Sexual intercourse is the primary method of conception, but about 13 percent of couples are unable to get pregnant through unprotected sex. Many potential causes of infertility exist in both men and women, and in over a third of these cases, the male is responsible. This is a condition known as male infertility.
Male infertility is most often due to complications with sperm production or sperm delivery. It can be affected by a variety of factors and causes, but a number of treatment and prevention options are also available.
In a normal, fertile male reproductive system, the body makes small cells called sperm. During intercourse, male ejaculation delivers the sperm into the woman’s body, where it can fertilize an egg and begin the conception process. This sperm production in males is controlled by hormones.
If there are problems with genes, hormone levels or environmental factors, however, it’s possible for this process to be interrupted.
Causes of Infertility
Several factors are involved in the production of mature, healthy sperm. For conception to take place, all of the following factors must be present:
- Healthy sperm must be produced
- Sperm have to be carried into the semen before ejaculation
- There needs to be enough sperm in the semen—a sperm count too low decreases the odds of egg fertilization
- Sperm needs to be functional and capable of moving
Causes of male infertility can be medical, environmental or lifestyle-related. Medical causes of infertility include:
- Sperm disorders: Sperm can have many growth issues, including less-than-full growth, odd shapes, improper movement, low numbers or even no production at all. Sperm disorders can be genetic, but they can also be impacted by lifestyle factors, infections, sickness and chromosome or hormone problems.
- Varicoceles: Swollen veins in the scrotum are found in about 16 percent of men, but are more common in infertile men. They block proper blood drainage and damage sperm growth.
- Retrograde ejaculation: This is a condition where semen goes backwards in the body—into the bladder instead of out of the penis. It happens when nerves and muscles in the bladder do not close during orgasm.
- Immunologic infertility: When the male immune system makes antibodies that attack his own sperm, often after injury, surgery or infection.
- Tumors: Certain cancers and nonmalignant tumors can directly affect fertility, as well as their treatments.
- Obstruction: Blockages of sperm, often through repeated infections, surgery, swelling or developmental defects can affect fertility..
- Undescended testicles: This refers to testicles that have not descended from the abdomen into the scrotum.
- Hormones: Hormone imbalances can cause problems with sperm production.
- Tube defects: Many different tubes carry sperm, and these can be blocked for various reasons, including surgeries or prior trauma.
- Chromosomes: Sperm carry half of the needed DNA to the egg, but issues with chromosome structures and numbers here can affect fertility.
- Intercourse issues: Painful intercourse, premature ejaculation, erectile dysfunction or other intercourse issues.
- Celiac disease: A digestive disorder caused by gluten sensitivity.
- Medications: Testosterone replacement therapy, anabolic steroids, cancer medications like chemotherapy, antifungal medications, ulcer drugs and certain other medications can impair sperm production.
- Previous surgeries: Vasectomies, hernia repairs, prostate surgeries and others can prevent sperm from being present in the ejaculate.
Environmental causes of male infertility relate to elements like heat, toxins and chemicals that decrease sperm production or function. These causes include:
- Chemicals: Benzenes, toluene, xylene, pesticides, herbicides, organic solvents and painting materials
- Heavy metal exposure (particularly lead)
- Radiation or X-rays
- Overheated testicles
Factors related to health, lifestyle and other causes include:
- Drug use: Cocaine, marijuana or anabolic steroids can cause issues with sperm quality and production.
- Alcohol use: This can lower testosterone, lead to erectile dysfunction and decrease sperm production.
- Tobacco: Can lead to lower sperm count.
- Emotional stress: Can interfere with hormones needed for sperm production.
- Weight: Obesity can directly impact sperm, and can also cause hormone changes.
There are numerous possible treatments for male infertility, and in many cases, it can be fixed with drugs or surgery to allow proper conception through intercourse. There are also tactics you can try to help prevent infertility in some cases. If you’re experiencing issues with fertility, speak to your doctor about options for your specific diagnosis.
Our staff offers a variety of services, including in-office PSA testing, a screening for prostate cancer. We work with you and your primary care physician to develop an individualized care plan for you based on the latest technology and research.
“Male infertility.” The Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/male-infertility/basics/definition/con-20033113
“What is Male Infertility?” Urology Care Foundation. http://www.urologyhealth.org/urologic-conditions/male-infertility