Male infertility refers to a males inability to reproduce and is a result of many factors, including lifestyle choices, chronic disease, illnesses, genetics and other conditions. Male infertility accounts for 40% – 50% of infertility in couples and affects approximately 7% of all men.
Fertility Factors
Male fertility is a complex process that begins in puberty. In order to produce healthy sperm, there are a number of factors that must be functional for fertility. These include:
• Men must have at least one functional testicle and be able to produce testosterone to trigger the production of semen.
• The sperm must also be free to be carried into the semen, which means the health of the delicate tubes for easy transport.
• There must be enough sperm within the semen to make it effective. If sperm count is low it means that there is a lower chance of a females eggs being fertilised. A low count is considered anything below 39 million sperm per ejaculation or 15 million sperm per millimetre of semen.
• The sperm must also be healthy and functional enough to move to reach the egg.
Causes
There are many different causes of male infertility that affect the aforementioned factors. Causes can include lifestyle choices, chronic disease, illnesses, genetics and other conditions. There are two main types of causes of infertility, pre testicular causes, which are factors that cause poor testicular and hormonal health, and post-testicular causes which affect the male genitalia after the production of seamen.
Here are some common pre testicular causes:
• Varicoceles are a condition that causes the veins of the testicles to swell and is one of the most common reversible causes of infertility.
• Lifestyle factors such as obesity, consumption of drugs, alcohol and smoking can all contribute to a lower sperm count.
• Medication such as chemotherapy and various types of steroids can affect sperm mobility.
• DNA damage is a large factor that contributes to the health of sperm and is an issue as men get older. The damage manifests in sperm cells by DNA fragmentation and sensitivity to heat and acid.
• Epigenetic factors can cause problem sperm such as DNA methylation.
Post-Testicular causes include:
• Obstruction of the vas deferens
• Infections
• Retrograde ejaculation due to injury
• Ejaculatory duct obstruction
• Impotence
Symptoms
The main symptom of male infertility is the inability to conceive a child and there may not be any other symptoms that indicate sexual health problems. Still, some problems will show symptoms such as:
• Issues with sexual function such as impotence (difficulty maintaining an erection) or small amounts of semen ejaculated.
• Pain in the testicles or prostate or surrounding area.
• Decreased facial hair, body hair or abnormal breast growth.
• Persistent urinary tract infections.
Diagnosis and Treatment
If you haven’t been able to conceive a child within a year of unprotected sex, it’s probably time to see a urologist who can diagnose the condition. The most common types of tests performed are physical examinations and sperm tests, however, blood tests may also need to be performed.
As there are many factors that contribute to male infertility, treatments vary according to the underlying condition. Many pre-testicular conditions can be treated with an improvement of lifestyle factors, however, if you are in doubt and you think there may be a more serious underlying problem, it’s a good idea to get in contact your urology specialist.
Dr Arianayagam is an expert in the field of urology and is widely considered one of the top urological oncologists in Australia.
If you have any questions about male fertility or would like to book an appointment, please feel free to contact or call Dr Arianayagam’s office on 1300 307 990 and his staff will be able to assist.
