What are the causes of Male infertility ?
Male infertility is a complex and multifaceted problem that affects many men around the world. It is defined as the inability of men to conceive a woman even after a year of regular, unprotected intercourse with women. About 40-50% of all cases of infertility are due to male factors alone. Here we will try to know the causes that are responsible for infertility in men:-
1. Sperm Production Problems
(i) Low Sperm Count (Oligospermia): One of the most common causes of infertility in men is low sperm count. Which is defined as less than 15 million sperm per milliliter of semen. This can be due to a variety of factors including genetic abnormalities, infections or their lifestyle.
(ii) Abnormal Sperm Morphology (Teratozoospermia): Sperm morphology in men refers to the shape and size of their sperm. Abnormal sperm morphology can impede the entry of sperm into the egg. Which results in hampered fertilization in women.
(iii) Poor Sperm Motility (Asthenozoospermia): Here by sperm motility we mean how efficiently the sperm can swim towards the egg. Poor sperm motility means that the sperm has difficulty in moving (swimming) which results in the sperm not reaching the female egg for fertilization. Due to which the chances of successful fertilization in women are greatly reduced.
(iv) Azoospermia: This condition in men is the complete absence of sperm in the ejaculate. Azoospermia in men can cause problems in the formation of sperm or if sperm is being formed then there may be difficulty in coming out.
This can happen due to many reasons like cancer treatment, kidney failure, congenital impotence disorder, contaminated or bad semen, excessive physical and mental exertion, excessive consumption of alcohol, excessive smoking, consumption of bidi cigarettes or tobacco, defective structure of genitals etc.
(v) Varicocele: Varicocele is the enlargement of veins within the scrotum in men which can affect sperm production and quality. These veins carry deoxygenated blood away from the testicles. This is similar to varicose veins in the legs and is one of the most common causes of male infertility.
(vi) Infection: Infection in the male reproductive tract such as epididymitis or orchitis can cause infertility. This can harm sperm production and health. Sexually transmitted infections (STIs) such as gonorrhoea and chlamydia can also cause blockage and scarring.
(vii) Testicular Torsion: This medical emergency in men occurs when their testicles twist. This causes the blood supply to them to be cut off. If not treated immediately, testicular torsion can cause permanent damage. This can disrupt their sperm production.
2. Sperm Delivery Problems
(i) Blockage In The Sperm Ducts: Blockage in the seminiferous tubules in men can cause obstruction of sperm coming out during ejaculation. It can happen due to many reasons like infection, injury or congenital defects.
(ii) Retrograde Ejaculation: This condition occurs in men when semen enters the bladder instead of exiting the penis during ejaculation. Retrograde ejaculation can happen due to many reasons like surgery, certain medications or diabetes which can result in nerve damage.
(iii) Congenital Absence Of Sperm Ducts: The vas deferens are the tubes that carry sperm from the testicles to the urethra. But some men are born without vas deferens. This is associated with a genetic disorder that often causes cystic fibrosis.
(iv) Sexual Dysfunction: Erectile dysfunction (ED) and premature ejaculation in men can have a negative impact on their ability to have sexual intercourse which can affect their fertility. ED can happen due to many reasons including physical problems like heart disease, diabetes or hormonal imbalances as well as psychological factors like mental stress or anxiety.
3. Hormonal And Genetic Factors
(i) Hormonal imbalance: Sperm production in men is controlled by the balance of hormones produced by the hypothalamus, pituitary gland and testicles. An imbalance in hormones such as testosterone, luteinizing (LH) and follicle-stimulating (FSH) can impair sperm production.
(ii) Klinefelter Syndrome: This genetic condition occurs when a man has an extra X chromosome (47,XXY instead of the normal 46,XY). Klinefelter syndrome affects testicular development, leading to low testosterone levels and decreased sperm production.
(iii) Y Chromosome Microdeletion: Certain regions of the Y chromosome are important for sperm production. Microdeletions in these regions can lead to decreased sperm production or azoospermia.
(iv) Hypogonadism: This condition occurs when the testicles produce insufficient amounts of testosterone in men, which is necessary for sperm production. Hypogonadism can be congenital or acquired. It can result from a number of factors, including injury, infection, or tumors.
(v) Chromosomal Abnormalities: Genetic disorders in men such as Kallmann syndrome that affect the development of the hypothalamus. Other chromosomal abnormalities can affect hormone production and reproductive health.
4. Lifestyle And Environmental Factors
(i) Substance Abuse: Recreational drug use, excessive alcohol consumption, and smoking by men can badly affect their sperm production and quality. For example, smoking can reduce sperm count and motility, while excessive alcohol consumption can cause hormonal imbalances.
(ii) Exposure to toxins: Men’s exposure to environmental toxins such as various pesticides, heavy metals, and industrial chemicals at work can affect their sperm health. Long-term exposure to these substances can reduce their sperm count and motility.
(iii) Radiation And Chemotherapy: Cancer treatments such as radiation and chemotherapy can impair sperm production in men. These treatments can damage the DNA in their sperm cells and reduce the total number of sperm produced.
(iv) Obesity: Being overweight in men can affect their hormone levels. Which can lead to a decrease in testosterone levels and sperm production. Obesity can lead to a number of other diseases that can further affect their fertility.
(v) Stress: High levels of stress in men can affect their hormone levels. Which can lead to a decrease in sperm production. Stress can also contribute to sexual dysfunction, which can further affect fertility.
Diagnosis and Testing of Male Infertility
(i) Semen Analysis: The cornerstone of diagnosing infertility in a man is analyzing his semen to evaluate sperm count, motility, and morphology. This test helps identify problems associated with sperm production or function.
(ii) Blood tests: Men’s blood tests can help identify hormonal imbalances that may affect sperm production. The major hormones tested include testosterone, LH, FSH, and prolactin.
(iii) Genetic testing: His genetic testing can identify chromosomal abnormalities or genetic mutations that may affect fertility. Testing for conditions such as Klinefelter syndrome or Y chromosome microdeletion can provide valuable information.
(iv) Ultrasound: Scrotal ultrasound can detect structural problems such as varicoceles, testicular abnormalities or obstructions in the reproductive tract.
Conclusion
Male infertility is a multi-faceted condition that can have many causes, from genetic and hormonal factors to lifestyle and environmental influences. Understanding the causes and proper diagnostic testing can help men overcome infertility and fulfill their desire to become fathers. It is important for men to seek professional medical advice to identify the underlying causes for their infertility and explore available treatment options. We recommend that you seek professional medical advice to address your infertility problems.