Causes
of Male Infertility
What are the indications
for male infertility
Statistics show that in at least
40% of infertile couples, there is a male factor contributing to the problem.
Male fertility screening is done through semen analysis. The general rule
is that the lower the sperm count and the poorer the sperm quality, the
longer it will take and the more difficult it may be for a pregnancy to
occur. However, even men with very low sperm counts may eventually be successful
in causing a pregnancy. The sperm count only needs to be high enough for
that one time that ovulation occurs, in order for a pregnancy to be possible.
What are the major
factors affecting sperm production
Oligospermia is the term used to
describe the condition when the sperm count is low. If there are no sperm
at all in the semen sample, the condition is termed azoospermia. In such
cases, the clinic will wish to see your husband to take a more detailed
history and to examine him. In his history, specific questions will
be asked about any past condition that may have affected the testicles.
For instance, he will have to answer queries regarding whether he has had
any operations in the groin area or for undescended testicles in childhood.
The specialist will also ask questions to determine whether there has been
any major injury or infection in the genital area.
Infected semen can be a cause of
infertility. Earlier, it was believed that mumps could cause sterility
in men. However, it is now known that even when the testicles are involved
in mumps orchitis (very painful swelling of the testicles), it is extremely
rare for this to lead to sterility.
What other factors
affect sperm production
-
Heat can have a detrimental effect on
normal sperm production. It is for this reason that nature has placed the
testicles outside the body in the scrotum rather than in the abdomen like
the ovaries. Some infertile men soak themselves in a bathtub full of scalding
water and emerge looking like lobsters. This can almost stop sperm production
completely. Obese men can also become sterile because the sagging layers
of fat can overheat the testicles. Men whose jobs involve long hours of
sitting, e.g. long distance lorry-drivers may have infertility due to the
increased heat to the genital area.
-
Very frequent intercourse can lead to
the demand exceeding the supply. There are quite a number of infertile
men whose sex drive is such that they must ejaculate 2-3 times a day. This
explodes the myth that links infertility to lack of virility. It can be
extremely difficult for these men to reduce their ejaculation rate to every
48 hours.
-
Smoking over 20 cigarettes a day has
been shown to reduce both the sperm count and the sperm motility to quite
a major degree.
-
Excessive alcohol intake will lead to
infertility mainly because a man loses both the inclination and the ability
to rise to the occasion! Alcohol can also lower the production of sperm
and of the male hormone testosterone.
-
The workaholic husband can find that
fatigue can have similar effects on his interest in intercourse as excessive
alcohol intake.
What problems can
be identified during examination
Every infertile man must be carefully
examined. The examination of the external genitalia in the male rarely
shows anything out of the ordinary. However, sometimes one or both testicles
are very small or rarely may even be absent. Additionally there may be
congenital absence of each vas deferens, the ducts through which sperm
pass from the testicles to the female at intercourse.
Other factors which may contribute
to lowered fertility, and which can be identified on examination include:
-
Varicocele is a term used to describe
a condition where there are varicose veins around the testicle and vas
deferens. In the case of varicoceles, there is an increase in the blood
flow and temperature around the testicle. Even a small varicocele may be
significant and affect sperm production.
-
The presence of excessive fluid around
the testicle is known as a hydrocele.
-
There can occasionally be anatomical
defects in the development of the penis. Consequently, during intercourse
and ejaculation the sperm cannot be deposited within the vagina very easily.
Retrograde ejaculation is a rare condition when some men ejaculate backwards
into the bladder. This could be the result of earlier surgery to the urethra
(the outflow tube from the bladder).
-
A rectal examination can help determine
whether the prostate gland may be a source of chronic infection.
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