Male infertility could be the result of many conditions and often the only symptom is the inability to conceive a child. The following aspects of male fertility are important:
- Your sperm should be healthy. This means that at least one of your testicles must be functioning normally and the levels of the hormones in your body must be normal.
- The passage of your sperms into the semen should be free from obstructions
- Your sperm count should be normal which is at least > 15 million sperm /ml of semen
- Sperm should be motile and healthy
There are a number of causes that may affect male fertility and these might be medical, environmental or lifestyle reasons why you are not able to conceive even after a year of unprotected sex.
Medical causes include:
- Varicocele– This refers to the swelling of the veins that drain the testicles. The reason for infertility with a varicocoele is that it affects the regulation of the temperature in the testes which in turn affects the quality of the sperm.
- Infection-Inflammation of the epididymis or testes or sexually transmitted diseases like gonorrhea and HIV can cause male infertility.
- Ejaculation Issues– Chronic illness like diabetes, certain medications, surgeries of the bladder or prostate or spinal injuries can sometimes cause the semen to enter the urinary bladder instead of being ejaculated from the tip of the penis; a condition called retrograde ejaculation. Ejaculation itself may be an issue with spinal injuries or medication.
- Tumors- Sometimes tumors of the reproductive organs or tumors of the brain that affect the production of hormones that affect the production of sperm. Chemotherapy or radiotherapy for cancer can result in infertility.
- Blockage of the tubules that carry the sperm may result in failure of the sperm to be ejaculated. This may be because of infection, damage caused by surgery or trauma or because of abnormal development.
- Undescended testes: This is a developmental condition and presents at birth or may not be noticed till later. Reduced fertility may be associated with this condition.
- Hormonal imbalances- problems with the production of testosterone by the testes itself or because of dysfunction in various hormone regulating glands can cause low testosterone levels that result in infertility.
- Problems with sexual intercourse- Erectile dysfunction or premature ejaculation have adverse effects on fertility. They may be caused due to psychological problems like anxiety or low self-esteem or due to health problems like diabetes or certain drugs. Relationship issues may affect normal sexual intercourse and fertility.
Prolonged exposure to environmental toxins or industrial chemicals can reduce sperm production or affect sperm function. Exposure to radiation like X-rays or radioactive substances like uranium can also affect sperm production. Elevated temperatures impair sperm production and function. The frequent use of hot tubs or working with your laptop on your lap for long stretches of time can temporarily affect sperm production.
Lifestyle cause of infertility
Smoking, including secondhand smoking, illicit drug use or drinking alcohol can lower sperm counts. Being overweight can cause changes in sperm production or cause hormonal changes that affect male fertility. Severe or prolonged emotional stress can interfere with sperm production.
These are some of the main causes of male infertility. Some of these causes are treatable and others can be reversed with lifestyle changes. Other conditions in which there may be a problem with sperm ejaculation, can be managed by using your own sperm through assisted reproductive techniques (ART). Since symptoms of the causes of male infertility are not always evident, it is important to consult a specialist who will come to a diagnosis and work with you to develop a treatment plan.