It is estimated that half of infertility cases worldwide are due to male infertility. For women, the quantity of eggs in their ovaries is determined at birth and will naturally decline as they age. For men, their testicles are capable of producing millions of new sperm every day, but this process depends on making and delivering normal sperm. Male infertility can occur if the testicles fail to produce healthy and motile sperm.
The main causes of male infertility are:
- Sperm disorders
Typically caused by chromosomal abnormalities which leads to low sperm count, poor sperm motility and abnormal sperm.
- Retrograde ejaculation
Also called a ‘dry orgasm’, it refers to a situation where semen is released into the bladder during orgasm, thus resulting in little to no semen being ejaculated.
- Immunologic infertility
Occurs when the immune system targets the sperm, resulting in a decline of sperm production and also impaired sperm motility.
- Obstruction of sperm passages
Obstructions may occur in the epididymis (the tubes that connect to the testicles), vas deferens (the tube connected to the epididymis) or the ejaculatory duct (the tubes that allow the sperm to exit).
This condition refers to enlarged veins in the scrotum, and it can cause low sperm count due to poor blood flow to the testicles.
- Hormonal issues
Certain hormones such as follicle stimulating hormones, luteinising hormone, and testosterone can affect sperm production and motility.
- Certain medications
Testosterone replacement therapy, long-term use of anabolic steroids, chemotherapy, and even some ulcer and arthritis medication have been known to lead to male infertility.
Other possible factors also include stress, obesity, erectile dysfunction (ED), and decreased libido. Environmental factors can also contribute to male infertility, e.g. exposure to excessive heat due occupational hazards (such as welders or firefighters), lifestyle habits (such as excessive use of sauna/hot tub), and even frequently wearing tight clothing.
Dealing with male infertility
In order to cope with it, take the initiative to get a proper diagnosis. This will involve consulting a doctor who will do the necessary physical examination. You will also need to provide a semen sample for analysis, as this will reveal crucial information such as the sperm volume, count, concentration, movement and structure. Blood samples may be taken to provide further information on your hormone levels as well. You may also be required to undergo further tests that involve procedures such as ultrasound or biopsy.
The treatment will be dependent upon the results of these tests, and many problems can be managed with changes to your lifestyle, medication and/or surgery. If this still fails to result in natural conception, you may then opt to try assisted reproductive techniques such as Intrauterine Insemination (IUI), In Vitro Fertilisation (IVF) and/or ICSI (Intracytoplasmic Sperm Injection). However, if there is no viable sperm at all, then your only other option would be to consider the use of donor sperm.
It’s important to note that male infertility is not always permanent or untreatable. The crux of the problem lies in acceptance of the fact that the male partner is the cause (or contributing factor) of fertility issues. Remember, having a baby requires effort from both partners, thus it is crucial for both to take equal responsibility not just for bringing up a child, but also for conceiving one.