Introduction to Male Infertility

Starting a family is an event that most couples anticipate eagerly. Unfortunately, many couples struggle with infertility issues, which can take the sheen off the experience. More often than not, the common societal misconception when a couple is having trouble getting pregnant is that the woman is the one with problems. This isn’t true – in fact, studies show that male factor infertility is the cause of around 40% of infertility cases!

Male infertility can be caused by hormone disorders, illness,infection, injury to reproductive anatomy, obstruction or sexual dysfunction. These factors can temporarily or permanently affect sperm and thereby prevent conception. Some disorders become more difficult to treat, the longer they are left untreated. Which is why it is important to first make a definite diagnosis of what’s causing your infertility.

We advocate that both partners get tested for infertility and treat any obstacle that prevents you from realising your dream to become parents. And if male factor infertility is a cause, you can rest assured that our specialistswill find you the best treatment option.

Factors of Male Infertility

Infertility in males normally stem from one of two reasons: a deformity in the reproductive system itself, caused by injury, infection or disease, or from issues with the sperm produced. We have briefly defined the various physical conditions that can affect fertility in men in this section.

• Cryptorchidism,  a condition where the testes have not descended, impairs sperm production.
• Cystic fibrosis  can cause the absence of the ducts that transport the sperm.
• Ductal obstruction,  brought on by a vasectomy, repeated infection, inflammation or a development defect, prevents transport of sperm.
• Hemochromatosis,  a metabolic disorder, results in deposits of iron in the testes.
• Hormone dysfunction,  caused by a hypothalamic-pituitary-gonadal axis disorder.
• Inflammatory infections  of the prostate, epididymis and testicle before puberty.
• Retrograde ejaculation  where the semen flows backwards into the bladder as a result of a defect in the urethra or bladder, or diseases such as diabetes.
• Sexually transmitted diseases  cause obstruction, infection and scarring.
• Sickle cell anaemia  often causes decreased functionality of the testes.
• Spinal cord injury   can cause ejaculatory dysfunction, abnormalities of sperm production, chronic infections and blockage of sperm within the reproductive track.
• Systemic disease,  which can affect sperm production.
• Testicular cancer  limits or destroys the ability to produce sperm.
• Varicocle  or the enlargement of the veins in the scrotum, often causes decreased sperm production and quality, and in some cases shrinks the testes.

Sperm Disorders

Approximately 25% of all infertility is caused by a sperm defect, and around 40-50% of infertility cases have a sperm defect as the main cause, or a contributing cause. Yet, we also know that men with very low sperm counts can have children, while those with healthy sperm counts sometimes do not. This tells us that it’s not the number of sperm that matter as much as their ability to fertilise an egg.

Defects and disorders of the sperm are usually on a molecular level – the sperm can be irregularly shaped, have poor motility, or be low in numbers, all of which can impede the fertilisation of the eggs.

Lifestyle Factors

Your lifestyle and choices can also affect your sperm production and their viability. Therefore taking stock of your lifestyle and making healthier choices can help you overcomes some of your infertility issues.

The lifestyle habits and substances that can negatively impact your fertility are listed below.

• Age:  Sperm production drops after age 40.
• Illegal drug use: Anabolic steroids that are taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. Use of cocaine or marijuana may temporarily reduce the quantity of sperms produced, as well as their quality.
• Alcohol: Drinking alcohol can lower testosterone levels and cause decreased sperm production.
• Caffeine: Caffeine may perk you up when you’re tired, but coffee and medications with caffeine appear to make sperm sluggish.
• Cimetidine:   If you are taking this drug and you are trying to conceive at the same time, talk your doctor about a lower dose or if you can stop the medication for a while. This drug is used to treat ulcers but decreases testosterone levels and may affect sperm production.
• Occupation:  Certain occupations may increase your risk of infertility, including those associated with extended use of computers or video display monitors, and those involving long sitting periods, shift work and work-related stress.
• Tobacco: Men who consume or smoke tobacco may have a lower sperm count than do those who don't smoke.
• Emotionalstress: Severe or prolonged emotional stress, including stress about fertility itself, may interfere with sperm production.
• Weight:  Obesity can cause hormone changes that reduce male fertility.
• Heat: Frequenting hot tubs can lower sperm count by overheating sperm production cells.