Introduction

Men’s fertility levels are considered good after being evaluated based on these criteria’s:

• Have normal and fully functional reproductive organs

• Have normal functioning penis that can deliver sperm into the vagina

• Have both testis that normal in size and can produce quality sperms (in numbers and active). Have normal spermatic cord that able to transfer sperms from testis to the urethra (tip end of penis)

• Have normal accessory reproductive glands- prostate gland, seminal gland and cowper gland that produce seminal fluids function to support sperms during ejaculation into vagina

• Normal sex drive and will power to perform

Diagram of Criteria for Normal Male Fertility

1. Testis can produce millions of sperms (150-250 million per day)

2. Prostate, seminal and cowper glands that produce fluid to support spermatic cells

3. Spermatic cord that able to collect and channel seminal fluid during ejaculation

4. Erect penis that able to penetrate and ejaculate inside the vagina

5. Have normal sex drive and able to perform intercourse

Factors that reduce male fertility level

• Hot working environment i.e in factory, using laptop computer on lap and wearing tight underwear (optimal temperature for testis is 2 degree Celcius below normal body temperature)

• Trauma or infection of testis. Haematoma after fall or being hit. Viral mumps can also cause infection of testis.

• Exposure to toxic substance like nicotine (from cigarrete smoke), alcohol (from drinking beverages) and certain drugs like propranolol (for hypertension), cimetidine (for gastric) and maxolon.

• Erectile dysfunction

• Abnormal ejaculation – delayed or absent and retrograde ejaculation into the bladder

From the above causes, treatable fertility problems in male are:

• Production and functional problem of sperms

• Abnormal level of male hormone ‘adropause’

• Formation of antibody towards sperms

• Blocked spermatic cord

You are advice to consult your Doctor early. The earliest to get advice and examination the earliest you will get treatment and problem identified. Hopefully you level of fertility become normal again.

Examination and screening for male infertility

Examination for health status and sexual function including genital examination by doctor are required.

• Blood test for sugar and cholesterol

• Testosterone hormone level

• Sperm analysis to measure how much sperms count in one ejaculation, identify normal movement of sperms and normality of sperms shape.