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The top five questions men ask about infertility

The top five questions men ask about infertility

Infertility is often attributed to the female partner. Many do not realise that the male partner contributes equally to the problem.

In my daily fertility clinic, couples ask a variety of fertility questions. Today, I would like to share some of the more common male infertility questions that come up.

I can ejaculate regularly during sex, can I still be infertile?

The answer is yes.

Your semen or ejaculate comprises a mixture of fluids from the seminal vesicles and prostate, as well as the sperm cells.

Sperm cells, which are produced in the testicles, travel through a tube called the vas deferens and mix with fluids from the seminal vesicles and prostate before being ejaculated.

Thus, the presence of semen does not equate to the presence of sperm cells.

Semen can be of normal volume and consistency even without the presence of sperm cells.

Do I have a low sperm count because my semen volume is low?

This is another common misconception. Semen volume does not correlate to the sperm cell concentration in your semen.

Semen volume can be low for various other reasons.

It can be as simple as a short abstinence period before the sperm test or incomplete ejaculation to more serious reasons like retrograde ejaculation and ejaculatory duct obstruction.

Even in a man with low semen volume, the sperm concentration can still be within normal range, i.e. more than 15 million sperm in each millilitre (ml) of semen.

My erection is weak, can I be infertile?

This is a very common question and I can understand why.

A poor erection can directly lead to “infertility” due to the inability to deposit semen in the vagina.

Thus, it is natural for every man to assume that a poor erection leads to infertility.

This is a false alarm.

If erectile dysfunction (ED) is the main issue, there are simple fertility treatments such as intravaginal sperm insemination (IVI) or intrauterine insemination (IUI), that can overcome the issue of semen deposition into the vagina or the womb.

However, I urge men to seek the consultation of a fertility specialist or an urologist to find the root cause of their erection issue.

While fertility treatment can give them an immediate solution to getting pregnant, the couple needs to find a long-term solution that will enable them to get pregnant naturally in future, if they so wish.

I was diagnosed with azoospermia, what can I do?

Azoospermia (no sperm cells seen in the ejaculate or semen) is not the end of the world.

The first step is to see a male infertility doctor, in order to determine the most likely cause for the azoospermia.

This could be due to either a problem with sperm production or a blockage of sperm transport.

Most of the time, the cause is more likely to be related to a problem with production, rather than blockage.

In this situation, several blood tests will be done to assess your sperm production capability, together with assessment of your testicle size. In some situation, a testicular ultrasound will be done.

Hormonal treatment can be started for a few months to stimulate sperm production.

If this fails, a minor surgery is needed to retrieve sperm from the testicles. This procedure is known as surgical sperm retrieval.

Besides hormonal treatment, supplements to improve both quantity and quality of sperm will be recommended.

Once sperm cells are obtained, either via ejaculation or surgery, assisted reproductive techniques can be used to make the couple pregnant.

Is IVF (in-vitro fertilisation) the only treatment in male infertility?

In most cases, the answer is yes. This is because, even if hormonal treatment works, the amount of sperm found is usually minimal.

Furthermore, the effect of hormonal treatment may not last forever. Thus, IVF treatment is more appropriate.

However, there are men with azoospermia who, with hormonal treatment, manage to make enough sperm and successfully became parents with IUI.

Therefore, the treatment options are determined based on the amount of sperm cells available, taking into account the couple’s fertility history.

These are some of the most common questions asked in my male fertility clinic.

My advise to couples diagnosed with male infertility is to come forward earlier, rather than later, to seek help.

Female partners play an important role in supporting their male partners to go through this challenging journey towards parenthood.

Dr Agilan Arjunan is an obstetrician and gynaecologist, and fertility specialist. For more information, e-mail starhealth@thestar.com.my.
Walking Backwards: Reasons to Try this Walking Technique

Walking Backwards: Reasons to Try this Walking Technique

Each day we put one foot in front of the other. Step by step we cover different distances on foot, without spending a minute to think about the process. Since we are so used to walking forwards, it is tough to suddenly start trying to walk backwards…

Why should we walk backwards?

