperm to be injected into the oocyte. While some causes of infertility are incurable, particularly in the case of infertility of genetic origin, others can be treated, enabling the man to improve his sperm parameters and the quality of his spermatozoa, or even to regain natural fertility. This is where andrological consultations come into their own.
