Male Infertility, Causes, Symptoms And Treatment – HEALTH
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Male Infertility, Causes, Symptoms And Treatment

Infertility is known to affect one in six couples. And one in three couples faces difficulty in conceiving due to male fertility problems

It is needless to say that male fertility is as important as female fertility for a couple to conceive and have children. When is a male termed infertility, what are its causes, and what can you do about it?

Defining Male Infertility

Experts define male infertility as the inability of a man to impregnate a woman even after one year of unprotected sexual activity. It mostly depends on the quality and quantity of his sperm

Causes Of Male Infertility

Male infertility occurs if the number of sperms ejaculated is low, or if they are of poor quality. Without healthy sperms, the chance of conceiving is almost none.

Hormones can affect fertility by bringing down sperm motility (movement) and count.

A man’s lifestyle, physical problems, and psychological or behavioral health concerns can all influence the health of his fertility . Let’s see some of the most influential factors:

Lifestyle factors
  • Smoking
  • Use of recreational drugs
  • Alcoholism
  • Testosterone deficiency
  • Anabolic steroid use
  • Intense physical workouts such as cycling and horse-riding
  • Lack of vitamin C, iron, and zinc in their diet
  • Wearing tight underwears
  • Exposure to environmental toxins
  • Malnutrition and anemia
  • Stress
Hormonal disorders
  • Hyperprolactinemia (elevated prolactin reduces sperm production)
  • Hypothyroidism (low thyroid levels result in poor semen quality)
  • Congenital adrenal hyperplasia (suppressed pituitary that causes lower sperm cell motility)
  • Hypogonadotropic hypopituitarism (low pituitary gland arrests sperm development)
  • Panhypopituitarism (the failure of pituitary gland decreases libido)
Physical, psychological and behavioral problems
  • Varicocele (enlargement of spermatic veins causing abnormal sperm)
  • Damaged sperm ducts
  • Torsion (supportive tissue abnormality affecting the testes)
  • Infection and disease (such as mumps, tuberculosis, typhoid, smallpox, influenza) can cause low sperm count and low sperm motility
  • Klinefelter’s syndrome (a genetic disorder that decreases the testosterone levels)
  • Retrograde ejaculation (semen ejaculates into the bladder causing low sperm count)
  • Erectile dysfunction (inability to have an erection firm enough for sexual intercourse)
  • Premature ejaculation (inability to control ejaculation shortly after sexual penetration)
  • Ejaculatory incompetence (inability to ejaculate during intercourse)

Certain factors increase a man’s risk of being infertile.

Factors That Increase The Risk Of Male Infertility

  • The risk factors include:
  • Overweight
  • Prior infections
  • Genital exposure to high temperatures
  • A family history of fertility disorders
  • Mumps after puberty
  • Prior vasectomy or pelvic or abdominal surgery
  • Tumors or other chronic illnesses
  • Taking certain prescription medications or undergoing medical procedures

Signs Of Male Infertility

Some possible signs and symptoms could be

  • Difficulty in erection or ejaculation, ejaculating low fluids and low sexual desire
  • Pain, lump or swelling in the testicle region
  • Abnormal breast growth
  • Decreased body or facial hair
  • Reduced muscle mass
  • Recurrent respiratory infections
  • Lower sperm count

If you are unable to conceive and/or facing any of the above issues, then see a healthcare provider for diagnosis of the problem.

How Is Male Infertility Diagnosed

Both the partners may have to get the diagnosis done. The initial diagnosis includes an analysis of the medical history, physical examination, and common lab tests, and probably a few semen tests.

Medical history analysis includes:

  • A complete review of past conditions, medications, and surgeries
  • Knowing about the family history of infertility or birth defects
  • A review of social history and exposure to occupational hazards to understand if they had an impact on fertility
  • A review of sexual habits and practices

Physical examination evaluates the genitals including the penis, testes, scrotum, and prostate.

Laboratory tests include:

  • Urinalysis to detect the presence of infections.
  • Semen analysis to evaluate the motility (movement), shape (morphology), and maturity of the sperm, the volume and liquidity of ejaculation, and the actual sperm count. The sperm counts mostly fluctuate from one analysis to the other. Therefore, multiple semen evaluations are done over a period to get accurate results.
  • Hormonal tests to evaluate the levels of testosterone and follicle stimulating hormone (FSH) to understand the overall hormonal balance and state of sperm production. Sometimes, the initial hormonal testing indicates the need for other hormonal tests such as serum luteinizing hormone and prolactin.

If the above diagnostic tests are unable to determine the condition, further testing is done to identify the cause of infertility.

  • Scrotal ultrasound uses high-frequency sound waves to detect obstructions or problems in the testicles and other supporting structures.
  • Transrectal ultrasound is done by inserting a tiny and lubricated wand into the rectum to check the prostate and tubal blockages (ejaculatory ducts and seminal vesicles) that they might carry.
  • Post-ejaculation urinalysis helps detect the sperm in the urine indicating retrograde ejaculation, where the sperm travels backward into the bladder.
  • Seminal fructose test checks if seminal vesicles are producing fructose in the semen. The fructose sugar provides energy to the sperm.
  • Semen leukocyte analysis checks for white blood cells in the semen.
  • Anti-sperm antibodies test looks for the presence of antibodies that could cause infertility.
  • Sperm penetration assay (SPA) identifies the ability of the sperm to fertilize.
  • Kruger and the World Health Organization (WHO) morphology detects the sperm morphology and motility closely.
  • Testicular biopsy checks for the impairment or a blockage in sperm production.
  • Vasography detects the structure of the ducts and finds obstructions.
  • Genetic testing identifies mutations in gene regions of Y chromosome and diagnoses various inherited or congenital syndromes.

Treatment For Male Infertility

Male infertility is treatable with medications and other options. In some cases, where the treatments do not work, the couple may have to go for sperm donors or adopt a child.

Medications and devices:

  • Gonadotropin injections are suggested for hypogonadism to improve fertility. They trigger sexual glands to produce testosterone and sperm.
  • Pseudoephedrine medications work in treating retrograde ejaculation. They close the opening of the bladder thereby helping the sperm to ejaculate through the penis.
  • Sildenafil (Viagra) helps treat the ejection issue.
  • In the case of problems with erection, your doctor might suggest you try a vacuum pump. You need to place the pump over the penis and pump the air out to create a vacuum. It causes the blood to shift into the penis, thus erecting it. A constriction band is placed at the base to maintain the erection .

Surgery

  • Variocele (swollen veins in the scrotum) is corrected through surgery to improve the quality of your sperm.
  • Obstructive azoospermia is surgically treated by removing the blockage.
  • Vasectomy (surgery that stops sperm from going into the semen) can also be reversed.

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