8 Questions Your Male Partner Has About Fertility

When it comes to fertility and reproductive health education, there’s a lot they didn’t teach us in high school sex ed class - including information that’s really valuable to have prior to trying to conceive so that we can properly plan and prepare for any obstacles that may come up along the way. My female friends and I lament all the time about everything we wish we knew sooner about our menstrual cycles, age-related fertility decline, ovarian reserve, and more. For men, conversations around reproductive health are even more taboo, and the information even less readily available. 

I asked my boyfriend what he wished he knew about fertility, and to ask his friends what their own questions and concerns are. Here’s what they wanted to know, and the information Spring Fertility Dr. Joseph Chervenak had to share: 

If you're actually releasing multiple eggs per cycle, why is only one matured and able to be fertilized?

In a typical menstrual cycle, only one egg is matured, ovulated and “released” from the ovary. On ultrasound, we are able to visualize the group of eggs capable of growing at any given time as “antral follicles.” The follicle containing the egg destined for ovulation and possibly fertilization makes estrogen that limits the growth of other follicles, usually leading to maturation and release of a singular egg.

What are the fallopian tubes' role in conception? If one of the tubes is blocked or not working properly, why wouldn't you remove that tube and ovary so that you get a 100% “hit rate” with the functional tube?

The fallopian tubes are where sperm typically meets egg and the earliest stage of pregnancy development takes place following fertilization. These tubes are critical in transporting a fertilized egg or “zygote” to the usual place of implantation inside the uterus. The decision to remove a fallopian tube depends on the nature of blockage or problem. There can be a spectrum of pathology ranging from minor dysfunction to complete blockage. A significant obstruction leading to a fluid collection known as “hydrosalpinx” is an example of where an abnormal tube can lower pregnancy chances through a normal one on the opposite side and removal is recommended.

Why does egg quality decline before women stop being able to carry pregnancies?

Egg quality – or the capability of a given egg to lead to normal pregnancy development – is highly influenced by aging. The uterus – where pregnancies are carried – is linked to ovarian function through hormones such as estrogen and progesterone. We can effectively replace these hormones with medication when egg number, quality and hormone production declines in the ovary over time.  

For heterosexual couples, what's the likelihood of fertility issues for the woman vs. the man? And what are the most common causes of infertility for each gender?

It is thought that as many as 30-40% of causes of infertility in heterosexual couples are “male factor” with a roughly similar percentage representing the number of cases where a female cause has been identified. In women, the most common cause is ovulatory dysfunction or the failure of the ovary to successfully develop, mature and release an egg capable of being fertilized. In men, the most common identified causes have to do with failure of normal sperm development due to testicular dysfunction. It should noted in many cases of male factor infertility, we are not able to establish a clear cause.

My coworker thinks that sex positions have something to do with the likelihood of conception - is there any truth to that?

The American Society of Reproductive Medicine (ASRM) has reviewed current data and find that there is no evidence that specific coital positions affect the chance of successful conception. Sperm travels rapidly and studies have shown that they are able to reach a fertilizable egg within minutes. Nonetheless, when sperm number and quality are suboptimal, it is possible positions that do not allow for semen retention could further limit pregnancy chances.

Are you more likely or able to get pregnant again right after you’ve had a baby?

Immediately after childbirth, for many women breastfeeding acts as a “natural” form of contraception by inhibiting ovulation. The combination of active breastfeeding and no resumption of monthly periods is associated with a very low pregnancy chance in the 6 months after delivery. Women who do have resumption of ovulation – whether breast feeding or not – are not “more likely” to get pregnant than before. However, compared to the general population, women and couples who have recently had a baby have the benefit of knowing that they can successfully conceive.

Do saunas/steam rooms negatively impact sperm?

Exposure to high temperatures that can occur in saunas or steams rooms has been established as a risk factor for improper sperm development. While difficult to define the exact impact clinically, it stands to reason that frequent exposure could negatively impact male fertility in those actively seeking to conceive.

What is one thing you wish more men knew about fertility and fertility treatment?

That much of fertility treatment which includes intrauterine insemination (IUI) and In Vitro Fertilization (IVF) effectively covers for many of causes of male infertility whether or not a specific cause can be identified.