Overview of Male Infertility
Infertility is the inability to conceive after at least one year of unprotected intercourse. Since most people are able to conceive within this time, physicians recommend that couples unable to do so be assessed for fertility problems.
In men, hormone disorders, illness, reproductive anatomy trauma and obstruction, and sexual dysfunction can temporarily or permanently affect sperm and prevent conception. Some disorders become more difficult to treat the longer they persist without treatment.
Sperm development (spermatogenesis) takes place in the ducts (seminiferous tubules) of the testes. Cell division produces mature sperm cells (spermatozoa) that contain one-half of a man’s genetic code. Each spermatogenesis cycle consists of six stages and takes about 16 days to complete. Approximately five cycles are needed to produce one mature sperm. Energy-generating organelles (mitochondria) inside each sperm power its tail (flagellum) so that it can swim to the female egg once inside the vagina. Sperm development is ultimately controlled by the endocrine (hormonal) system that comprises the hypothalamic-pituitary-gonadal axis.
Because sperm development takes over 2 months, illness that was present during the first cycle may affect mature sperm, regardless of a man’s health at the time of examination.
What Causes Male Infertility?
Conception is a lengthy process that requires a lot of unique events to occur in perfect order at exactly the right time. This leaves room for lots of potential problems along the way.
Problems with the Sperm
Typically, if a man is having fertility issues it can be linked back to how healthy his sperm are. Examples of abnormalities in sperm include:
- Sperm that is oddly shaped
- Sperm that is produced in small quantities
- Sperm that is unable to develop fully
- Slow sperm, or sperm that does not travel in the correct direction
- An inability to produce any sperm at all
There are several possible sources to abnormal or defective sperm. Some medications used to treat common illnesses like high blood pressure, depression, infections, arthritis, digestive diseases, or cancer can alter the sperm’s functionality.
Low hormone levels are another potential cause of male infertility since a lack of crucial male hormones can lead to low sperm count or poor sperm growth.
There have also been cases wherein the antibodies in a man’s body mistakenly attack the sperm. It is not clear as to what causes the antibodies to perceive the sperm as a threat, but immunological infertility is typically seen in those recovering from a surgery, injury, or type of infection.
What If the Sperm are Healthy?
Even with great sperm, some men can still experience problems in conceiving a child such as having a blockage within the reproductive tract that may have been caused by a congenital or acquired defect.
Swollen veins in the scrotum called varicoceles are also thought to worsen a man’s fertility functions. These varicoceles supply the scrotum with excess blood, which overheats the scrotum and kills many of the sperm living inside.
Men who suffer from retrograde ejaculation are unable to get their sperm to the woman’s egg because instead of exiting through the urethra, the sperm is directed back into the man’s bladder. Retrograde ejaculation is caused by issues of the nervous system and is characterized by a “dry” ejaculation.
Incidence and Prevalence of Male Infertility
According to the National Institutes of Health, male infertility is involved in approximately 40 percent of the more than 2 million infertile married couples in the United States. One-half of these men experience irreversible infertility and cannot father children, and a small number of these cases are caused by a treatable medical condition.
Treatment for Male Infertility
In order to appropriately treat a case of male fertility, your doctor will first need to diagnose the source of the problem.
This process will typically begin by checking the patient’s sperm to see if it indeed healthy or not. If the exact cause is still unclear after this initial investigation then further tests will need to be conducted to determine what is preventing the sperm from reaching or properly fertilizing the partner’s egg.
Again, based on the particular source of the man’s fertility issues, recommended treatment will vary. Some male infertility cases will require surgery to treat, while others will not. In order to discover the best solution for yourself and your partner, you will both need to have a thorough discussion with your doctor.