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Further Thoughts on Male Infertility

04:56 7th April 2013 | Sperm Count

Male Fertility WHO Fertility Level Sperm Count Fertile Woman Pregnancy Younger Women Sperm Samples Regression Biological Variables

This vagueness about the definition of male infertility is an important point. A study carried out in New York a few years ago showed that 50% of men carrying their babies out of maternity hospitals have low sperm count according to the WHO parameters discussed in the previous post.

As a result, it is important to take into consideration the female when defining male infertility. This is because the fertility level of the female affects the expression of male infertility. For a given sperm count, a younger and more fertile woman may be able to achieve pregnancy while an older and less fertile woman will not be able to achieve pregnancy. This fact explains the situation when a man is unable to conceive with his older wife but then achieves a pregnancy with a younger woman or when a woman is unable to achieve a pregnancy with her husband with a certain sperm count but then achieves pregnancy with another man.

A study carried out by the WHO where sperm samples were taken from a man twice a week for 120 days showed mild fluctuations in the sperm count with time. This phenomenon called regression around the mean is an important concept and it occurs with all biological variables. The important thing for any particular couple is whether the man spends most of his time above 20million sperm/ml or most of his time below 20million sperm/ml. A man with a sperm count consistently above 20million/ml will have a 25% chance every month of achieving a pregnancy with his partner while a man with a sperm count consistently lower than 20million/ml will drop this to about 5% per month depending on the sperm count.

This chance of 5% will tend towards 0% after about 3 years if the couple is not able to achieve a pregnancy within that period. This is because men with low sperm counts usually have periods of normal sperm counts and it’s a question of probability i.e. when this occurs and if it coincides with the period of ovulation.

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