Infertility is a condition that affects many couples worldwide. It can be a challenging and emotional experience. For men, understanding and identifying infertility can be particularly difficult. This article aims to provide a comprehensive guide on how to tell if you are infertile as a man. We will cover the basics of male infertility, its causes, symptoms, and the steps you can take to diagnose and manage it.
What Is Male Infertility?
Male infertility refers to a man’s inability to cause pregnancy in a fertile female. It accounts for about 40-50% of all infertility cases. Infertility in men can result from various factors, including medical, environmental, and lifestyle issues.
Causes of Male Infertility
Several factors can contribute to male infertility. These can be broadly categorized into medical causes, environmental causes, and lifestyle causes.
Medical Causes
1. Varicocele
Varicocele is a condition where the veins that drain the testicle are swollen. It is one of the most common causes of male infertility. Varicoceles can affect sperm production and quality.
2. Infections
Certain infections can interfere with sperm production or sperm health, or they can cause scarring that blocks the passage of sperm. These include infections such as epididymitis, orchitis, and some sexually transmitted infections, including gonorrhea or HIV.
3. Ejaculation Issues
Retrograde ejaculation occurs when semen enters the bladder instead of emerging through the penis during orgasm. Various health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, and surgery of the bladder, prostate, or urethra.
4. Antibodies that Attack Sperm
Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.
5. Tumors
Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. Surgery, radiation, or chemotherapy to treat tumors can also affect male fertility.
6. Undescended Testicles
In some males, one or both testicles fail to descend from the abdomen into the sac that normally contains the testicles during fetal development. Decreased fertility is more likely in men with this condition.
7. Hormone Imbalances
Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems, including the hypothalamus, pituitary, thyroid, and adrenal glands.
8. Defects of Tubules that Transport Sperm
Many different tubes carry sperm. They can be blocked due to various causes, including unintended injury from surgery, prior infections, trauma, or abnormal development, such as cystic fibrosis or similar inherited conditions.
9. Chromosome Defects
Inherited disorders 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, cause abnormal development of the male reproductive organs.
10. Problems with Sexual Intercourse
These can include difficulty with maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex.
11. Celiac Disease
A digestive disorder caused by sensitivity to gluten, celiac disease can cause male infertility. Fertility may improve after adopting a gluten-free diet.
12. Certain Medications
Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal and antibiotic medications, some ulcer medications, and some other medications can impair sperm production and decrease male fertility.
Environmental Causes
1. Industrial Chemicals
Extended exposure to certain chemicals, pesticides, herbicides, organic solvents, and painting materials may contribute to low sperm counts.
2. Heavy Metal Exposure
Exposure to lead or other heavy metals can cause infertility.
3. Radiation or X-rays
Exposure to radiation can reduce sperm production. It can take several years for sperm production to return to normal. With high doses of radiation, sperm production can be permanently reduced.
4. Overheating the Testicles
Elevated temperatures impair sperm production and function. Frequent use of saunas or hot tubs may temporarily impair sperm count. Sitting for long periods, wearing tight clothing, or working on a laptop for long stretches also may increase the temperature in your scrotum and slightly reduce sperm production.
See Also: Does Chemotherapy Affect Male Fertility?
Lifestyle Causes
1. Drug Use
Anabolic steroids taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. Use of cocaine or marijuana might temporarily reduce the number and quality of your sperm as well.
2. Alcohol Use
Drinking alcohol can lower testosterone levels and cause decreased sperm production.
3. Tobacco Smoking
Men who smoke may have a lower sperm count than those who don’t smoke. Secondhand smoke also may affect male fertility.
4. Emotional Stress
Severe or prolonged emotional stress, including stress about fertility, may interfere with certain hormones needed to produce sperm.
5. Weight
Obesity can impair fertility in several ways, including directly impacting sperm and by causing hormone changes that reduce male fertility.
Symptoms of Male Infertility
The primary sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms. However, in some cases, underlying problems such as an inherited disorder, hormonal imbalance, dilated veins around the testicle, or a condition that blocks the passage of sperm may cause signs and symptoms. These can include:
1. Problems with Sexual Function
This includes difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire, or difficulty maintaining an erection (erectile dysfunction).
2. Pain, Swelling, or a Lump in the Testicle Area
This can be caused by a variety of conditions, including infections and varicocele.
3. Recurrent Respiratory Infections
This can indicate genetic issues such as cystic fibrosis.
4. Inability to Smell
Some genetic problems are associated with a lack of the ability to smell.
5. Abnormal Breast Growth
Gynecomastia, which is abnormal breast growth in males, can be a sign of hormonal imbalance.
6. Decreased Facial or Body Hair
Other signs of a chromosomal or hormonal abnormality can include a decrease in facial or body hair.
7. A Lower Than Normal Sperm Count
A lower than normal sperm count is fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate.
