Table of Contents

• What is Male Infertility?
• Causes of Male Infertility
• Symptoms of Male Infertility
• Diagnosis and Treatment of Male Infertility
• Frequently Asked Questions
• Conclusion
• References

What is Male Infertility?

Infertility is a condition affecting the reproductive system, which hinders the ability to conceive a child with a female.

If a male and a female engage in unprotected sexual intercourse for more than one year without achieving pregnancy, either one or both individuals may be experiencing infertility problems.

Causes of Male Infertility

The categories of male infertility include:

• Problems related to ejaculation or erection
• Problems within the complicated and narrow tubes of the reproductive tract
• Issues related to the production of sperm

Sperm production issues are the most prevalent among the three types of problems. Various factors can contribute to unusual sperm production, such as:

Varicocele:

Varicocele is a medical disorder characterised by the abnormal enlargement of the veins in the testicles, leading to excessive heat accumulation. This might have an impact on the morphology or quantity of sperm.

Genetic issues:

Inherited disorders, like Klinefelter's syndrome, result in aberrant development of the male reproductive organs due to the presence of two X chromosomes and one Y chromosome, instead of the usual one X and one Y chromosome.

Infections:

Certain infections can disrupt sperm production, impair sperm quality, or result in scarring that obstructs the flow of sperm.

These encompass conditions such as epididymitis (inflammation of the epididymis) or orchitis (inflammation of the testicles), as well as certain sexually transmitted illnesses like gonorrhea or HIV.

Defects of the tubules responsible for sperm transportation

Various distinct tubes transport sperm.

Obstructions can occur for different reasons, such as unintended harm during surgery, previous infections, physical injury, or aberrant growth, like in the case of cystic fibrosis or other hereditary disorders.

Obstruction can happen in various locations, such as within the testicle, in the tubes that carry fluid away from the testicle, in the epididymis, in the vas deferens, close to the ejaculatory ducts, or in the urethra.

Sperm transportation can be hindered by congenital bilateral absence of the vas deferens in men or additional conditions that totally obstruct the development of certain components of the male reproductive system.

Encounters with high temperatures or harmful substances:

Prolonged exposure to specific chemicals, pesticides, herbicides, organic solvents, and painting materials can potentially lead to reduced sperm counts.

Pharmaceutical substances and therapeutic agents:

Testosterone replacement therapy, prolonged anabolic steroid usage, cancer therapies (chemotherapy), certain ulcer drugs, specific arthritis drugs, and other pharmaceuticals can hinder sperm production and reduce male fertility.

Hormonal instability:

Testicular disorders and anomalies in other hormonal systems, including the pituitary, thyroid, adrenal, hypothalamus, and thyroid, might result in infertility.

Male hypogonadism, often known as low testosterone, can be attributed to various potential underlying factors, along with other hormonal issues.

Symptoms of Male Infertility

Infertility is the primary symptom. Describing the adverse psychological and emotional effects of infertility on a couple desiring parenthood is very challenging.

Oftentimes, the act of conceiving a child becomes the sole preoccupation of their existence. Both males and females wanting pregnancy commonly experience feelings of depression, loss, grief, inadequacy, and failure.

Individuals or couples who are experiencing any of these emotions may consider seeking assistance from healthcare professionals, such as a therapist or psychiatrist who specialise in addressing infertility concerns.

These providers can assist you in confronting the situation pragmatically and offering assistance throughout your therapy process.

Diagnosis and Treatment of Male Infertility

The diagnostic process commences with a comprehensive physical examination to assess your overall health condition and detect any physical issues that can affect your fertility.

Your healthcare professional may also conduct interviews with both you and your spouse regarding your sexual behaviours.

If the physical examination and medical history do not reveal any apparent factors contributing to your failure to conceive, the further course of action may involve conducting diagnostic tests to ascertain the underlying cause of infertility.

In most cases, a blood test to determine hormone levels or a sperm analysis to ascertain the underlying cause of infertility will be advised by your physician.

To examine the structure of your testicles and other scrotal fluids, an ultrasound or infection test may be prescribed. Very rarely, a testicular biopsy may be necessary to make a medical diagnosis.

The treatment of male infertility is dependent upon its underlying cause.

If the cause of your infertility is attributed to a particular area of your lifestyle, your doctor can assist you in modifying your behaviour.

