Why GP’s should consider referring men to a Urologist or Andrologist early on in fertility investigations.

Male Infertility

Meet Professor Sheryl Homa – Clinical Scientist and director of Andrology Solutions, an HFEA licensed male fertility clinic offering expert care and advice on men's fertility.

Sheryl spoke about how we currently deal with infertility is wrong and how Sheryl she believes the triaging for fertility is inappropriate. Women are fully investigated however there is currently very little focus on the man. As a result, couples are put forward for IVF treatment when they may not necessarily need it.

If a man is investigated appropriately and treated then men’s fertility may be improved to optimize their natural fertility or improve their chances of successful IVF treatment.

Sheryl recommends that GPs consider referring men to a urologist or andrologist early on for proper management. More awareness on this issue is required and greater empowerment and education of both GPs and patients.

A physical examination or ultrasound scan

Can pick up conditions such as a varicocele or an obstruction. Varicocele repair is not always successful and not indicated for very small varicoceles, however, pregnancy rates following a repair are equal to or better than IVF success rates. Whilst it repairs fertility, IVF gives the couple a baby but the couple is still infertile, there is no treatment for their infertility.

Men may not always notice a varicocele, however, it is most likely to present on the left side, the teste may be larger, may feel discomfort and the pain may come and go. Men also complain of their teste feeling like a bag of worms.

Lifestyle factors and male fertility

More men are being diagnosed with poor sperm parameters from using protein supplements and shakes. A recent study showed that these supplements contained some steroid compounds. Sheryl recommends that men should not take any protein supplement or shake as not all ingredients are listed.

Supplements such as antioxidants work to reduce oxidative stress. A varicocele can raise oxidative stress and damages DNA. You can have a normal sperm analysis but still have oxidative stress. Sheryl recommends that men have oxidative stress testing before starting antioxidants and then repeat testing after 12 weeks.

Mumps in adult men

The mumps virus can cause inflammation of the testes and can cause men’s tubes to become blocked. Men have 6kms of tubes in their testes! Sheryl believes that unexplained infertility is actually un-investigated when it comes to men. She recommends that men are proactive and ask their GP for a referral to an uro-andrologist and that fertility clinics are more inclusive in working with male fertility specialists. Treating male infertility will reduce the need for invasive IVF and the demand on NHS resources, leaving more money for couples who really need IVF treatment. Support for men – men need support and information in a different format to women and a podcast or male-only fertility support groups on Facebook, for example, allows for anonymity.

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