London: Up to 15 percent of couples are infertile. This means they aren’t able to conceive a child, even though they’ve had frequent, unprotected sexual intercourse for a year or longer. In over a third of these couples, male infertility plays a role.
Male infertility is due to low sperm production, abnormal sperm function, or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices, and other factors can play a role in causing male infertility.
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Symptoms: The main sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms. In some cases, however, an underlying problem such as an inherited disorder, a hormonal imbalance, dilated veins around the testicle, or a condition that blocks the passage of sperm causes signs and symptoms.
Although most men with male infertility do not notice symptoms other than the inability to conceive a child, signs, and symptoms associated with male infertility include:
- Problems with sexual function — for example, difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire, or difficulty maintaining an erection (erectile dysfunction)
- Pain, swelling, or a lump in the testicle area
- Recurrent respiratory infections
- Inability to smell
- Abnormal breast growth (gynecomastia)
- Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality
- A lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate)
Causes: Male fertility is a complex process. To get your partner pregnant, the following must occur:
You must produce healthy sperm. Initially, this involves the growth and formation of the male reproductive organs during puberty. At least one of your testicles must be functioning correctly, and your body must produce testosterone and other hormones to trigger and maintain sperm production.
Sperm have to be carried into the semen. Once sperm are produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis.
There needs to be enough sperm in the semen. If the number of sperm in your semen (sperm count) is low, it decreases the odds that one of your sperm will fertilize your partner’s egg. A low sperm count is fewer than 15 million sperm per milliliter of semen or fewer than 39 million per ejaculate.
Medical causes: Problems with male fertility can be caused by a number of health issues and medical treatments. Some of these include:
Varicocele. A varicocele is a swelling of the veins that drain the testicle. It’s the most common reversible cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it may be related to abnormal testicular temperature regulation. Varicoceles result in reduced quality of the sperm.
Infection. Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhea or HIV. Although some infections can result in permanent testicular damage, most often sperm can still be retrieved.
Ejaculation issues. Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out the tip of the penis. Various health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, medications, and surgery of the bladder, prostate, or urethra.
Tumors. Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. In some cases, surgery, radiation, or chemotherapy to treat tumors can affect male fertility.
Undescended testicles. In some males, during fetal development one or both testicles fail to descend from the abdomen into the sac that normally contains the testicles (scrotum). Decreased fertility is more likely in men who have had this condition.
Hormone imbalances. Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid, and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes.
Blockage can occur at any level, including within the testicle, in the tubes that drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts, or in the urethra. mayoclinic.org