Male infertility refers to the inability of a male (man) to give birth to a child. Abnormal semen flow or insufficient quantity and poor quality of semen is primarily the reason. Also, problems affecting sperm transport or motility could be reasons. Typically, a healthy sperm has a tail that assists it with swimming inside the female reproductive system. Poor motility sperms may not swim or swim feebly.  

Generally, blockages or obstructions in tubes (epididymis and vas deferens) may hinder sperm presence in the semen, the condition referred to as azoospermia. A lower sperm count is referred to as oligospermia. A man could be born with sperm-related issues. For instance, birth without vas deferens, the primary sperm pipeline. Otherwise, problems may arise later in life courtesy injury or illness. Cystic fibrosis is an example.

Causes

The causes for male infertility can be categorized as:

Sperm-Related/ Physical

  • Damaged sperm duct, or the sperm’s inability to move to the penis from the testicles.
  • Torsion or scrotum twisting.
  • Premature and retrograde ejaculation, erectile dysfunction, ejaculation failure, and infrequent sexual intercourse.

Hormonal

  • Brain’s inability to produce the gonadotropin hormone, which causes sperm production and testosterone synthesis.
  • Pituitary gland’s failure to make sufficient follicle stimulating hormone (FSH) and luteinizing hormone (LH) for stimulating sperm production.
  • Presence of other chemical compounds and hormones disrupting the sex-hormone balance.
  • Some other disorders include hyperprolactinemia, hypothyroidism, hypogonadotropic hypopituitarism, congenital adrenal hyperplasia, and panhypopituitarism.

Lifestyle- and Environment-Related

  • Significant smoking reduces both sperm cell motility and sperm count. Chronic drinking hurts fertility. For instance, a couple of alcoholic drinks per days can hurt sperm production. Moderate drinking, on the other hand, may cause infertility in men with an already low sperm count.
  • Anabolic steroids, usually taken for sports or bodybuilding, causes testicular atrophy.
  • Hardcore exercising results in high adrenal steroid hormone levels, causing testosterone deficiency.
  • Obesity increases abnormal sperm risks.
  • Tight-fitting underwear causes heat stress. Hot baths must be avoided too since they slow down sperm production.
  • Exposure to environmental toxins, including lead, pesticides, paint, mercury, benzene, radioactive substances, boron, etc.

Health Issues

  • Infections and diseases such as tuberculosis, mumps, gonorrhea, brucellosis, influenza, smallpox, typhoid, and syphilis could lead to testicular atrophy, or low sperm motility and count.
  • Nerve damage and spinal cord injury can cause ejaculation and erection issues.
  • Klinefelter’s syndrome resulting in peanut-sized testicles.
  • Medical history of venereal disease, varicocele and prostate inflammation.
  • Cancer chemotherapy treatment, celiac disease, and prior surgeries.
  • Anemia and malnutrition.

Detection Phase

The initial evaluation comprises a couple of semen analyses for determining sperm count, sperm shape (morphology), and motility (sperm movement). Since the ability of sperms to enter eggs vary, two sperm tests are performed to ensure accuracy. Other tests include:

  • General physical exam
  • Blood test to determine hormone levels
  • Testicular biopsy for checking the tube network inside the testicles to determine sperm presence.
  • Chlamydia test to unblock the epididymis tube.
  • Ultrasound test to capture reproductive organ images – for instance, the prostate gland.

Treatment

Treatments for male infertility generally comprise measures to address premature ejaculation, erectile dysfunction, presence of varicose vein within the scrotum, and various blockages preventing the sperm from carrying out its duties (ejaculatory duct blockage and retrograde ejaculation). Behavioral therapy could also be used to address sexual problems. Antibiotics may be used for curing infections hurting sperm count. A surgery may help remedy a problem wherein the semen has zero sperm.