urology Male Infertility

Infertility is inability to achieve pregnancy after attempting with unprotected sex for one years. As much as 15% of couples turn out to be infertile. Over half of these couples face this problem due to problem in male reproductive system.. Male infertility can be due to abnormal sperm function, low production of sperms or blockages in the delivery of sperms. The cause of this can be illnesses, chronic health problems, injuries, lifestyle choices among others. This can be stressful and frustrating. However, a number of treatment methods are available.

What are the symptoms of male infertility?

Obviously, the main symptom would be the inability to conceive a child. There might not be any other sign or symptom. There might be some underlying problems in some cases like a hormonal imbalance, a congenital disorders, sexual dysfunction. Most men with this problem do not notice the symptoms other than being unable to conceive a child, some signs and symptoms that may include:

  • swelling, pain or a lump in the testicle area
  • problems with sexual function like difficulty in ejaculation, low ejaculation volume or a difficulty in maintaining an erection or simply an erectile dysfunction.
  • Abnormal secondary sexual characters like decreased facial hair or abnormal growth of breast or small gemitalia.
  • recurrent infections of the respiratory tract

What are the different causes of male infertility?

The different causes include:

1.Medical causes:

  • Varicocele - This disorder is a swelling of the veins that drain the testicle. It is the most common surgically treatable cause of male infertility. Testicular viens that drains the testes carry blood away from testes. There are valves in these veins that prevent reversal of blood flow . But when these valves go defunct because of gravity blood seeps back in to testes and cause puddle of blood, stagnation. This is called varicocele. This is very common in professions where men spend lot of time in standing postures like police, post man, sales persons, guards, sportsmen. Varicocele with adversely affect both quantity and quality of sperms. Simple micro surgery is the treatment option for varicocle.
  • Issues with ejaculation - Retrograde ejaculation occurs when the semen enters the bladder instead of emerging out the tip of the penis. Spinal injuries, diabetes, surgery of the bladder, urethra or prostate or medications can be the cause of this. Often men with spinal cord injuries or certain diseases cannot ejaculate though they do produce sperms. However, the sperm can be retrieved for assisted reproductive techniques.
  • Infection - There are some forms of infection that can interfere with the sperm health or production, causing scarring, blocking the passage of sperms. this can be caused by sexually transmitted infections, like gonorrhea, complicated urethritis, or an infection of the epididymis or testicles like tuberculosis.
  • Undescended testicles - During fetal development, one or both of the testicles fail to descend into the sac from the abdomen, which results in a undescended testis. This can cause decrease in quality of sperms.
  • Tumours - Some non-malignant tumours and cancers can directly affect the male reproductive system by blocking the functions of the glands that release certain hormones. This can include the pituitary gland. There are also some unknown causes as well.

2. Environmental causes:

  • Exposure to heavy metals - Infertility can be caused by exposure to heavy metals like lead and others.
  • Overheating the testicles – Testes are kept outside the body so that the testicular temperature is 2 degree less than the body temperature. Elevated temperatures can affect the sperm production and function. Wearing tight pants, wearing undergarments even at night, long working hours in areas like kitchen, furnaces and foundry, frequent use of saunas or hot tubs can impair the sperm count.
  • Industrial chemicals - Exposure to chemicals like xylene, toluene, benzene, organic solvents, herbicides, pesticides and painting materials can account for low sperm counts.

3. Lifestyle causes:

  • Alcohol use - The testosterone levels can be lowered from drinking alcohol. It can also cause erectile dysfunction and decreased sperm production. The liver diseases caused cause problems with fertility.
  • Use of drugs - The anabolic steroids that are taken to stimulate the strength of muscles like body builders, can cause the testicles to shrink and cause a decreased sperm production. Chemotherapy drastically reduces the sperm production.
  • Emotional stress - Certain hormones that are required for sperm production can be interfered by elevating stress. Problems with infertility and severe or prolonged emotional stress can affect the sperm count.
  • Weight - Obesity can also be a contributing factor
  • Depression - Depression in men can cause sexual dysfunction.
  • Smoking- Tobacco and Ganja smoking directly interferes with infertility.

What are the risk factors of male infertility?

The various risk factors include:

  • being overweight
  • using certain drugs like steroids and hormones
  • excessive alcohol consumption.
  • smoking tobacco
  • being exposed to toxic substances
  • severe depression or stress
  • trauma to the testicles or to pelvis
  • chronic infections of the genitalia like tuberculosis
  • having certain medical conditions like chronic illnesses and tumors

How can male infertility be prevented?

Some causes of male infertility can be avoided by following these guidelines:

  • Eat healthy
  • Regular exercise like brisk walking
  • reducing stress in life
  • keep testes as cool as possible.
  • No to drug addiction
  • abstaining from smoking or alcohol
  • loose weight
  • avoiding exposure to heavy metals, pesticides or toxins
  • Avoid drugs like steroids and hormones

When should you be visiting a doctor?

The doctor should be consulted if you cannot conceive a after a year of regular and unprotected intercourse.

Male infertility can often be treated successfully, thus doctor should be approached without hesitation.

Authored By : Dr. Mahendra Jain

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