Male Infertility - Causes
A variety of factors can decrease sperm count or motility, or impair their ability to fertilize the egg. Common causes of male infertility include irregular sperm production or function, diminished delivery of sperm, general health and lifestyle issues, and excessive exposure to certain environmental elements.
Reduced production or function of sperm. Many cases of male infertility are due to problems with the sperm, such as:
Below normal sperm concentration. Minimum sperm should be greater than or equal to 15 million sperm per milliliter of semen. Sperm counts of 15 million or fewer per milliliter of semen indicate low sperm concentration. Some of the causes mentioned below may impair sperm production to varying degrees and consultation with your urologist can help identify the exact cause of low sperm production, though some cases can remain unexplained.
Varicocele. This is dilated veins that drain the testicle in the scrotum that could prevent normal cooling of the testicle, which may cause reduced sperm count and movement. This is a cause of decreased sperm production in about 40% of men with infertility.
Undescended testicle. This condition occurs when one or both testicles fail to move from the abdomen into the scrotum during fetal development. Due to the fact that the testicles are exposed to the higher internal body temperature, when compared with the temperature in the scrotum, sperm production may be affected.
Testicular failure. Infertility may result from disorders of the testicles themselves, or an irregularity affecting the hypothalamus or pituitary gland in the brain that produces the hormones that control the testicles. Low sperm count and low testosterone levels are a result but remember, testosterone treatment is BAD for your fertility. There are ways to treat this condition that can raise testosterone levels and sperm production.
Genetic defects. Klinefelter's syndrome is a genetic defect that occurs when a man has two X chromosomes and one Y chromosome instead of one X and one Y. This causes unusual development of the testicles, resulting in low or absent sperm production and possible low testosterone. In certain cases, when sperm production is very low or absent, a small portion of the Y chromosome is missing. This is known as a Y chromosome microdeletion.
Infections. Sperm motility can be temporarily affected by certain infections. Repeated attacks of sexually transmitted diseases (STDs), such as chlamydia and gonorrhea, are most often associated with male infertility. These infections can cause scarring and block sperm passage. An occurrence of mumps after puberty may cause inflammation of the testicles and can impair sperm production. Inflammation of the prostate, urethra or epididymis also may alter sperm motility.
In some cases, no cause for reduced sperm production is found. Nevertheless, it is important to let your urologist help you try and identify a cause. If none is found, then there is value in knowing a thorough evaluation has been completed.
Delivery of sperm impaired. Complications with the delivery of sperm from the penis into the vagina can result in infertility. These may include:
Sexual issues. Often treatable, problems with sexual intercourse or technique may affect fertility. Erectile dysfunction, painful intercourse or psychological or relationship problems can contribute to infertility.
Retrograde ejaculation. Semen enters the bladder during orgasm instead of emerging out through the penis. Diabetes, bladder, prostate or urethral surgery, and the use of certain medications may cause retrograde ejaculation.
Epididymis or ejaculatory ducts blockage. In some cases, men are born with blockage of the part of the testicle that contains sperm, the epididymis or ejaculatory ducts. Certain men lack the tube that carries sperm (vas deferens) from the testicle out to the opening in the penis.
No semen (ejaculate). The sperm is carried from the penis into the vagina by the ejaculate.(semen). Men with spinal cord injuries or diseases may experience the absence of ejaculate.
General health and lifestyle. Frequent causes of infertility related to health and lifestyle include:
Emotional stress. Stress may hinder certain hormones needed to produce sperm. Extreme or prolonged emotional stress may affect your sperm. Fertility problems can sometimes become long term and disappointing, producing more stress. Social relationships and sexual performance can affect infertility.
Obesity. Unhealthy body weight may contribute to fertility problems in men.
Alcohol and drugs. Excessive alcohol use or drug dependency may be associated with poor health and lowered fertility.
Other medical conditions. Male fertility can be affected by severe injury or major surgery. Diabetes, thyroid disease or anemia may be linked to infertility.
Environmental exposure. Excessive exposure to environmental elements such as heat, toxins and chemicals may lead to a reduced sperm count, either direct or indirect. Examples include:
Pesticides and other chemicals. Studies have shown that herbicides and insecticides can cause female hormone-like effects in the male body and furthermore may be associated with reduced sperm production and testicular cancer. Exposure to lead and other heavy metals may also cause infertility. Research is uncovering other substances in commonly used products that are thought to be “Endocrine Disruptors” and may impair hormone levels and fertility.
Overheating the testicles. Regular use of saunas or hot tubs can increase your testicular temperature. This may interfere your sperm production and lower your sperm count.
Tobacco smoking & substance abuse. Smoking, excessive alcohol use, or drug use may lower your quality and count of sperm. These activities should be avoided, especially when trying to have a child.
Urology Clinics of North Texas includes board-certified urologists who are trained to help men identify their infertility problems and help them in their effort to start a family. Click here to request an appointment.