African Woman and Child Feature Service

Although women are invariably blamed when a couple cannot have children, studies show that over 40 per cent of causes of infertility are directly attributable to the man. But due to stigma around infertility men keep it a secret when they realize they are infertile.

Infertility is defined as a condition resulting from abnormal functioning of the reproductive system. Nowadays, doctors insist on testing both the woman and man when investigating causes of infertility.

In women, the leading cause of infertility is the blockage of the fallopian tubes, followed by fibroids and lack of ovulation. Ectopic pregnancies, cancer treatment or an epilepsy condition, can also lead to infertility.

In men, three critical areas are a source of infertility: sperm quantity, motility, and sperm shape and structure.

The recommended sperm quantity in a single ejaculate by a fertile man is over 20 million sperm cells per milliliter, according to World Health Organization guidelines on male fertility.

Men with sperm count between 10 and 20 million per milliliter sperms cells are classified as having a mild sub-fertile condition. Anything below 10 million is severe form of sub-fertility.

“For such men, we investigate if the testes are producing enough sperm or if there is a blockage in the sperm ducts,” said Prof Koigi Kamau of Nairobi Hospital’s Fertility Enhancement Centre during a past interview.

Dr Solomon Wasike of Afya Royal Clinics says the other factors they look-out for in man with low sperm count includes the man’s life-style or state of health.

Stress, illness, alcohol, injury or excessive heat to the testicles, sexually transmitted infections, vitamin deficiencies, and blockage of Vas Deferens-sperm ducts are possible causes of male infertility.

Although some of these causes can be rectified, Dr Wasike explains, those resulting from natural factors cannot. IVF and hormonal replacement increase the sperm count can be used to correct some of these problems.

Nutritional supplements such as vitamin E, C, zinc and L-arginine; avoiding sitting in sauna or bathing with hot water; wearing loose underwear; and avoiding alcohol, can boost sperm count.

Sperm motility on the other hand is the ability of the sperm to move and swim quickly, with immotile sperms unable to fertilise an egg.

For sperms in a single ejaculate to be considered normal and able to fertilize an egg, 50 percent of them need to be motile. A progressively motile sperm is known to swim forward in a straight line, while the non-progressive one swims in an abnormal path like in tight circles.

Men with sperms have to be go through assisted reproduction for their sperms to fertilize an egg. Under this procedure, the man’s sperm is retrieved and then inserted in a woman’s uterus when she is ovulating.

In addition to sperm quantity and motility, sperm structure and viscosity determines how fertile a man is. Scientists argue that more than 14 per cent of the sperm should have normal structure of an oval head and a tail for them to fertilize an egg.

Sperms without a tail, with large, small, tapered or crooked heads, curled or double tails are less likely to fertilize an egg.

On viscosity, quality sperm should flow with ease 30 minutes outside the body for it to fertilize an egg. If it remains sticky and mucus, then fertilization is likely to be difficult.