Almost 40% of infertility cases are estimated to be due to reproductive anomalies or disorders in the male partner. Male infertility is most caused by problems in ejaculation, low or absent number of sperm in the ejaculate (sperm count) or abnormal shape (morphology) and movement (motility) of the sperm.
Causes of Male Infertility
Male fertility is a complex process. For pregnancy, the following must occur:
- Production of healthy sperm
- Delivery of sperm into the seminal fluid (semen)
- Presence of an adequate number of sperm in the semen
- Movement of sperm to reach the partner’s egg
Any problems in these functions lead to male infertility. Some of the causes are listed below:
According to the World Health Organisation, sperm is considered fertile if:
- There is a concentration of 15 million sperm per ml of semen
- There is a motility of 40% or more
- Shape of sperm by strict Kruger analysis is 4% or higher
Sperm disorders such as low or no sperm count, low sperm motility and abnormal morphology are some of the most common problems associated with male infertility. These disorders can be congenital or acquired through poor lifestyle choices, certain medical treatments (such as chemotherapy) and trauma.
Varicoceles are enlarged veins in the testicles. They are similar to varicose veins found in the leg. Varicoceles generally develop over time and are a common cause of low sperm production and reduced sperm quality.
Improper ejaculation can also cause infertility. Retrograde ejaculation is a condition where semen enters the bladder during an orgasm instead of emerging out of the tip of the penis. Retrograde ejaculation can be caused by several health conditions such as diabetes, spinal injuries or even certain medications and surgical interventions.
Disorder of the testicles or problems with other hormonal systems including hypothalamus, pituitary, thyroid and adrenal glands can impact fertility. These hormonal problems are generally symptoms of other underlying conditions.
Sperm is produced in the testicles and transferred into the semen via tubes. Blockage in these tubes impact the flow of sperm into the semen, resulting in low or no sperm count in the ejaculate.
Blockage can occur in any part of the male reproductive system including the testicles due to various causes like surgery, trauma, prior infections, and inherited conditions.
Genetic defects and certain inherited disorders can cause infertility. These conditions can result in low, abnormal sperm production or even cause abnormal development of the male reproductive organs.
Prolonged exposure to certain environmental factors such as industrial chemicals, heavy metals, radiation, or heat can hamper sperm production or reduce sperm function. These factors include industrial chemicals, heavy metals, and radiation.
Unhealthy lifestyle choices like consumption of alcohol, tobacco and illicit drugs can have a negative impact on sperm quality and sperm count as well as cause sexual dysfunction. Being obese or overweight can also impair fertility in several ways.
Diagnosing Male Infertility
Male fertility is primarily tested by a physical check-up and a semen analysis. The semen analysis checks for sperm count, sperm motility and shape. Further investigations like ultrasound, hormone testing, post-ejaculation urinalysis, genetic tests, testicular biopsy, and specialised sperm function tests may be recommended to explain any anomalies detected in the preliminary investigations.
Treatments for Male Infertility
Advances in the field of fertility medicine have brought about dramatic changes in the ability to diagnose and treat problems with male fertility. ICSI or Intra Cytoplasmic Sperm Injection is an ART technique that involves injecting a single sperm cell directly into the egg to promote fertilization in an IVF cycle. This procedure was introduced in the early 1990s and is a preferred treatment for patients with mild or severe male factor infertility.
In some situations, interventional procedures like varicocele repair can be used to improve reproductive function in men.
Surgical sperm retrieval procedures are used to retrieve sperm from the testes in cases where normal sperm production or sperm ejaculation is inhibited. Fortunately, treatment is possible in almost all cases of male infertility.
Frequently Asked Questions
What are the different methods for sperm retrieval?
There are various surgical and non-surgical methods to retrieve sperm – TESA (Testicular Sperm Aspiration), PESA (Percutaneous Epididymal Sperm Aspiration), MicroTESE(Microsurgical Testicular Sperm Extraction) and electroejaculation.
What are the risk factors of Male Infertility?
Risk factors of male infertility include smoking tobacco, alcohol abuse, obesity, overheating of testicles, history of trauma to the testicles, congenital fertility disorders, prior vasectomy, certain medical conditions like sickle cell disease and specific treatments such as cancer treatments.
How to boost Male Fertility?
Following a balanced diet, maintaining healthy body weight and avoiding unhealthy habits like smoking tobacco and consuming excess alcohol can have a positive impact on male fertility and sexual function.