Causes for male infertility
Generally, a man's infertility is related to problems with the following:
- efficient sperm production – a man must produce healthy sperm. Initially, this involved the formation and the development of the reproductive sexual organs during puberty. It is necessary for at least one of the testicles to function properly and for the body to produce testosterone and other hormones to trigger and maintain sperm production.
- number of spermatozoa – there must be enough spermatozoa in the sperm. If this number is reduced, the chances of one of them fertilizing their partner’s egg also decrease.
- spermatozoa must be transported in the sperm – once the spermatozoa are produced in the testicles, there are some very thin tubes that transport them until they reach the sperm and are ejaculated from the penis
- the shape of the spermatozoa, the mobility of the spermatozoa – the spermatozoa must be functional and mobile, otherwise they will not be able to reach the egg or they will not be able to penetrate it
- The risk factors associated with male infertility should be mentioned first: old age, smoking, alcohol abuse, overweight / obesity, family history of infertility, hernia surgery, previous genital or prostate infections, testicular lesions or torsion, early/late puberty.
Medical causes for male infertility include:
Varicocele
this is the inflammation of the veins that drain the testicle, being the most common reversible cause for male infertility; it leads to reduced sperm quantity and quality
Infections
there are several infections that can affect sperm production or their health or can lead to scars that block sperm transport; this category includes epididymitis (inflammation of the epididymis) or orchitis (inflammation of the testicles), sexually transmitted diseases (including gonorrhea or HIV)
Ejaculatory problems
retrograde ejaculation involves the penetration of sperm into the bladder during orgasm instead of coming out through the tip of the penis; this problem can occur due to spinal injuries, diabetes, medication or surgery (to the prostate, urethra or bladder)
Antisperm antibodies
are cells of the immune system that confuse sperm with pathogenic cells and try to eliminate them from the body
Tumors
cancers and other benign tumors can directly affect the male reproductive system through hormone-secreting glands. There are situations in which the radiation therapy or the chemotherapy associated with cancer has an impact on a man's fertility
Undescended testicles
in some men during fetal development one or both testicles fail to descend from the abdomen to the scrotum, being more likely to later face reduced fertility
Hormonal imbalances
this may concern a malfunction of the hypothalamus, the pituitary gland, the thyroid or the adrenal glands. Male hypogonadism (low testosterone levels) can have a range of possible causes.
Defects in the tubes that carry sperm
these tubes can become blocked either as a result of injuries associated with surgery, post-infectious, post-traumatic or due to abnormal development (cystic fibrosis and other congenital diseases). The blockage can be located in any level of the testicle, either in the epididymis, in the vas deferens or even in the urethra.
Chromosomal defects
hereditary diseases such as Klinefelter's syndrome (a man is born with 2 X chromosomes and a single Y chromosome) lead to abnormal development of the sexual organs. The Kallmann syndrome or the cystic fibrosis have the same effect
Problems with the sexual function
this category includes erectile dysfunction, premature ejaculation, but also hypospadias (urethral opening located under the penis)
Certain medications
testosterone replacement therapy, long-term use of anabolic steroids, tricyclic antidepressants, chemotherapy, ulcer or arthritis medication (sulfasalazine), antihypertensive medication (calcium channel blockers) and other medications may affect sperm production and reduces fertility
Surgery
certain surgeries may prevent the transport of sperm into the ejaculate, including vasectomy, operations to the scrotum, prostate or testicles, major abdominal surgery (testicular or rectal cancer) etc.
The environmental factors that influence male fertility are:
Industrial chemicals
long-term exposure to certain chemicals such as pesticides, herbicides, organic solvents and paint materials can lead to low sperm count
Exposure to heavy metals
the main heavy metal that can affect male fertility is lead
Radiation exposure
in case of massive doses of radiation, sperm production can be permanently reduced
Recreational drugs
marijuana and cocaine reduce the number and quality of sperm
Overheating of the testicles
high temperatures can affect the production and functioning of sperm; for this reason, hot baths and saunas are not recommended, nor is sitting for a long time or wearing tight underwear / clothing (increases the temperature of the scrotum, decreasing sperm production).
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