It may sound strange or silly at first, but if you take a closer look at the technique, you will see that it has tons of benefits for your physical and mental health:

walking backwards

walking backwards

Walking backwards….

  • sharpens the senses and mental clarity
  • improves coordination
  • boosts body consciousness
  • adds variety to your training
  • strengthens less used leg muscles
  • decreases lower back pain
  • puts less strain on the knees
  • speeds up the body’s metabolism
  • increases energy level
  • improves sleep
  • strengthens the heart

Expert tip:

In order to reap all the benefits, you should walk backwards three to four times per week for 10 to 15 minutes.

Since we practice “normal walking” every day without thinking about it, the body and the brain are forced to adapt to new, unfamiliar demands when you start walking in reverse.

In China walking backwards is already becoming a part of everyday life:

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Running backwards for advanced

After you have practiced walking backwards extensively and feel comfortable with it, you can even move on to running backwards. The School of Healthcare Sciences in Cardiff researched the benefits this has for the body. The study discovered that pain in the front of the knee can be reduced by running backwards.(1) Another study, conducted by the University of Stellenbosch in South Africa, showed that a combination of running forwards and backwards can improve cardiorespiratory fitness.(2)

How it works:

Before you run backwards, you should make sure to practice walking backwards a lot. The best way to do this is on a treadmill, because you have railings to hold onto. Start slowly and work up to a fast walk.

When you have reached a higher speed on the treadmill, you can carefully try jogging backwards. This is especially good if you struggle with knee pain, because this technique – as mentioned above – reduces the strain on your knees.


Concentrate on every step – your brain has to get used to the new way of moving. Safety is the top priority.


Expert tips on how to boost body confidence

Expert tips on how to boost body confidence

WHEN it comes to body image and self-acceptance most of us have parts of our bodies that we don’t like, or days when we lack a little confidence.

Although such feelings now and then are completely normal, being too hard on ourselves long-term can lead to other more serious issues such as depression and eating disorders. So how can we improve our attitudes about our bodies and learn to love ourselves the way we are?

Dr Elizabeth McIngvale from Baylor College of Medicine, US, gives her tips on how to achieve a healthy attitude to our bodies and positive self-image.

Be wary of social media

Social media can be a contributing factor to how we see our bodies says Dr McIngvale, but it is important to try to avoid comparing ourselves, especially to unrealistic images.

“Many times we compare ourselves to images that are airbrushed and filtered, which is not where we should be placing our importance or our significance,” she says. “Often when people go on trips, for example to the beach, one might get caught up looking at images on social media and think that is what they are supposed to look like in a swimsuit, and they forget the real importance of the trip, which is to spend time with the people they care about.”

Work out for health

Dr McIngvale recommends doing activities that you enjoy to feel healthier and spend time with friends, rather than to specifically change your body, adding, “Health is not synonymous with looks, we must remember that.”

A recent study also suggests that working out can boost body confidence, finding that just one 30-minute workout caused women to feel stronger, slimmer, and better about their body, even though there were no visible physical changes, compared to an activity which involved sitting and relaxing.

Use positive language

Changing your language from negative to positive can also help change your mindset. McIngvale recommends practising positive self-talk, such as reminding yourself that you are worthy, you are beautiful.

“It is important to remind yourself of your worth and of the things that you love about yourself.”

Focus on longer lasting goals

Body image can change every day says Dr McIngvale, and even if we reach our ideal body goals we are still are not guaranteed to be completely satisfied with how we look. Because of this she says our focus should be on long-term health and wellness and who we are as a person, not body image.

“Remember to think about your attributes that make you feel good and that are rooted in substance,” McIngvale said. “You should always be keeping yourself motivated about the traits that you love most about yourself and are most proud of about yourself. Often these qualities have nothing to do with looks but instead are focused on principles important to you and the way you define who you are and what you do.” – AFP Relaxnews

Spice Tea for the Common Cold

Spice Tea for the Common Cold


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