Common Reasons Male Infertility

[Kousalya bala]

For the 1 in 8 couples experiencing difficulty getting pregnant, male factor issues are involved in about half the cases.¹
There are many reasons why a man may have fertility problems. Fortunately, once diagnosed, some of these causes may be treatable.
Sperm disorders and Male Infertility

A major cause of male infertility is a sperm disorder. Of the millions of sperm normally deposited into the vagina, only a few hundred will get close to the egg and have a chance to fertilize it. Many factors play a role in determining whether or not the sperm will succeed:

• Sperm count (total number of sperm in a sample)²
• Sperm concentration (number of sperm per milliliter of semen)²
• Volume of semen the man produces²
• Sperm motility (number of sperm with the ability to move)²
• Forward progression (quality of movement)²
• Sperm shape²

A deficiency in any of these factors may cause male infertility. Although sperm count is important, sperm motility and forward progression appear to be even more crucial in determining the likelihood of whether or not the sperm will succeed in fertilizing the egg. Despite a low sperm count, many men with high-quality sperm may still be fertile.
As a result of these many male infertility factors, it is important to perform semen analysis early on in the attempt to determine the reasons for infertility.³ Two to three analyses should be performed over a period of two to six months since sperm quality can change over time.¹ These tests will help give doctors a broader overview of any infertility issues related to the man's sperm.
What causes male infertility sperm disorders? A variety of issues including:

• Age. Generally, a man's fertility starts declining at around the age of 35 as the quality of a man's sperm diminishes. In addition, sperm motility can also decline with age.⁴
• Immune disorders. Problems with the immune system can cause a man's body to treat sperm as if it were a foreign matter. As a result, the immune system may produce antibodies to fight and destroy the sperm.⁵
• Cancer treatments. Depending upon the location of the treatment and the drug and dosage used, chemotherapy and radiation may contribute to male infertility. If you're undergoing treatment for cancer, you can find fertility information and support at Fertile Hope.
• Sexually transmitted diseases (STDs). STDs may damage the parts of the body that transport sperm through the reproductive tract.
• Other factors. Lifestyle and environmental factors may lead to issues with a man's sperm.

Anatomical issues and Male Infertility

A variety of possible anatomical problems can influence fertility:

• Scrotal varicocele. Varicocele is one of the most commonly identifiable causes of male infertility. Varicocele is a varicose vein around a testicle that may hinder sperm production, movement and shape by raising the testicle's temperature.⁶
  Scrotal varicoceles are found in about 15% of males and in approximately 40% of infertile men, most often on the left side or simultaneously on both sides.³
• Retrograde ejaculation. Retrograde ejaculation involves the ejaculate flowing backward into the bladder instead of leaving the penis.⁷
• Undescended testis. An undescended testicle is one that has failed to complete its passage from within the abdomen to reach its normal position in the scrotum. This condition is present in about 3% of newborns, with fewer than 1% needing treatment. Testicles that don't descend into the scrotum are not likely to function normally. Because they may not make sperm, they can cause fertility difficulties.⁷
• Erectile dysfunction. Erectile dysfunction is the inability to get or maintain an erection. An erection is essential for ejaculation.

When should you see a healthcare provider about Male Infertility?

You should see a healthcare provider any time you have concerns about your fertility. Don't wait! You should visit a healthcare provider if any of the following risk factors apply to you:

• History of sexually transmitted disease
• History of pelvic/genital infection
• Previous abdominal surgery
• Reversal of surgical sterilization
• Chronic medical condition (e.g., diabetes and high blood pressure)
• History of chemotherapy or radiation therapy
• Mumps after puberty
• Previous urologic surgery
• Prostate infection
• Family history of cystic fibrosis or other genetic disorders

[nlakshmi]

About 30 percent of cases are due to problems in the man, 30 percent to problems in the woman, and the rest to unexplained causes or multiple factors involving both partners.

If you've had regular, unprotected sex for more than a year (or six months if you're over 35) without conceiving, see your doctor. Nearly 90 percent of couples with infertility problems can be successfully treated.

Read on to learn about the common causes of infertility, treatments, and how many couples become pregnant with treatment. Keep in mind that success rates may vary, since one couple can have multiple problems.

Blockages

A small percentage of men have a blockage in their ejaculatory duct that prevents sperm from getting into their ejaculate fluid. If your vas deferens or epididymis tubes are blocked or damaged, they can prevent your sperm from getting to your partner's egg. Infection, injury, congenital defects, or a vasectomy could cause this blockage.

• Possible symptoms: none
• Possible solutions: surgery to repair an obstruction or reverse the vasectomy
• Success rates: Depending on the problem and the type of surgery used to treat it, about 50 to 90 percent of men have more sperm in their semen after surgery. About 20 to 65 percent of couples can conceive either through intercourse or with in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

Varicocele

Varicocele (enlarged veins, similar to varicose veins, in the scrotum) raise the temperature in the testes, which may affect sperm production.

• Possible symptoms: None. (The problem can be detected through a physical exam.)
• Possible solutions: surgery to repair the varicocele
• Success rates: Up to 43 percent of men impregnate their partner within a year of surgery, and up to 69 percent do so within two years.

Irregular sperm

If you have little to no sperm, poor sperm motility (its ability to move), or abnormally shaped sperm, your sperm may not be able to fertilize your partner's eggs on its own.

• Possible symptoms: none
• Possible solutions: fertility drugs; artificial insemination with donor sperm or with your own if your count, shape, and motility are not too abnormal; or intracytoplasm​ic sperm injection (ICSI)
• Success rates: When fertility drugs to increase egg production are combined with artificial insemination, the success rate is between 8 and 17 percent per cycle. The success rate is about 30 percent per cycle with ICSI.

Source:Baby Center

[nlakshmi]

Sperm allergy
Your body can develop antibodies that kill your own sperm, most commonly after a vasectomy, testicular torsion (where the testicle twists inside the scrotum), infection, or trauma.

Possible symptoms: none
Possible solutions: Artificial insemination, assisted reproductive technologies (ART), or intracytoplasmic sperm injection (ICSI).(Steroid drugs such as prednisone are sometimes used to suppress sperm antibodies, but many doctors don't recommend them because of side effects.)
Success rates: When fertility drugs to increase egg production are combined with artificial insemination, the success rate is between 8 and 17 percent per cycle. The success rate is about 30 percent per cycle with ICSI

Unexplained fertility problems
Your doctor may diagnose you with an "unexplained fertility problem" if he can't pinpoint the cause of your trouble conceiving. Some experts think environmental toxins may be contributing factors, but no direct links between fertility and these possible problems have been confirmed.
Possible symptoms: none
Possible solutions: fertility drugs combined with artificial insemination or assisted reproductive technologies (ART) procedures such as in vitro fertilization (IVF)
Success rates: When fertility drugs to increase egg production are combined with artificial insemination, the success rate is between 8 and 17 percent per cycle. About 20 to 40 percent of cycles result in a pregnancy with IVF. After three years of treatment, the chance that a couple will conceive decreases by about 20 to 25 percent each year.

Combination fertility problems
A couple is said to have "combination" fertility problems when both the man and the woman have a fertility problem.
Possible symptoms: Symptoms vary, depending on causes.
Possible solutions: Treatments vary, depending on causes.
Success rates: Rates vary, depending on causes.

Source: babycenter