Causes of Male Infertility

One of the myths of male infertility is that if you are a healthy person, you will be fertile. This is not always the case as sometimes even healthy men can be infertile. There are many factors that affect male fertility, ranging from physical to psychological problems. A few of these are outlined below.

Health: Abnormal sperm production or function caused due to damage to the ducts – epididymis (a duct behind the testes, passing sperm to the vas deferens) and vas deferens (the duct which carries sperm from the testicle to the urethra), testicular torsion (reducing blood flow to the scrotum) and varicocele (enlarged veins around the testes) can result in infertility.

Infections: of the male reproductive tract caused by diseases such as mumps, orchitis (inflammation of the testicles), tuberculosis or gonorrhea can cause both low sperm count and low motility. However, these infections can be cured with antimicrobial therapy.

Sexual problems: can have an impact on fertility, because of the prevention of sperm from entering the vagina.

These can be due to erectile dysfunction (impotence), premature ejaculation, delayed ejaculation, anejaculation (inability to ejaculate semen) and retrograde ejaculation (where the sperm enters the bladder instead of going through the penis).

Genetic disorders: Chromosome conditions affect the way sperm is produced. A person who has an extra X chromosome has low sperm count or sometimes no sperm at all in the semen. Sometimes, Y microdeletions (missing genes in the Y chromosome) lead to reduced sperm count. A disorder in the autosomal chromosome, where one/both of the testes is/are undescended can contribute to male infertility. Cystic fibrosis, a hereditary disorder, blocks passages (usually to the respiratory ducts) but also causes congenital bilateral absence of the vas deferens (CBAVD), resulting in azoospermia (absence of sperm in the semen).

Environmental factors: Overexposure to certain elements such as toxins, heat and chemicals can affect sperm function and sperm quality and reduce sperm levels. Some of these are industrial chemicals like petrochemicals, pesticides, herbicides and painting materials. Heavy metal exposure can also contribute to low sperm counts. Radiation or x-rays can reduce sperm production though it usually returns to normal after some time. However, it can be permanently affected with high-dose radiation treatment. Elevated temperatures are said to impair sperm function, though studies have been inconclusive. However, some of the things to watch out for are frequent use of saunas, sitting for long periods, working on a laptop/computer for long periods and wearing tight clothing – as these may increase the temperature in the scrotum and lead to reduced sperm production.

Lifestyle causes: Some of the lifestyle causes are listed below:

• Tobacco: Men who smoke can have a lower sperm count and secondhand smoke also affects male fertility.
• Alcohol: can lower testosterone levels, cause erectile dysfunction and affect sperm production. Excessive drinking can also result in disease of the liver which may lead to fertility problems.
• Drug use: Anabolic steroids (synthetic variations of the male sex hormone testosterone) can cause the shrinking of testicles and decrease in sperm production. Use of marijuana may temporarily reduce the sperm count and quality. Sometimes, drugs to treat bacterial infections can also affect fertility. Even anti-anxiety medications may prevent the proper movement of sperm or harm the sperm. Steroids such as cortisone and prednisone impact sperm DNA quality.
• Stress: can lower the sperm count as it affects certain hormones required to produce sperm.
• Depression: can cause sexual dysfunction due to delayed ejaculation, low libido (decreased interest in sexual activity) and erectile dysfunction.
• Obesity: Overweight can directly impact the sperm themselves and also cause hormonal changes which will reduce male fertility.
  However, these lifestyle factors can be changed to prevent your fertility from being affected.

Hormones: It is not common for infertility to result from a hormone deficiency. The LH (luteinizing hormone) and the FSH (follicle-stimulating hormone) cause the testes to produce testosterone and sperm. Elevated LH and FSH levels cause primary hypogonadism (primary testicular failure) and low or low-normal levels suggest secondary hypogonadism (where the testicles are normal but don’t function properly).
Even though there are many causes for male infertility, if you are having any such problems, one of the priorities would be to consult an Infertility specialist or Andrologist. The consultations will include a detailed previous history of health conditions/surgeries/allergies, lifestyle and occupation history and finally a physical examination. Most doctors will prescribe some blood tests and a semen analysis initially, which will help determine the cause.

To get a Semen Analysis or Sperm DNA Fragmentation Test done, contact Andrology Center on info@andrologycenter.in or +91 94437 93934.