Diagnosing Male Infertility
If you and your partner have been trying to conceive without success, it may be time to see a doctor. A variety of tests and procedures can help determine the cause of male infertility. These include:
1. General Physical Examination and Medical History
This includes examining your genitals and asking questions about any inherited conditions, chronic health problems, illnesses, injuries, or surgeries that could affect fertility. Your doctor might also ask about your sexual habits and your sexual development during puberty.
2. Semen Analysis
A semen analysis is the most common initial test. Your doctor will ask for one or more samples of your semen. Semen is generally obtained by masturbating or by interrupting intercourse and ejaculating your semen into a clean container. A laboratory analyzes your semen sample. In some cases, sperm may be tested for in the urine.
3. Hormone Testing
Hormones produced by the pituitary gland, hypothalamus, and testicles play a key role in sexual development and sperm production. Blood tests can measure the level of testosterone and other hormones.
4. Genetic Tests
When sperm concentration is very low, there could be a genetic cause. A blood test can reveal whether there are subtle changes in the Y chromosome — signs of a genetic abnormality. Genetic testing might be needed to diagnose various congenital or inherited syndromes.
5. Testicular Biopsy
In selected cases, a testicular biopsy can be performed to identify abnormalities contributing to infertility. In this procedure, samples are obtained from the testicle with a needle.
6. Imaging
In certain situations, imaging studies such as a brain MRI, transrectal or scrotal ultrasound, or testicular biopsy might be recommended.
7. Other Specialty Testing
In rare cases, other tests to evaluate the quality of the sperm may be performed, such as evaluating a semen sample for DNA abnormalities.
Treatment of Male Infertility
The treatment of male infertility depends on the underlying cause. Here are some common treatment options:
1. Surgery
For example, a varicocele can often be surgically corrected, or an obstructed vas deferens can be repaired. Prior vasectomies can be reversed. In cases where no sperm are present in the ejaculate, sperm can often be retrieved directly from the testicles or epididymis using sperm retrieval techniques.
2. Treating Infections
Antibiotic treatment might cure an infection of the reproductive tract, but this doesn’t always restore fertility.
3. Treatments for Sexual Intercourse Problems
Medication or counseling can help improve fertility in conditions such as erectile dysfunction or premature ejaculation.
4. Hormone Treatments and Medications
Your doctor might recommend hormone replacement or medications in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones.
5. Assisted Reproductive Technology (ART)
ART treatments involve obtaining sperm through normal ejaculation, surgical extraction, or from donors, depending on your specific situation and wishes. The sperm are then inserted into the female genital tract, or used for in vitro fertilization or intracytoplasmic sperm injection.
Lifestyle and Home Remedies
Some steps can increase your chances of achieving pregnancy:
1. Increase Frequency of Sex
Having sexual intercourse every other day near the time of ovulation increases the chances of getting your partner pregnant.
2. Have Sex With Penile Penetration
Ejaculating sperm into your partner’s vagina maximizes the chances of your sperm reaching the egg. Sexual positions that ensure deeper penetration might help deliver more sperm closer to the cervix.
3. Avoid Lubricants
Several over-the-counter lubricants, including Astroglide or K-Y jelly, saliva, and olive oil, can impair sperm movement and function. If necessary, consider using a sperm-friendly lubricant, such as Pre-Seed.
4. Stay Active
Moderate physical activity can increase levels of powerful antioxidant enzymes that help protect sperm.
5. Avoid Substance Abuse
Abuse of substances such as drugs, alcohol, and tobacco can negatively affect fertility. Avoid these substances to improve your chances of conceiving.
6. Manage Stress
Emotional stress can interfere with hormones needed to produce sperm. Stress management techniques such as yoga, meditation, or therapy can help.
7. Maintain a Healthy Weight
Obesity can reduce fertility in many ways, including directly affecting sperm and by causing hormonal changes that reduce male fertility. A healthy diet and regular exercise can help you achieve and maintain a healthy weight.
When to See a Doctor
See a doctor if you have been unable to conceive a child after a year of regular, unprotected sexual intercourse, or sooner if you have any of the following symptoms:
- Problems with ejaculation or erection
- Pain, discomfort, a lump, or swelling in the testicular area
- A history of testicular, prostate, or sexual problems
- A groin, testicle, penis, or scrotum surgery
- A partner over the age of 35
Conclusion
Male infertility can be a difficult and sensitive issue, but it is important to understand that many causes of infertility are treatable. Identifying the signs and seeking appropriate medical help can significantly improve your chances of conception. By taking the necessary steps to diagnose and address the underlying issues, many men can overcome infertility and achieve their dream of starting a family. If you suspect you may be facing infertility, consult with a healthcare professional for a thorough evaluation and personalized treatment plan.
Related Links:
