Fertility ProblemsFertility Problems: Free advice – ask me today!
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By Dr Helen Webberley MBChB MRCGP MFSRH | GMC no. 3657058
I am a GP and a sexual health and hormone specialist. I can give advice on any medical matter, and I offer safe access to medical advice, prescription medication, blood tests and x-rays, and specialist referrals to your local private hospital as needed.
Male infertility can be quite complex and a challenge to treat. Evidence suggests that with infertile couples, abnormalities can occur in 1 in 4 males. About 15% of couples report infertility but only about 5% remain childless. There are multiple potential causes, including poor lifestyle, genetic abnormalities, hormonal problems, anatomical abnormalities, infections, drugs and immunological disorders.
Treatment however is fairly limited, to improvements in lifestyle, treating infections, correcting hormonal imbalances and surgery (for anatomical problems).
There are no good studies to show how effective these treatments are although treatments with Clomid and HCG have shown benefits.
We can help as much as possible but unfortunately there are no guarantees.
Frequently Asked Questions
My sperm count is poor, what can I do to improve it?
Any activity which increases testicular temperatures (such as wearing tight underwear or thermal underwear, regular use of hot tubs and saunas) should also be avoided.
If these adaptations do not help, you may need further investigation and treatment.
Do vitamins help my infertility?
In addition, treatment with antioxidants, including folic acid (vitamin B9), vitamin E, zinc and selenium, have been shown to improve sperm quality and subsequent likelihood of conceiving.
Should I have any special tests for my poor sperm count?
We may also recommend an ultrasound of your scrotum, testicles and prostate to exclude any physical abnormalities.
Most men however, have only mild abnormalities in their sperm counts which do not need specialised tests.
My wife and I have both had tests for infertility but they were all normal
What blood tests should I have if I have a low sperm count?
- Serum testosterone (the male hormone)
- Serum oestrogen (the female hormone)
- FSH and LH (to make sure the pituitary is working normally)
- Prolactin ( this hormone can be elevated in some men and may need medical treatment to control)
What drug treatments are available to help male infertility?
- If your testosterone levels are low or at the lower level of the normal range, we would recommend testosterone therapy, either by injection or as a gel which you rub on the skin.
- HCG injections may also be required whilst on testosterone, to maintain testicular volume and to improve the sperm count
- Clomid taken daily has been shown to improve male fertility
- Tamoxifen taken daily has also been shown to improve male fertility
- If oestrogen levels are high then aromatase inhibitors (such as anastrozole and letrozole), may help to correct the hormonal imbalance
- If prolactin levels are high then medications such as cabergoline are occasionally needed to reduce the levels
- hMG injections (human menopausal gonadotropin) is helpful in men and women and may occasionally be prescribed but is very expensive.
Clomid and tamoxifen
Both of these medications are ‘anti-oestrogen’ in other words they block the effect of the female hormone oestrogen. They actually work, not by reducing oestrogen levels, but by blocking the receptors on cells that oestrogen attaches to, therefore not allowing oestrogen to exert its effect.
This is the male hormone that stimulates sperm production. If your levels are low (or at the lower end of the normal range), testosterone therapy can help to improve sperm production. This can be administered either by injection or by rubbing gel on the skin.
hCG stands for human chorionic gonadotropin.
If the pituitary hormone levels are low, or you have had to start testosterone replacement therapy, hCG may be used to stimulate the testicles, which has the effect of maintaining testicular volume (which can drop off with testosterone therapy) and to stimulate sperm production.
This is an aromatase inhibitor. Sometimes too much testosterone is converted to oestrogen by the aromatase enzymes. This brings about an imbalance in hormone levels, with higher oestrogen and lower testosterone levels. These drugs prevent this from happening.
Safe, real prescriptions for Fertility Problems.
Testosterone and oestrogen
It is important to exclude a hormonal imbalance, both low testosterone and high oestrogen levels may independently cause infertility. This can be controlled with medication
These are hormones which are released from the pituitary gland in the brain, that stimulate the testicles to produce testosterone and sperm. High levels of these hormones may suggest an underlying testicular problem (as the pituitary is having to work harder) and low levels may suggest an underlying pituitary problem.
This is another hormone produced in the pituitary that if elevated, causes poor testicular function, including reduced testosterone and sperm production. This may need special medication to reduce levels.
Contact me now for advice, prescriptions, blood tests and referrals.
Please note that this service does not aim to replace advice given to you by your own doctor, it is meant to supplement your health knowledge and awareness.
It is never to be used in the case of a medical emergency.
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