Infertility is a common concern that can affect both men and women. Male infertility is a condition in which a man is unable to father a child because of a problem with his reproductive system, meaning his partner does not conceive even after repeated attempts at unprotected intercourse. Understandably, this can take a toll on the emotional and mental well-being of both partners.
Key Takeaways
- Male infertility means a man is unable to father a child despite regular, unprotected intercourse.
- Common causes include sperm disorders, varicoceles, hormonal problems, and blockages in the reproductive tract.
- The number of cases is rising in India, but many causes are treatable.
- Treatment options range from medication and surgery to assisted reproductive techniques.
The number of male infertility cases is rising rapidly in India. Fortunately, several treatment options are available. The right treatment depends on the underlying cause, which the doctor will identify before recommending a plan.
What are the causes of male infertility?
Sperm disorders
Sperm disorders are the most common cause of male infertility. Some men are born with sperm problems, while others develop them as a result of unhealthy lifestyle choices such as recreational drug use, smoking, and drinking. In these cases, the sperm may be immature, abnormally shaped, or unable to move correctly.
Other factors, such as long-term illness, childhood infections, and chromosomal or hormonal problems, can also cause sperm disorders or reduce the number of sperm produced.
Varicoceles
Varicoceles are swollen veins in the scrotum. They are a common finding in infertile men and can harm sperm production by disrupting normal blood flow. In some cases, a varicocele allows blood to pool in the scrotum, making the testicles too warm to produce sperm, which lowers sperm numbers and can lead to infertility.
Retrograde ejaculation
In retrograde ejaculation, semen travels backwards into the bladder instead of out through the penis. This happens when the muscles and nerves at the neck of the bladder do not close properly during climax. The semen may contain normal sperm, but because it does not leave the penis, it cannot reach the vagina. Retrograde ejaculation can result from surgery, certain medications, or nervous-system disorders. Common signs include reduced ejaculate volume or cloudy urine after climax.
Immunologic infertility
Sometimes the body produces antibodies that attack its own sperm. These antibodies may form after injury, infection, or surgery, and they can prevent sperm from moving and functioning normally. Researchers are still studying exactly how these antibodies affect fertility, but they can make it harder for sperm to reach and fertilise the egg.
Obstruction
Obstruction occurs when the tubes that carry sperm become blocked. Repeated infections, swelling, surgery, or developmental defects can all cause a blockage. An obstruction can affect any part of the reproductive tract, preventing sperm from leaving the body during ejaculation.
Hormonal problems
Hormones produced by the pituitary gland signal the testicles to make sperm. Very low hormone levels can lead to poor sperm production and infertility. Hormonal problems in men may be linked to an unhealthy lifestyle, tobacco use, and a sedentary routine.
Chromosomal factors
Sperm carry half of the DNA passed on to the egg. Changes in the number or structure of chromosomes can therefore affect fertility.
Medications
While medication is rarely a direct cause of infertility, some drugs can affect the production, function, or delivery of sperm. Medicines used for conditions such as infections, high blood pressure, depression, arthritis, digestive disorders, and cancer can reduce sperm production.
What are the treatment options for male infertility?
At your appointment, the doctor will discuss your symptoms and ask about your sexual history, past medical history, and lifestyle. They may also perform a physical examination to check for varicoceles, blockages, and other problems affecting the urological tract.
Before recommending treatment, the doctor will usually arrange a semen analysis, which helps identify the cause of infertility. Further tests may include a hormone profile, a biopsy, and an ultrasound scan.
Depending on the findings, the doctor may recommend the following options.
Medication
If your infertility is caused by hormonal problems, low ejaculate volume, retrograde ejaculation, or another condition affecting sperm development, the doctor may prescribe medication to treat it.
Surgery
Surgery may be recommended for varicoceles, blockages, or other physical defects that obstruct the passage of sperm.
Assisted reproductive techniques
This approach is used when the cause of infertility cannot be identified or treated by other means. Techniques such as intrauterine insemination (IUI) and in vitro fertilisation (IVF) are commonly used to help achieve a pregnancy.
Takeaway
Male infertility is a common condition with many possible causes, from biological factors to lifestyle habits. It is worth being watchful for the symptoms and seeing a doctor if you notice them. If you are unsure whether to seek help, our article on the reasons to visit an andrologist without delay may help you decide.
Every treatment plan starts with a proper assessment, so you only get the care your condition actually needs. If you have symptoms or a question about your health, book a consultation with Dr. Anish Gupta.