Overview:

Approximately 1 in 7 couples face infertility, defined as the inability to conceive after a year or more of regular, unprotected intercourse. In about half of these cases, male infertility is a contributing factor.

Male infertility can arise from issues such as low sperm production, irregular sperm function, or blockages that hinder sperm delivery. Factors like illnesses, injuries, chronic health conditions, lifestyle choices, and other elements may also play a role.

While dealing with infertility can be challenging and stressful, there are various treatments available to address male infertility.

Symptoms:

The primary indication of male infertility is the difficulty in conceiving a child, and there may be no other apparent signs or symptoms.

However, some underlying issues that cause male infertility can present with additional signs. These may include:

• Sexual function problems, such as difficulty with ejaculation, a reduced volume of ejaculate, decreased sexual desire, or erectile dysfunction.
• Pain, swelling, or lumps in the testicle area.
• Frequent respiratory infections.
• Loss of the sense of smell.
• Abnormal breast growth (gynecomastia).
• Decreased facial or body hair, or other signs of hormonal or chromosomal abnormalities.
• A lower-than-normal sperm count, defined as fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate.

Causes:

Male fertility involves several key processes to conceive a child, including:

• Healthy Sperm Production: During puberty, the male reproductive organs develop, and at least one testicle must function properly, producing sperm under the influence of testosterone and other hormones.
• Sperm Transport: Sperm must travel from the testicles through delicate tubes to mix with semen and be ejaculated.
• Adequate Sperm Count: A low sperm count (fewer than 15 million sperm per milliliter of semen or fewer than 39 million per ejaculate) reduces the likelihood of fertilizing an egg.
• Sperm Function and Motility: Sperm must be functional and capable of moving effectively to reach and penetrate the egg.

Medical Causes of Male Infertility:

• Varicocele: Swelling of veins draining the testicle, affecting sperm quantity and quality.
• Infections: Conditions like epididymitis or sexually transmitted infections can impact sperm production or block sperm passage.
• Ejaculation Issues: Retrograde ejaculation, where semen enters the bladder, can be caused by various health conditions.
• Antibodies Against Sperm: Immune system cells that mistakenly target sperm.
• Tumors: Cancers or tumors affecting reproductive organs or hormone-producing glands.
• Undescended Testicles: Testicles that fail to descend into the scrotum can impact fertility.
• Hormone Imbalances: Disorders affecting hormonal systems or low testosterone can impact fertility.
• Sperm Transport Tubule Defects: Blockages or abnormalities in tubes that transport sperm, often linked to conditions like cystic fibrosis.
• Chromosome Defects: Genetic conditions such as Klinefelter’s syndrome or cystic fibrosis affecting reproductive development.
• Sexual Intercourse Issues: Problems such as erectile dysfunction, premature ejaculation, or anatomical abnormalities.
• Celiac Disease: A gluten sensitivity that may affect fertility, potentially improving with a gluten-free diet.
• Certain Medications: Drugs like testosterone replacements or cancer treatments can impair sperm production.
• Prior Surgeries: Procedures such as vasectomy or surgeries for cancer can affect sperm availability.

Environmental Causes:

• Industrial Chemicals: Exposure to pesticides, solvents, and other chemicals may lower sperm count.
• Heavy Metals: Lead and other metals can affect fertility.
• Radiation: Radiation exposure may reduce sperm production temporarily or permanently.
• Heat Exposure: Overheating, from sources like saunas or prolonged sitting with a laptop, may impair sperm production.

Health, Lifestyle, and Other Causes:

• Drug Use: Anabolic steroids, cocaine, and marijuana can impact sperm production.
• Alcohol: Excessive drinking can lower testosterone levels, cause erectile dysfunction, and reduce sperm production.
• Tobacco Smoking: Smoking may lower sperm count, and secondhand smoke can also affect fertility.
• Obesity: Excess weight can negatively impact sperm quality and hormone levels, affecting fertility.

Risk factors:

Several risk factors are associated with male infertility, including:

• Tobacco Smoking: Smoking can negatively impact sperm production and quality.
• Alcohol Use: Excessive drinking may lower testosterone levels and reduce sperm count.
• Illicit Drug Use: Certain drugs can impair sperm production and function.
• Obesity: Being overweight can affect hormone levels and sperm quality.
• Infections: Past or current infections can interfere with sperm production or transport.
• Exposure to Toxins: Contact with chemicals and pollutants may reduce sperm count.
• Testicular Overheating: Prolonged heat exposure can impair sperm production.
• Testicular Trauma: Injury to the testicles can affect fertility.

Treatment and prevention:

Can Male Infertility Be Treated?

Yes, male infertility can often be treated and sometimes reversed. The approach depends on the underlying cause and may include:

1. Lifestyle Changes

-Maintain a Healthy Weight: Achieve and keep a weight that’s right for you.

– Healthy Diet: Increase your intake of fruits and vegetables.

– Regular Exercise: Engage in physical activities like walking, jogging, cycling, or weightlifting.

– Stress Management: Find effective ways to manage stress.

– Avoid Harmful Substances: Quit smoking, limit alcohol, and avoid recreational drugs.

– Skip Lubricants: Refrain from using sexual lubricants during intercourse if advised.

2. Medications

– Hormone Therapy: Regulate imbalanced hormone levels to improve sperm quality.

– Medication Adjustments: Consider alternatives to certain drugs that may affect fertility, such as tricyclic antidepressants, calcium channel blockers, and anti-androgens.

3. Surgery

-Vasectomy Reversal: Reconnect the vas deferens if you previously had a vasectomy.

-Vasoepididymostomy: Remove blockages in the epididymis to allow sperm to enter the semen.

-Sperm Retrieval: Obtain sperm through a biopsy if needed.

-Varicocelectomy: Surgery to treat varicocele by removing varicose veins in the scrotum, which may improve sperm quality.

4. Assisted Reproductive Technology (ART)

-Intracytoplasmic Sperm Injection (ICSI): Inject a single sperm directly into an egg.

-In Vitro Fertilization (IVF): Fertilize eggs with sperm in a lab, then implant the embryo into the uterus.

Can Male Infertility Be Prevented?

You can lower your risk of male infertility by:

• Taking food supplements that improve sperm quality such as L-Carnitine and L-Arginine.
• Avoiding Harmful Substances: Don’t smoke, drink excessively, or use nonprescription drugs.
• Minimizing Chemical Exposure: Limit contact with hazardous chemicals.
• Staying Vaccinated: Get vaccines for viruses that might affect fertility.
• Preventing Overheating: Avoid prolonged heat exposure to the testicles.
• Maintaining a Healthy Diet and Weight: Avoid high-fat foods and keep a healthy weight.