If the drug prescribed for a medical problem is potentially causing your infertility, alternate treatments can be explored.

Hormonal therapy or other medications may be prescribed by your doctor to address your infertility.

If varicocele or blockages of the urogenital tract are identified as the underlying causes of your infertility, surgical interventions can be conducted to rectify these conditions.

FAQs

Is it easy to conceive?

No. Many factors influence the complexities of the conception process:

• The production of healthy sperm by the male and healthy eggs by the female.
• Unblocked fallopian tubes that allow the sperm to reach the egg.
• The sperm's ability to fertilise the egg when they meet.
• The potential of the fertilised egg (embryo) to be implanted inside the uterus of the female.
• Good embryo quality.

Lastly, the embryo must be healthy and the female's hormonal conditions should be sufficient for its development for the pregnancy to carry to maturity.

Infertility may result from a single deficiency in one of these components.

Which age group of males are most likely to experience infertility?

Certain males have a higher tendency for infertility compared to others. There is a higher probability if:

• You are either overweight or obese.
• You are 40 years old or above.
• You have been subjected to radiation.
• You have encountered environmental pollutants such as lead, calcium, pesticides, or mercury.
• You engage in the consumption of tobacco, marijuana, or alcohol.
• You are exposed to heat that elevates the temperature of your testicles. Individuals who engage in regular sauna or hot tub usage, as well as those who rely on a wheelchair, may encounter this phenomenon.

What are the treatment options for male infertility?

The advancement of modern technology and methodologies has led to an increase in the range of therapy alternatives available for male infertility. Possible therapies for infertility vary depending on the underlying cause and may include:

• Prescribed drugs.
• Utilising hormone therapy to augment sperm count.
• Modifications to one's way of living.
• Ensure that your body weight remains within a range that is considered healthy for your circumstances.
• Quit smoking, consumption of alcohol, smoking marijuana, and any recreational usage of drugs.

Is there a way to prevent male infertility? What measures can I take to minimise my chances of experiencing infertility?

If your infertility is influenced by lifestyle factors such as smoking and occupational exposure to specific chemicals, you may have the potential to reduce your risk.

Engage in a discussion with your medical professional regarding other risk factors and the appropriate actions you can take to address them.

What is the long-term outlook for males with infertility?

Having infertility issues does not necessarily imply that you will never have the chance to conceive children of your own. Various methods of therapy are available.

Working with both your partner and your doctor can enhance the likelihood of achieving conception.

At what point should I schedule an appointment with my healthcare provider?

If you and your spouse have been unsuccessful in conceiving after a year of attempting, it is advisable to consult your healthcare physician.

Consult a therapist or psychiatrist if you are experiencing difficulties with mental health issues.

Conclusion

Always remember that you are not alone in your struggle. With advancements in current science, 90% of males who are unable to conceive naturally now can father a child with their genetic material.

Treatments exist for the underlying causes of infertility, preventive measures can be taken to reduce infertility, and various surgical and procedural interventions can be attempted.

Make sure that you see a healthcare professional if you and your partner have been unsuccessful in achieving pregnancy after one year of engaging in sexual intercourse without using any form of contraception.

References

• Glazer et al., 2017. Male Infertility and Risk of Nonmalignant Chronic Diseases: A Systematic Review of the Epidemiological Evidence.
• Centers for Disease Control and Prevention. Advancing Men’s Reproductive Health in the United States: Current Status and Future Directions (https://www.cdc.gov/reproductivehealth/productspubs/pdfs/male-reproductive-health.pdf). 
• Yao DF, et al. Male infertility: Lifestyle factors and holistic, complementary, and alternative therapies. Asian Journal of Andrology. 2016; doi:10.4103/1008-682X.175779.
• Anawalt BD, et al. Approach to the male with infertility. https://www.uptodate.com/contents/search.
• Strasser MO, et al. Care delivery for male infertility — The present and future. Urology Clinics of North America. 2020; doi:10.1016/j.ucl.2019.12.006.
• Agarwal et al., 2015. A unique view on male infertility around the globe. Reproductive Biology and Endocrinology
• Mayo Clinic. (2022). 'Male Infertility'. Available at https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773
• Cleveland Clinic. (2021). 'Male Infertility'. Available at https://my.clevelandclinic.org/health/diseases/17201-male-infertility#diagnosis-and-tests