Behind the Diagnosis: Exploring the Causes of Male Infertility
Male infertility is often considered taboo because of traditional standards and expectations of men. But it’s a real issue. Around 13 out of 100 couples are unable to get pregnant even with regular unprotected sex, and in more than one-third of cases, the issue is with the man—usually due to problems with sperm delivery and sperm production. Thankfully, modern science and doctors are now able to address the causes of male infertility more effectively than before.
If you and your partner have consulted a doctor and you found out that your sperm has problems, it’s best to approach a specialist to talk about and understand your condition and find the best treatment. The earlier you address infertility, the sooner you can improve your condition and increase your chances of helping your partner conceive.
What are the causes of male infertility, and what can you do about them? This blog has all the answers to help you make informed choices with your partner and physician.
How sperm works
To understand the causes of male infertility, it’s important to know how sperm is produced and delivered.
Under normal conditions, a man’s body makes sperm, which is delivered into the woman’s body when he ejaculates during sex. The male reproductive system creates, keeps, and transports sperm while hormones control these processes. The testicles make both the sperm and testosterone, the male sex hormone, and these are in the scrotum, the sac of skin beneath the penis. When sperm exits the testicles, they should be in the epididymis or the tube behind each testicle.
Before ejaculation, sperm enters the vas deferens, another set of tubes leading from the epididymis to behind the bladder in the pelvis. Each tube joins the seminal vesicle with the ejaculatory duct, so sperm mixes with fluid from the seminal vesicles and prostate during ejaculation, creating semen. Then, semen goes through the urethra to exit the penis.
The causes of male infertility depend on your body’s ability to make and deliver normal sperm. However, it can also depend on the health of your sperm.
When sperm is in your female partner’s vagina, it goes through her cervix, then to her uterus and fallopian tubes, where it meets the egg for fertilisation. However, this only happens under appropriate environmental conditions, hormone levels, and genes.
Reasons for male infertility
Making healthy, mature, and potent sperm can depend on many factors. Some involve issues that prevent cells from becoming sperm or keep them from reaching the egg. Even the scrotum’s temperature can make a difference in a man’s fertility.
The most common causes of male infertility are:
·
Hormonal
imbalance: Usually attributed to an
imbalance in the pituitary, thyroid, and adrenal glands and the hypothalamus.
·
Infections: Inflamed testicles or the epididymis can result in blockages
that prevent sperm production and delivery.
·
Physical
causes: Injuries can occur on the
urethra or bladder after surgery or an accident and cause a blockage in the
ejaculatory pathways. However, they can also be due to medication, spinal
conditions, or diabetes.
·
Sexual
issues: Some men have erectile
dysfunction, experience early ejaculation, painful intercourse, or cannot
ejaculate at all.
·
Varicocele: This is a reversible condition where veins swell and drain the
testicle, resulting in poor sperm quantity and quality.
·
Anti-sperm
antibodies: Sometimes, the body
makes antibodies that identify sperm as foreign substances, so they attack and
eliminate them.
·
Genetics: Single gene mutations and chromosomal abnormalities, cystic
fibrosis, Klinefelter’s syndrome, and Kalman’s syndrome are among the
genetic causes of male infertility.
·
Retrograde
ejaculation: This occurs when the
semen goes to the bladder instead of exiting through the urethra and penis
during orgasm, resulting in minimal to no semen.
·
Surgeries or
medication: Medications for
arthritis and cancer, long-term anabolic drugs, and medicines for ulcers may
impair sperm production and lead to male infertility.
·
Lifestyle
factors: Obesity, smoking, alcohol
consumption, repeated use of cannabinoids, cocaine, and other drugs can damage
sperm DNA and negatively impact sperm quality.
· Environmental factors: Men exposed to hazardous chemicals, silicones, adhesives, insecticides, radiation, and other substances in the workplace could be at risk of male infertility. Likewise, those required to sit over prolonged periods (e.g. driving) and exposed to high temperatures (e.g. bakeries) can have problems with sperm production.
Apart from these major causes of male infertility, other medical conditions could be culprits, such as azoospermia. This means the semen doesn’t have any sperm, and it affects around 1% of men. Additionally, it’s evident in up to 20% of male infertility cases.
How azoospermia happens
A lack of sperm during ejaculation can be due to a blockage in the male genital system, even when the system normally generates sperm. This phenomenon is called obstructive azoospermia. However, non-obstructive azoospermia can also occur, meaning sperm production is completely poor.
Azoospermia is often identified as among the causes of male infertility during an evaluation. A test involves two semen analyses at separate instances when the specimen shows no sperm after centrifugation under the microscope. In addition, hormonal tests like Prolactin, Total Testosterone, LH, FHS, Karyotype, scrotum ultrasound, and semen test for fructose levels can help doctors diagnose the condition properly.
Here is a more in-depth look at azoospermia and why it’s one of the causes of male infertility:
·
Obstructive
azoospermia
This type means something is preventing the sperm from leaving the penis, even
when the testes normally make them. It can be due to a congenital blockage or
absence of the vas deferens, a previous vasectomy, epididymal blockage, or
other acquired obstructions, like scarring and infections from previous traumas
or surgeries.
·
Non-obstructive
azoospermia
This condition happens when the testes have sperm production issues. Even with
regular sperm transport pathways, sperm generation becomes absent or severely
impaired due to Sertoli cell-only syndrome, testicular failure,
hypogonadotropic hypogonadism, or genetic abnormalities.
There’s hope in overcoming male infertility.
Let seasoned fertility doctors like Dr Kaberi Banerjee help address the causes of male infertility and provide the right treatment in India. Book an appointment at Advance Fertility & Gyne Centre online or call +91-9871250235.
Source: https://www.advancefertility.in/behind-the-diagnosis-exploring-the-causes-of-male-infertility/
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