Male Infertility

Last updated date: 14-May-2023

Originally Written in English

Male Infertility 

Almost one in every seven spouses experience infertility issues. This generally means they are unable to conceive a child despite having regular, unprotected intercourse for one or even more years. Male infertility may play a role in up to half of the couples with the problem. 

Male infertility may occur due to abnormal sperm function, low sperm count, or sperm delivery blockages. Sometimes, it can be caused by injuries, illnesses, chronic medical conditions, lifestyle choices, or other aspects.

Generally, the inability to make a partner pregnant might be frustrating and stressful. Luckily, there are a variety of male infertility treatments options available. 

 

Symptoms of Male Infertility 

The inability to make a partner pregnant is the most obvious indication of male infertility. However, other apparent signs and symptoms may not exist. In certain situations, an underlying health issue like hormonal imbalance, a genetic disorder, dilated veins on the testicle, and a problem that obstructs sperm passage triggers the signs and symptoms. One might also notice the following signs and symptoms of male infertility:

  • Disorders with sexual function, such as trouble ejaculating or ejaculating small amounts of fluid, decreased sexual desire, or trouble sustaining an erection (also known as erectile dysfunction)
  • Respiratory infections that recur
  • Experiencing swelling, pain, or formation of a lump around the testicle area
  • Incapacity to smell
  • Reduced body or facial hair, as well as other symptoms of a hormonal or chromosomal abnormality
  • Breast growth that is abnormal (gynecomastia)
  • A sperm count that is lower than usual (less than 15 million sperm per milliliter of semen or a sum of sperm count of lower than 39 million in every ejaculate)

If you haven't been able to conceive even after a year of frequent, unprotected sexual intercourse, consult your doctor or urologist. 

 

Causes of Male Infertility 

A variety of environmental and biological factors can have an impact on male fertility. Some of the possibilities are:

  • Oligospermia: This is the production of low-quality sperm.
  • Azoospermia: Male infertility may be caused by a lack of live sperm cell production.
  • Deformed sperm: This refers to the sperm that is unable to survive for some time to fertilize the egg.
  • Hereditary disorders: Klinefelter's syndrome, microdeletion, myotonic dystrophy, and other genetic diseases can lead to male infertility.
  • Certain medical conditions: Diabetes, cystic fibrosis, certain autoimmune disorders, and some infections are examples of conditions that can contribute to male infertility. 
  • Variococles: A condition in which the veins on the testicles are bigger than usual, making them overheat and affecting the number or shape of the sperm.
  • Use of certain drugs and supplements.
  • Cancer therapies: Examples include radiation therapy, chemotherapy, or testicular removal surgery (one or both).
  • Testicular trauma
  • Unhealthy habits; such as excessive alcohol consumption, illegal drug use, smoking, and the use of anabolic steroids.
  • Hormonal disorders: Problems affecting the pituitary or hypothalamus glands can as well cause infertility in men

 

Risk Factors of Male Infertility 

The following risk factors can contribute to male infertility:

  • Tobacco smoking
  • Exposure to toxins
  • Using alcoholic drinks
  • Having had some infections in the past or present infections
  • Overweightness
  • Taking certain illegal drugs
  • Testicular overheating
  • Having been subjected to testicular trauma
  • Having an undescended testicle history
  • Having had a vasectomy or a major pelvic or abdominal surgery in the past
  • Having some health conditions, such as tumors or chronic diseases like sickle cell disease
  • Having a fertility disorder or a blood relative who has the fertility issue
  • Using some drugs or undergoing cancer treatments, like radiation therapy or surgery

 

Male Infertility Diagnosis 

Male Infertility Diagnosis 

Most infertile spouses often have more than one reason for their infertility. Hence, you both should consult a medical provider. Several tests may be required to identify the underlying male infertility causes. At times, the cause is not discovered in certain cases.

Typically, diagnosis of male infertility problems entails:

  • A comprehensive physical exam and a medical history

Typically, this entails examining the genitals and inquiring about any chronic medical problems, genetic conditions, injuries, illnesses, and surgeries that may impact fertility. The provider may also inquire about the sexual habits as well as sexual growth at puberty.

