Male Infertility: When to See a Doctor

Nearly one in seven couples are infertile, meaning they cannot conceive a child, even if they have had frequent unprotected sex for a year or more. In about half of these couples, male infertility plays at least a partial role.

Male infertility is associated with low sperm production, abnormal sperm function, or obstructions preventing sperm from being released. Illness, injury, chronic health problems, lifestyle and other factors can contribute to male infertility.

Not being able to conceive can be stressful and frustrating, but there are several treatments for male infertility.

Symptoms

The main symptom of male infertility is the inability to father a child. There are probably no other obvious signs or symptoms.

However, in some cases, underlying problems such as a hereditary disorder, hormonal imbalance, dilated veins around the testicle, or another condition that prevents sperm from being released can cause signs and symptoms. Signs and symptoms you may notice include:

Problems of sexual function. For example, difficulty ejaculating or a small amount of ejaculate, decreased sex drive, or difficulty maintaining an erection (erectile dysfunction).

Pain, inflammation, or swelling in the testicles

Recurrent respiratory infections

inability to smell

Abnormal breast growth (gynecomastia)

Sparse facial or body hair or other signs of a chromosomal or hormonal abnormality

Below normal sperm count (less than 15 million sperm per milliliter of semen or total sperm count less than 39 million per ejaculate)

When should you see a doctor?

See your doctor if you are unable to conceive after a year of regular unprotected sex or before if you have any of the following symptoms:

Problems with erection or ejaculation, decreased libido, or other problems with sexual function.

Pain, discomfort, swelling, or swelling in the testicular area

History of testicular, prostate, or sexual problems

Surgery of the groin, testicles, penis, or scrotum

Couple over 35

Causes

Male fertility is a complex process. For your partner to become pregnant, the following must happen:

You must produce healthy sperm. Initially, it is associated with the growth and formation of the male reproductive organs during puberty. At least one of the testicles must be functioning properly, and the body must produce testosterone and other hormones to start and maintain sperm production.

Sperm must be carried in semen. Once sperm is produced in the testicles, thin tubes carry it until it mixes with sperm and ejaculates through the penis.

There must be a sufficient number of spermatozoa in the semen. If the sperm count (sperm count) in the semen is low, the chances that the sperm will fertilize your partner’s egg are reduced. A low sperm count is less than 15 million sperm per milliliter of semen or less than 39 million per ejaculate.

The sperm must be functional and able to move. If the movement (motility) or function of the sperm is abnormal, it may not reach or penetrate your partner’s egg.

medical reasons

Male fertility problems can be caused by a variety of health issues and treatments:

Varicocele. This is swelling of the veins that drain the testicle. It is the most common reversible cause of male infertility. Although the exact reason why a varicocele causes infertility is not known, it may be due to impaired blood flow. Varicocele reduces the quantity and quality of sperm.

Infection. Some infections can interfere with the production or health of sperm or cause scarring that prevents sperm from passing. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections such as gonorrhea or HIV. While some infections can cause permanent damage to the testicles, it is most common for sperm to be restored.

Problems with ejaculation. Retrograde ejaculation occurs when semen enters the bladder during orgasm rather than exiting the tip of the penis. Various health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, medication, bladder, prostate, or urethral surgery.

Antibodies that attack sperm. Anti-sperm antibodies are immune system cells that misidentify sperm as harmful invaders and attempt to eliminate them.

Tumors. Cancer and non-cancerous tumors can directly affect the male reproductive organs through reproductive hormone-secreting glands, such as the pituitary gland, or for unknown reasons. In some cases, surgery, radiation, or chemotherapy to treat tumors can affect male fertility.

Undescended testicles. In some men, one or both testicles fail to descend from the abdomen into the sac that normally contains the testicles (scrotum) during fetal development. Decreased fertility is more likely in men who have had the condition.

Hormonal imbalance. Infertility can be caused by testicular disease or abnormalities affecting hormonal systems such as the hypothalamus, pituitary, adrenals, and thyroid. Low testosterone levels (male hypogonadism) and other hormonal problems have many underlying causes.

Defects in tubules that carry sperm. Sperm are carried by several different ducts. They can become blocked for a variety of reasons, including unintentional injury during surgery, previous infections, trauma, or abnormal development such as cystic fibrosis or similar hereditary conditions.

Obstruction can occur at any level: inside the testicle, in the ducts that drain it, in the epididymis, in the vas deferens, near the ejaculatory ducts, or in the urethra.

Chromosomal defects. Hereditary diseases such as Klinefelter syndrome, in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y), cause the male genitalia to develop abnormally. Other genetic syndromes associated with infertility are cystic fibrosis and Kallman’s syndrome.

Problems with sexual relations. These include problems maintaining or maintaining an erection sufficient for intercourse (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as a urethral opening under the penis (hypospadias), or psychological or relationship problems that interfere with sexual intercourse. sexual intercourse.

celiac disease Celiac disease is a digestive disorder caused by sensitivity to a protein found in gluten. This condition can contribute to male infertility. Fertility may improve after switching to a gluten-free diet.

certain medicines. Testosterone replacement therapy, long-term use of anabolic steroids, cancer medicines (chemotherapy), certain ulcer medicines, certain arthritis medicines, and other medicines can affect sperm production and reduce male fertility.

previous operations. Certain surgeries can prevent sperm from appearing in the ejaculate, including vasectomy, scrotal or testicular surgery, prostate surgery, and major abdominal surgery performed for various types of testicular and rectal cancer, among others.

environmental reasons

Overexposure to certain environmental elements, such as heat, toxins, and chemicals, can reduce sperm production or function. Specific reasons include the following:

industrial chemicals. Long-term exposure to certain chemicals, pesticides, herbicides, organic solvents, and paints can contribute to lower sperm count.

Exposure to heavy metals. Exposure to lead or other heavy metals can also cause infertility.

Radiation or X-rays Exposure to radiation can reduce sperm production, although it often eventually returns to normal. At high doses of radiation, sperm production can be permanently reduced.

Excessive heat in testicles. Elevated temperatures can affect sperm production and function. Although research is limited and inconclusive, frequent use of saunas or hot tubs can temporarily affect sperm count.

Sitting for long periods, wearing tight clothing, or working on a laptop for long periods of time can also increase scrotal temperature and slightly decrease sperm production. However, the study is not definitive.