Nowadays, about 1 in 7 couples may not be able to conceive and approximately one-third of the time, men are the cause of infertility.
Many factors can result in infertility. The only way to find the main reason behind male infertility is to see a doctor and take some tests. However, these tests can be very costly and, usually, insurance does not cover them. Moreover, in some cases, no test can determine the cause of infertility (idiopathic infertility). Therefore, in this article, we decided to examine all the causes of male infertility comprehensively to get a broader view of the issue. But first, let’s see how fertility occurs.
How does pregnancy happen?
Testicles produce sperm and then keep them in the epididymis that looks like a long coiled tube and is located on top of each testicle. On their way out, glands create semen which has the duty of nourishing the sperm. There are nearly 15 million sperm in every milliliter of semen.
For pregnancy to occur the sperm must travel through the vagina, cervix, uterus, and eventually into the fallopian tubes. Unlike what many people think, pregnancy happens in fallopian tubes; not inside the uterus. Every month women release an egg, about 14 days after their period starts, and it is sent into the fallopian tubes where the sperm are waiting. Pregnancy happens when one of the sperm cells penetrates (fertilizes) the egg.
What are the symptoms of male infertility?
No specific symptom can determine you are infertile. Nevertheless, some problems can lead to infertility such as hormone disorders or genetic inheritance disorders. For instance, if you are experiencing changes in your hair growth pattern or sexual function, they may be the symptoms of hormonal problems.
Other noticeable signs are as follows:
- Small volumes of semen or other problems with ejaculation.
- Clear or watery semen, which indicates a lower than usual sperm count.
- Low libido (sexual desire).
- Inability to achieve or keep an erection.
- Dry orgasm (retrograde ejaculation).
- Abnormal breast tissue development (gynecomastia).
- Any sign of hormonal problems.
- Prostate problems.
- Testicle lumps, swellings, or any sign of discomfort in that area.
- Testicles smaller than 3.5 centimeters (1.4 inches).
- Family history of infertility.
- Any sign of infection in the respiratory system.
- Losing the sense of smell.
Don’t forget that none of these symptoms can necessarily indicate infertility. Only a proficient doctor can assure what the real problem is.
When do I need to seek help?
You probably need to see a doctor if you have any of the above problems as well as not being able to conceive a child after trying for at least a year without using any kind of birth control.
On the other hand, if you or your partner are over 35, you should visit a doctor after 6 months of unprotected intercourse and no result.
What are the most common causes of male infertility?
Many things can cause or at least contribute to male infertility. As I mentioned earlier, one of the signs of male infertility is low sperm production. So what causes that? It is usually due to health problems or a result of previous medical treatments; such as:
- Varicocele (abnormal enlargement of veins within the scrotum)
- Epididymitis (epididymis swelling as a result of infection)
- Orchitis (inflammation of one or both testicles as a result of infection)
- Prostatitis (prostate gland becomes inflamed)
- A history of testicular or penile surgery (vasectomy reversal or hernia repair surgery)
- Any medicines, like anabolic steroids, that affects sperm production
- A history of chemotherapy
- Genetic problems
- Antibodies (sometimes antibodies fight and eliminate sperm)
- Cancer and tumor
- Low testosterone
- chromosomal abnormalities
- hypospadias (an abnormal condition in boys in which the urethral opening is not placed at the head of the penis)
- Celiac disease (a medical condition in which your immune system is sensitive to eating gluten)
Sometimes your body produces a normal volume of sperm but your semen does not contain enough sperm to fertilize. This can happen as a result of:
- Retrograde ejaculation
- Undescended testicles
- Premature ejaculation
- Lack of ductus deferens (a tube that transports sperm)
- blockage in the testicle
- Anti-sperm antibodies in semen
Other causes of male infertility
Sometimes environmental factors or unhealthy lifestyles can affect male fertility. For example, being exposed to the following environments may cause sperm dysfunction:
- Organic solvents
- Painting materials
- Heavy metal (lead, mercury, arsenic, cadmium, etc.)
- Saunas or hot tubs (Frequent exposure to high temperatures may overheat testicles and affect sperm production)
In addition, following these lifestyles may lead to fertility problems:
- Tobacco use
- Drug use (cocaine, marijuana, anabolic steroids, etc.)
- Drinking alcohol
- Being overweight
Can HIV cause male infertility?
HIV virus can impair the sperm and cause infertility. Usually, sperm parameters are normal in the second stage of HIV. However, as the disease advance from one stage to another, the quantity, shape, and function of the sperm will be adversely affected. Abnormal sperm morphology in HIV-positive men is a sign of impaired spermatogenesis and sperm production, leading to infertility.
HIV can also cause orchitis, hypogonadism, and leukocytospermia, all of which can affect the male reproductive system and eventually result in infertility.
What is retrograde ejaculation?
Retrograde ejaculation or dry orgasm happens when semen ends up in the bladder neck muscle as it fails to contract properly (this muscle is responsible for holding urine as well). In this condition, you can still have an orgasm but with little or no ejaculation.
According to andrology, retrograde ejaculation does not affect men’s health although it can cause male infertility. That is why all the treatments for retrograde ejaculation include restoring fertility.
Does smoking permanently damage fertility?
Smoking can reduce sperm quality and change male hormones. The toxins in cigarettes such as cadmium and lead have negative effects on fertility. Studies show that the amount of zinc in smokers’ semen is less than normal; zinc is necessary for sperm count and morphology.
However, it does not necessarily mean male infertility. There is no proven or clear evidence that how much smoking can affect male infertility. Although men who are prone to infertility may higher their chances by smoking.
Some findings indicate a significant increase in fertility rate after quitting smoking. Many cases did not need to use assisted reproductive technology after quitting because the sperm quality improved afterward.