Infertility in Men: Common Causes, Symptoms, and Treatment Options

In the modern world, infertility has seen a steep rise, with nearly 15% of couples having difficulty conceiving a child even after having unprotected sex for over a year or longer. Male infertility alone is the prime reason in one-third of these couples, and in another third, both male and female infertility are factors. Apprehending the gravity of the issue, it’s important to learn about the risks, causes, symptoms, and treatment options for male infertility.

What Is Male Infertility?

Male infertility occurs due to problems in the male reproductive system in either sperm production or sperm deposition into the female reproductive tract. Normally, sperms are produced in the testes that are in the scrotum, stored in a sac called the epididymis, and transported via a tube called the Vas Deferens. When you ejaculate, the sperm mixes with fluid from the prostate and seminal vesicles, forming semen. The semen then travels through the male urine tube called the urethra and is ejaculated out of the penis. Male fertility depends upon your body’s ability to produce enough normal sperm and deliver them into your female partner’s vagina. According to WHO, you should produce at least 39 million sperm per ejaculate or 15 million sperms per ml that can move forward rapidly mixed with normal fluids around them [no pus, not too viscous, contains fructose of 1.5-7.5 ml volume]. These sperms travel through your female partner’s cervix into her uterus to her fallopian tubes. During ovulation, fertilization happens if one of your sperm meets your female partner’s egg.  Any disturbance in this whole process can cause infertility.

Common Causes of Male Infertility

There are several conditions that can cause male infertility. Some of the most common are:

• Sexually transmitted diseases

STDs like Herpes, gonorrhea, HIV/AIDS, chlamydia, syphilis, hepatitis, and mycoplasma genitalium can damage the testes causing poor sperm production.

• Erectile or ejaculatory dysfunction

Inability to have an erection due to chronic ill health, diabetes, medication, spine injuries, or surgery on the male urogenital tract or Hypospadias where the urine opening is on the undersurface of the penis or psychological issues can lead to the inability to deposit sperms. Stress, lack of privacy, or travel at the time of ovulation can also cause infertility. Retrograde ejaculation is a rare condition where sperms are deposited in the urine bladder instead of to the exterior.

• Hormonal imbalances

Some hormones control sperm production in your body. Any imbalance in these hormones affects both sperm production and deposition, like low testosterone levels, thyroid disorder, hypothalamus, pituitary, or adrenal disorders.

• Congenital disabilities

Birth defects like undescended testes, chromosomal abnormalities like Klinefelter’s syndrome [XXY], cystic fibrosis that causes clogging of tubes, Kallmann’s syndrome, or congenital absence of both vas deferens CABVD can cause infertility.

• Undescended testes

At or soon after birth, the testes enter the scrotum. If they remain in the abdomen or groin area, sperm production is affected, causing subfertility or infertility.

• Cancer

Cancers and benign tumours of the male genital tract or pituitary can affect fertility. Surgery, chemotherapy, or radiotherapy for the treatment of cancer also affect fertility.

• Varicocele

Veins around the testes get swollen, raising the testicular temperature and causing low sperm count and motility.

• Medications

Steroids, some antacids, chemotherapeutic agents for cancer or ulcerative colitis, and arthritis drugs can affect sperm production.

• Surgery

Vasectomy, hydrocele or hernia repairs and testicular surgeries can lead to infertility.

• Environmental factors

Exposure to radiation or harmful chemicals affects sperm count and motility when working in high temperatures.

• Lifestyle factors

Excessive use of Alcohol, tobacco, marijuana, and cocaine, as well as obesity, affect sperms and hormones.

• Anti-sperm antibodies

Anti-sperm antibodies are immune system chemicals that mistake sperm for hazardous intruders and try to destroy them.

• Other infections

Some infections, such as mumps, tuberculosis, epididymitis (inflammation of the epididymis), or orchitis (inflammation of the testicles), can cause problems in sperm production.

• Sexual intercourse problems

This can include premature ejaculation, painful intercourse, and psychological or relationship problems that interfere with sex.

Who Are Likely to Suffer from Infertility?

Infertility in men brings many challenges in conceiving. Here is the list of males likely to be suffering from Infertility.

• Obese males
• Elderly males
• Males exposed to radiation and environmental toxins (lead, calcium, pesticides, or mercury)
• Tobacco, Marijuana, or Alcohol addicts
• Men who have a history of undescended testicles
• Men having varicocele history
• Males with low testosterone levels

Male Infertility Symptoms

The primary symptom of male infertility is the incapability of conceiving a child. However, other symptoms include:

• Erectile Dysfunction
• Pain or major injury in the testicles
• Hormonal imbalance
• Reduction in sperm counts

Male Infertility Treatment

The male infertility treatment varies from person to person depending upon the cause of infertility. The treatment for male infertility includes:

1. Treating the underlying condition like infection, diabetes, hormonal disturbance, and diet deficiencies, and making lifestyle changes to quit smoking and consumption of alcohol. Antioxidants are also given to improve sperm quality.
2. In mild cases, Intrauterine insemination (IUI) helps deposit an adequate number of motile sperm into the lady’s uterus during the female partner’s ovulation. A total motile sperm count of over 5 million per ml gives results with an IUI procedure.
3. If the male works overseas or on a ship or before he undergoes cancer treatment, his sperms are frozen and later used for IUI or IVF/ ICSI.
4. Medications like sildenafil are used for erectile dysfunction or premature ejaculation.
5. Vibrators or electro ejaculation [under anaesthesia] are used to collect a semen sample.
6. In severe cases, Intra cytoplasmic sperm injection, where a single sperm is chosen by examining it under high magnification, is injected into one egg using a micromanipulator.
7. Use donor sperm for IUI or ICSI where no sperms are available, or the couple cannot afford an ICSI.
8. PESE, TESA, and TESE procedures are used where sperms are sucked out by a needle from the epididymis, testis, or a testicular tubule and used for ICSI.
9. Micro TESA procedure is used where testes are examined under an operative microscope, and functioning areas are used to extract sperms.
10. In the case of severe bilateral varicoceles, varicocelectomy may be necessary where feeding vessels are tied or burnt and swollen veins are removed.

When to Consult a Doctor?

If you cannot conceive a child after a year without unprotected intercourse, consult the fertility specialist immediately for treatment. You can also get your appointment scheduled if you have:

• Sperm issue or low sperm count
• Problems with sexual function- problems with erection, difficulty in ejaculation, or small volume of ejaculate
• Reduced sexual desire
• Any history of sexual, prostrate, or testicular problems
• Undergone or will be undergoing cancer treatment
• Lumps or pain in the groin
• Abnormal breast growth
• Decreased facial or body hair
• Swelling in the scrotum
• A job that involves separation from your partner
• Partner above 35 who cannot conceive after trying for six months.
• Record of infertility in family ancestry.

  If you have any of these issues, consult a gynecologist or a gynecological hospital today. A professional gynecologist will run a sperm fertility test and diagnose your problem while creating a personalized treatment plan for you. You can schedule your appointment with Rotunda CHR to get rid of fertility issues with our professionals' help. Contact us today!