  • Sperm evaluation

There are several methods for obtaining sperm samples. For instance, you can give a sample at the physician's office through masturbation and ejaculating in a container. Other men may choose an alternative technique of sperm collection due to cultural or religious beliefs. In these cases, the sample can be obtained during intercourse through the use of a special condom.

In other cases, the doctor may suggest more tests to assist in determining the underlying cause of male infertility. Some of these tests are:

  • Ultrasound of the scrotum: This test generates images of the inner body using high-frequency sound waves. A scrotal ultrasound enables the provider to determine whether you have a varicocele or any other issues with your testicles as well as the supporting structures.
  • Hormone analysis: The hypothalamus gland, pituitary gland, and testicles all produce hormones that are important for sexual development as well as semen production. Other organ or hormone system abnormalities may also play a role in infertility. Therefore, a blood test can be done to determine the testosterone level and other hormones in the body.
  • Transrectal ultrasound: This involves inserting a tiny, lubricated wand into the rectum. It enables the doctor to examine the prostate and check for any obstructions within the tubes transporting sperm.
  • Urinalysis after ejaculation: Semen present in the urine may indicate that the sperms are moving back into the bladder rather than outside the penis when ejaculating (retrograde ejaculation).
  • Biopsy of the testicles: A needle is used to extract semen samples from the testicle during this test. If the testicular biopsy results indicate normal sperm production, the condition is most likely due to an obstruction or a different issue with semen transport.
  • Genetic tests: If the semen concentration is too low, a hereditary cause may be present. Hence, a blood test might help detect any slight alteration in the Y chromosome, which indicates a genetic irregularity. The doctor can recommend genetic testing to diagnose certain congenital or hereditary syndromes. 
  • Specialized semen function tests: The provider can use various tests to determine how well the sperm can stay alive after ejaculation. This also helps determine how well the sperm enters an ovum and whether or not they attach to the egg. These semen function tests are rarely used and do not often change treatment recommendations significantly.

 

Male Infertility Treatment 

In most cases, the actual reason for infertility cannot be determined. But even when the precise cause is unknown, the provider may be able to suggest treatments or other approaches that will result in successful conception.

In infertility cases, it is often preferable that the female partner undergoes examination as well. Your partner may also receive specific fertility treatments. Alternatively, you may discover that opting for assisted reproductive methods is suitable in your case.

Male infertility treatments can include the following:

  • Male infertility surgery: A varicocele, for instance, can be surgically repaired in most cases, as with obstructed vas deferens. Also, previous vasectomies are reversible. When there is no semen in the ejaculate, sperm is usually extracted directly from the testicles or the epididymis through sperm retrieval methods.
  • Treatment of problems with sexual intercourse: For conditions like premature ejaculation or erectile dysfunction, medication or therapy might assist in improving fertility.
  • Hormonal therapy and medication: Sometimes, infertility is due to high or low levels of particular hormones or issues with how the body utilizes the hormones. In such cases, the doctor may suggest hormonal medications or replacements.
  • Infection treatment: An antibiotic can help address a reproductive tract infection, although it does not always correct fertility.
  • Assisted reproductive technology (ART): This treatment may include various approaches based on the particular case and desires. It can be removing sperm via normal ejaculation, surgical removal, or from a donor person. After that, the doctor inserts the sperm into the female genital system or uses it for intracytoplasmic sperm injection or In Vitro fertilization.

Preventing Male Infertility 

Preventing Male Infertility 

Male infertility cannot always be avoided or prevented. On the other hand, you can attempt to keep away from certain well-known causes and contributing male infertility factors. You should, therefore;

  • Avoid smoking
  • Limit or avoid alcohol consumption.
  • Avoid using illegal drugs.
  • Keep a healthy weight.
  • Avoid getting a vasectomy.
  • Avoid anything that causes the testicles to become hot for an extended period
  • Reduce your stress.
  • Avoid pesticides exposure, heavy metals, or other toxins.

 

Conclusion 

Approximately 10 percent of all males worldwide who are trying to conceive are infertile. In such a struggle, however, you are not alone. Due to advancements in technology, about 90 percent of males with infertility cases can now conceive. 

There are various treatments for the underlying causes of male infertility. It can include making lifestyle changes to prevent infertility and attempting surgical procedures or other techniques. Overall, consider talking to your doctor in case you and your partner are unable to conceive after one year of regular unprotected sex.