We need to know some things before we go into detail. If you are looking at infertility, we have to know that we are not talking about male or female; it’s a mutual inability to conceive and have a pregnancy within one year of regular sex. It means 2 to 3 times per week without using any contraception as it is a peer diagnosis. We have to understand that females should be consulting in the case of natural pregnancy cannot be reached, but a male also needs to go to a specialist. It’s usually an andrologist, and if the partners do it simultaneously, it’s much faster, we can get a result. Approximately 15% of couples face fertility issues, one half of them having a malefactor.
In the future, there will be more and more couples facing fertility issues. If you remember, we look at sperm quality issues, and it’s still a problem, especially for Western countries where, and as I’ve mentioned, it is also a case for Europe. One-third of all male infertility cases, we cannot say why it is so-called idiopathic male infertility; a lot of it is still not clear in the field. A lot of studies are still ongoing, and I believe in the nearest future, we will have more and more information, and therefore we can help a lot of patients to get pregnant.
I already mentioned the age of the partner. It’s not only female age which is important but also male because, after the age of 35, several processes begin in the body that increases sperm DNA fragmentation, for example. As well as stem cells are starting to die slowly. Therefore we have to be very careful with planning our family. If we are delaying this decision the to late 30s or 40s, then there is more probability of getting some issue with natural pregnancy due to the malefactor. One of the cornerstones of male infertility tests is a semen analysis, and this is the first analysis which we are usually starting with to check the male. But semen analysis needs to be checked, and it’s an assessment of all body, all diseases, it’s a proper physical examination that needs to be done, like a further investigation for endocrine, genetic and maybe other tests.
This is something that we do during a visit case-by-case. Suppose you are looking at the probability of natural pregnancy by looking only at semen analysis. In that case, we can predict approximately only 60% because there’s a lot of other things that need to be taken into account besides semen analysis. Therefore I encourage not to look only at the semen analysis but to look at the whole body health.