MALE INFERTILITY

MALE INFERTILITY

Introduction

Approximately 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 - or for at least six months if the woman is age 35 or older. In about half of these cases, male infertility plays a role.

Male infertility is due to low sperm production, misshapen or immobile sperm, 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.

Causes

Male fertility is a complex process. To get your partner pregnant, you must be able to produce healthy sperm that can reach, penetrate and fertilize your partner's egg. For this to 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 20 million sperm per milliliter of semen.

•Sperm must be shaped correctly and able to move. If the movement (motility) or shape (morphology) of your sperm is abnormal, the sperm may not be able to reach or penetrate your partner's egg.

Medical causes:

Problems with male fertility can be caused by a number of health issues and medical treatments. Some of these include:

•Varicocele

•Infections

•Retrograde ejaculation

•Lack of ejaculation

•Antibodies that attack sperm

•Tumours

•Undescended testicles

•Hormone imbalance

•Chromosome defects

•Problems with sexual intercourse

•Celiac disease: A digestive disorder caused by sensitivity to gluten, celiac disease can cause male infertility. Fertility may improve after adopting a gluten-free diet.

•Certain medications: Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antibiotics, some ulcer medications and certain other medications can impair sperm production and decrease male fertility.

Risk Factors

A number of risk factors are linked to male infertility. They include:

•Being age 35 or older

•Smoking tobacco

•Abusing alcohol

•Using certain illegal drugs

•Being overweight

•Being underweight

•Having certain past or present infections

•Being exposed to toxins

•Overheating the testicles

•Having a prior vasectomy or vasectomy reversal

•Being born with a fertility disorder or having a blood relative with a fertility disorder

•Having certain medical conditions, including tumours and chronic illnesses

•Undergoing medical treatments, such as certain medications, surgery or radiation for cancer

•Bicycling for prolonged periods, especially on a hard seat or poorly adjusted bicycle