What Are The Causes Of Male Infertility?

Before discussing about male infertility, it is important to understand how male fertility works. To make female partner pregnant, a male has to have the following qualities:

  • Male partner must be able to produce normal healthy sperms. For production of normal and healthy sperm a male has to have normal puberty, functional testicles, normal level of testosterone and other hormones.
  • Healthy sperms need to be transported, mixed with semen and delivered through penis by ejaculation.
  • There should be adequate number of healthy sperms in semen (not less than 15 million per ml or not less than 39 million per ejaculate). Low sperm count reduces the chance of fertilization of ovum.
  • The sperms must be functional, healthy and able to move normally (able to swim). Inability of sperms to move/swim may make it not able to reach and penetrate partner’s ovum.

Medical causes of male infertility include:

  • Vericocele: this is swelling of veins that drain the testicles and it is the most common cause of male infertility. How vericocele cause male infertility is not clear, but may be due to abnormal temperature regulation of testicles, which lead to production of low quality sperms. If vericocele is treated adequately, sperm quality also improves and also improvement in infertility.
  • Infection: infection of testicles (orchitis) or epididymis (epididymitis) may lead to male infertility. Sexually transmitted diseases such as HIV and gonorrhea may also cause male infertility.
  • Undescended testicles: in some infants testicles fail to reach the scrotal sac at birth which is an important cause of male infertility.
  • Antibodies against sperms: anti-sperm antibodies if present lead to male infertility.
  • Ejaculation problems: there are several ejaculation problems such as retrograde ejaculation (when semen enters urinary bladder at male orgasm instead of ejaculating out through penis), or inability to ejaculate. These conditions may be due to various medical conditions such as diabetes, spinal injury, surgery (to urethra, bladder, prostate etc.), certain medications etc.
  • Tumors: cancer or non cancerous tumors that affect male reproductive system may lead to male infertility. Radiation therapy (especially in vicinity of male genital region) and cancer chemotherapy can also cause male infertility.
  • Hormonal problems: hormonal problems due to problem in hypothalamus, pituitary, thyroid and adrenal glands may lead to male infertility.
  • Chromosomal problems such as Klinefelter’s syndrome (in which a male is born with two X chromosomes and one Y chromosome instead of one X and one Y) and other chromosomal problems (such as cystic fibrosis, Kallmann’s syndrome, Kartagener’s syndrome etc.) may lead to male infertility.
  • Problem in tubular transport system of sperms. There are several tubular system involved in transport of sperms and defect in any tubular system can lead to male infertility.
  • Certain medicines: cancer chemotherapy, radiation therapy, testosterone replacement therapy, long term anabolic steroid therapy, certain anti fungal medications and some other medications may cause male infertility.
  • Sexual problems such as premature ejaculation, erectile dysfunction, painful intercourse and anatomical problem such s hypospasdias etc. may cause male infertility.
  • Prior surgery such as vasectomy, prostate surgery, and inguinal hernia repair, testicular or scrotal surgeries may cause male infertility.
  • Gluten sensitivity as seen in celiac disease may cause male infertility.

Environmental causes of male infertility:

There are various environmental factors that may lead to male infertility such as exposure to industrial chemicals (benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials, lead etc.), exposure to heavy metals, radiation or X-ray exposure, over-heating of testicles (when you frequently use sauna bath, hot tubs etc.).

Other causes of male infertility:

  • Smoking: smokers have low sperm count and also low quality sperms which may cause male infertility.
  • Alcohol abuse: excess alcohol intake lead to low sperm production, erectile dysfunction, lower testosterone level. Liver disease associated with alcohol abuse may also contribute to male infertility.
  • Drug addiction
  • Obesity: obesity is associated with infertility.
  • Stress: emotional stress lead to hormonal imbalance which may cause male infertility.



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