Historically, the problems related to infertility were often tied to women. However, studies have estimated that 1/3rd of all the causes of infertility are because of defects in the male partner. Another 1/3rd can be attributed to the females. And the rest are either due to a combination of both, or unexplained causes.
With respect to sperm quality and quantity, research has found that about 3 decades ago the sperm count of a normal Indian adult male used to be 60 million per ml. But today, it stands at around 20 million sperm per ml only. Every year, there is also a 2% reduction seen in the quality of sperm in the general population, which is leading to a surge in the number of infertility cases that are being reported.
Reasons for Infertility
The reasons for infertility can be many. While the overview of the mechanism of reproduction might seem simple, there are a number of smaller details that can play a big part in the smooth functioning of the system. Impairments in any of these smaller details can lead to an infertility diagnosis. To understand in depth the causes leading to male infertility, it is important to first understand the male reproductive system and the role it plays in conception.
The male reproductive system consists of :
- A pair of testicles (also known as testes) is present in sac-like structures called the scrotum below the penis.
- The testicles are the site of sperm production and growth, while the scrotum maintains the testes at a temperature lower than the normal body temperature. This environment is perfect for sperm development.
- Each testis is connected to a structure called the ejaculatory duct by a long tubular structure (called the vas deferens). If the tubes are blocked due to an injury or surgery, transport of sperm cannot take place leading to a lack of sperm in the ejaculations.
- The ejaculatory duct leads to a common opening for urine and semen, which opens out through an external structure called the penis.
- The sperm produced in the testes travels through this pathway and are ejected out as semen through the opening in the penis during copulation.
- Semen refers to the fluid that is ejaculated by sexual stimulation and contains sperm in it.
- Once expelled from the body, the sperm has to travel to the fallopian tubes successfully in order to fertilise the egg.
The sperm plays a major role in increasing or decreasing fertility.
For pregnancy to occur, the sperm has to be healthy, and structurally normal and should be present in adequate quantities in the semen. Once these conditions are met, the sperm should be able to travel through the female reproductive tract and fertilise the egg for natural conception to occur.
Some of the main causes of infertility in males include :
Conditions affecting Sperm Production.
The most basic requirement of the male reproductive system is to produce sperm. But certain conditions directly affect the quantity and quality of sperm formed by the testicles.
- Varicocele- It is a condition where the vein, specifically the pampiniform plexus vein in the scrotum swells up. Which messes with the flow of blood to and fro from the testes. This increases the temperature in the scrotum which affects the development of sperm in the testes. This leads to low sperm count, low motility and abnormal structure of the sperm.
- Infections- Some infections like mumps, gonorrhoea, or chlamydia cause inflammation of the testicles, which in turn affects the quality of sperm produced.
- Undescended Testicles- This condition is known as cryptorchidism. It happens when a testicle hasn’t moved from the abdomen to its correct position, which is the scrotum. In 10% of the cases, both testicles do not move to the correct location. This condition is linked with infertility problems such as low sperm count and reduced quality of sperm.
- Hormonal Imbalances- Hormones like testosterone basically control the production of sperm in the testicles. Hormonal imbalances like hypogonadism, which result in a reduction in the levels of testosterone, cause low sperm count.
- Chromosomal Factors- Chromosomal disorders which affect the number of chromosomes like Klinefelter’s Syndrome cause the production of very low quantity sperm or sometimes no sperm at all and hemochromatosis causes testicular dysfunction.
- Presence of Cancerous Tumours- Tumours affect the sperm quality and quantity even before being exposed to anti-cancer treatments. as the tumour can affect the hormone production in the testes. Furthermore, anti-cancer treatments such as chemotherapy or radiation therapy can have a sterilizing effect on the testicular cells that form the embryos.
- Immunological Infertility- In this case, the immune system produces antibodies (protein-based defence mechanisms produced by the body) that attack its own sperm and consider it as a foreign body. This can occur after an infection or surgery.
- Lifestyle factors- There is a link between lifestyle factors and sperm production. You can take several steps to improve your chances of producing the healthiest sperm possible. Eat a healthy diet and maintain a healthy weight with regular exercise. Cut out tobacco and limit alcohol because they can interfere with the sperm’s DNA and lead to the production of abnormal sperm.
Conditions affecting Sperm Movement within Male Reproductive System
- Retrograde ejaculation. – It is a condition where the sperm is ejected back into the bladder instead of out through the penis. Thus, the semen containing the sperm, even if present in normal amounts, does not reach the vagina. This can be caused due to the overuse of some medications or nervous dysfunctions.
- Structural abnormalities in the Male Reproductive Tract. – These include blockages in the sperm pathway which stop the sperm from travelling from the testes to the ejaculatory duct. A blockage in the tube could be formed by certain surgeries or repeated infections.
- Genetic Defects- Genetic disorders like cystic fibrosis cause a condition where no sperm is present in the ejaculation. The vas deferens or the tube carrying the sperm from the testes to the ejaculatory duct is absent in these cases.
- Erectile Dysfunction- This is a condition where the male is not able to keep his erection hard long enough to transfer the sperm from his reproductive tract to the woman’s reproductive tract during sex.
Conditions affecting Sperm Movement in the Female Reproductive System.
Once the semen is ejaculated within the uterus during copulation, the sperm needs to move to the fallopian tubes to fertilize the eggs. If the sperm contained in the semen is defective, low in quantity, or low in motility, it creates problems in fertilization.
Defective sperm do not grow completely and can be oddly shaped. They don’t move in the right pattern. This affects the ability of the sperm to move into the uterus. Sometimes, sperm are produced in very low numbers or they are not present in the ejaculation at all.
These conditions can be caused by a variety of factors. Apart from the ones mentioned above, lifestyle disorders like obesity and environmental factors also play an important role in causing infertility. Abnormal sperm play a major role in male infertility as it directly affects the sperm’s ability to survive the journey from the male reproductive tract to the fallopian tubes in the female reproductive tract and their ability to fertilise the egg.
Conclusion
Thus, the causes for infertility in males can be many and the reasons why they exist may also be complex. The sooner these defects are diagnosed and treated, the better it would be for the couple hoping for a pregnancy. Most of these issues can be normally remedied by medications, surgical procedures, or sperm harvesting methods like TESA or PESA, where the sperm extracted can then be used in ART procedures like IUI, IVF and ICSI to facilitate childbirth.
Consider Ferticare by scheduling a free consultation to know more about the prospects of getting pregnant. We provide support for surrogacy, donor sperm, egg IVF, IUI, and natural pregnancy. We offer individualized treatment that is appropriate for your requirements and circumstances.
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