Andrology and male fertility

We offer a comprehensive service which focuses on lifestyle, nutritional and evidenced based treatments working closely with our reproductive experts at The Portland to offer a streamlined and integrated team approach.

We also offer a specialised MDT for male infertility, where all challenging cases are discussed in an open meeting to enable our male fertility experts to provide you with the most appropriate up to date care.

Understanding male infertility

Infertility is defined as the failure to conceive after one year of unprotected sexual intercourse. Approximately 15% of couples attempting their first pregnancy meet with failure. In about 50% of couples seeking treatment, the infertility will be caused by a problem in the male. It is therefore important that both partners are seen and investigated together. There have been great technological advances in the development and success of assisted conception in the last two decades, such that many couples with infertility can now be offered treatment.

There are a number of causes of male infertility including erectile dysfunction, hormonal problems, previous chemotherapy or radiotherapy, surgeries on the testis including undescended testis, drugs and medications. It is important to be aware that in some cases a cause may not be found.

All male patients should undergo a thorough history and clinical examination, hormone profile, genetic studies and ultrasound scans depending upon their semen analysis and clinical findings.

Causes of male infertility

Causes of infertility in men can be explained by deficiencies in ejaculate volume, sperm concentration (e.g. too few – oligospermia – or no sperm – azoospermia – in ejaculate), sperm motility or sperm morphology (shape of the sperm).

Some specific causes are:

• Hypothalamic disease can include deficiency in GnRH, LH or FSH
• Pituitary disease e.g. tumours, thyroid problems
• Chromosomal abnormalities e.g. Klinefelter’s syndrome
• Trauma to the testicles
• Orchitis or infections such as mumps
• Defective testosterone production
• Varicoceles
• Cryptorchidism (or undescended testis)
• Other diseases (eg renal failure, hepatic disease, sickle cell disease)
• Difficulties with intercourse e.g. ejaculatory failure or impotence

Sometimes a cause for male infertility cannot be found – for more information on this, read our page on unexplained male infertility.

The Multidisciplinary Team (MDT) Male Fertility Meeting

At the Lister, we have set up the first multidisciplinary male fertility MDT in the UK.

This is a monthly meeting involving the top reproductive urologists, gynaecologists and embryologist who are involved in presenting an discussing all the complex male fertility cases with a holistic approach to ensure all clinicians and scientists involved in the care of the patient agree on and are aware of the often complex plans for the couple. 

The team utilise testing, sperm selection and procedures mentioned above, to achieve consensus on the best possible techniques to try to ensure the best outcomes in the safest manner for the couple.