What Causes Male Infertility?

Infertility is the inability to produce healthy, fertile reproductive cells. Sperm is produced in the testes of males and egg cells in the ovaries of females. Infertility is usually diagnosed after 12 months of regular, unprotected intercourse that has not resulted in a pregnancy.

Infertility may be caused by hormonal changes, structural changes in the reproductive organs or cells, genetic defects, health problems, diseases or infections ( such as Sexually Transmitted Infections (STIs)).

Signs of Infertility In Males

There are multiple signs and symptoms to indicate infertility but most of them could be associated with other diseases or issues as well. Thus, we cannot say that all of these signs and symptoms are specific to infertility but may indicate the possibility. If you have any of these signs or symptoms, it might be a good idea to visit a doctor or contact us for a consultation.

Decreased Sex Drive

Virility is the term used to indicate a man’s strength, his energy and his sex drive. A low virility level may indicate infertility as it is associated with a low sex drive and possible hormonal imbalances.

Ejaculation Issues

Inability to release semen from the body may indicate a problem with fertility and is a good indicator that it is time to see the doctor. There may be a physical explanation for this occurring or a psychological reason.

Scrotal Or Testicular Swelling

Red and shiny testicles could be due to cysts, testicular torsion, varicocele (swollen veins in the testicles causing a lump), cancer or some trauma where the testicles got hurt. Infections such as mumps or epididymitis may also cause pain in the testicles.

Inability to Maintain an Erection

Erection problems are usually associated with hormonal levels, especially when there is a reduction in the hormone level. The physical aspect, stress, tiredness, too much alcohol and hormonal aspect of erectile problems will cause problems attempting to conceive.

Small And Firm Testicles

The gonads, or testicles of a male, are where the sperm is stored. Hypogonadism could be the reason for smaller testicles since this condition is present or noted when the body of a male is not producing enough testosterone. Undescended gonads may also be the reason for smaller testicles in males.

Most Common Causes of Infertility In Males

There are 3 main categories of infertility problems in males: sperm disorders, structural problems and another disease or issue.

Sperm Disorders

Producing healthy sperm is imperative for fertilisation. Without healthy sperm, conceiving a child with your female partner will not be possible. Some problems that may be encountered with sperm may be: non-swimming sperm (immobile), sperm that is shaped abnormally or sperm that has not matured.

Conditions that may cause these problems include Inflammatory conditions or infections, pituitary gland or hormonal imbalances and issues, an autoimmune disease where antibodies are produced against your own sperm, lifestyle factors like smoking, drug use, environmental toxin exposures or alcohol abuse and some genetic diseases.

Structural Issues In The Reproductive Organs

A blockage may occur in the urethra of the penis, which will block the sperm from exiting during ejaculation. Birth defects, infections, inflammatory conditions or genetic defects can cause blockages as well. A previous surgery may have left a scar that can also cause a blockage.

Other Causes

Erectile dysfunction and premature ejaculations can cause infertility problems as well. Treatment for diseases like kidney disease, liver disease or seizures may also influence ejaculation and erections.

Who Is At Risk of Developing Infertility?

Previous conditions, medications or infections may put you at risk of developing infertility. Some of the prior conditions include: prostate infections, genital infections, torsion of the testicles, puberty that occurred too early or late, testicles and genitals being exposed to reoccurring hot temperatures (hot shower, laptop heat, etc), hernia repair or testicles that did not drop or descend. Various medications may also have a detrimental effect on male fertility. Medications for conditions like depression, psoriasis, hypertension or stomach ulcers may cause infertility.

Tests And Diagnosis

A physical examination would be the first step to assess if your vitals are normal and if the macroscopic structure of the reproductive organ is normal. After a physical examination, the doctor may request follow-up laboratory tests.

Semen Analysis

This is when the patients’ sperm is assessed for any abnormalities in the amount of sperm produced (the volume), the pH level of the sperm (how acidic it is) and the consistency of the sperm (how uniform it looks). The motility of the sperm (how well they swim or move) and how they look structurally under a microscope (the morphology) will also be used to determine the cause of infertility.

Hormone Tests

Various blood tests may be performed to check your hormone level. In men, testosterone (T) and follicle-stimulating hormone (FSH) are the two hormones usually the culprits if infertility is suspected. A high or low level of either of these hormones may cause issues with the production of semen or the inability to have intercourse. In men, follicle stimulating hormone helps to control the production of sperm.

Other hormones, which are usually not tested but could be tested if everything else is normal, are prolactin, estradiol and luteinizing hormone (LH).

Scans

Ultrasound may be used to determine any structural problems or blockages on the inside of the reproductive tract.

Biopsies

A biopsy will be done if the results indicate a very low to no sperm count during the semen analysis. This will then be viewed by a Histopathologist to determine the cause.

Frequently Asked Questions


The good news is that you have already taken the first step - consulted with a reproductive specialist. Your doctor will help you identify the underlying causes and treat them as well as possible. They might suggest lifestyle modifications and/or prescribe medicine.

If all else fails and you are still unable to reproduce, we can put you in contact with specialists in assisted reproductive techniques, which may include intrauterine insemination (IUI) and in vitro fertilisation (IVF). If these strategies do not work, you might consider using a sperm donor.
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