MALE INFERTILITY: CAUSES, DIAGNOSIS, AND TREATMENTS

Male infertility refers to the incapacity of a man to impregnate a fertile female partner, even after having unprotected sexual intercourse for at least one year. In fact, male infertility is the main cause of infertility in about 20% of cases and contributes to another 30% to 40% of cases¹.

The right to determine the number, timing, and spacing of one’s children is a fundamental human right that belongs to individuals and couples. Unfortunately, infertility can impede the fulfillment of this right. Therefore, it is crucial to address infertility as a means of promoting the right of individuals and couples to start a family².

Causes of Male Infertility

Male infertility can result from various health issues and medical treatments, including³:

Varicocele, a swelling of the veins that drain the testicle, which can reduce sperm quantity and quality.
Infections that can interfere with sperm production or cause scarring that block the passage of sperm.
Ejaculation issues, such as retrograde ejaculation, occur when semen enters the bladder during orgasm instead of emerging out the tip of the penis.
Antisperm antibodies, which are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.
Tumors can affect the male reproductive organs or the glands that release hormones related to reproduction.
Undescended testicles, which can lead to decreased fertility.
Hormone imbalances that affect the testicles or other hormonal systems
Defects of tubules that transport sperm, which can be blocked due to various causes.
Chromosome defects, such as Klinefelter’s syndrome, cause abnormal development of the male reproductive organs.
Problems with sexual intercourse, include erectile dysfunction, premature ejaculation, painful intercourse, and anatomical abnormalities.
Celiac disease, which may contribute to male infertility but can improve after adopting a gluten-free diet.
Certain medications, such as testosterone replacement therapy, long-term anabolic steroid use, and cancer medications, which can impair sperm production and decrease male fertility.
Prior surgeries, such as vasectomy or prostate surgeries, may prevent sperm in the ejaculate.
Overexposure to certain environmental elements, including industrial chemicals, heavy metal exposure, and radiation or X-rays, which can reduce sperm production or function.
Health, lifestyle, and other causes, such as drug use, alcohol use, tobacco smoking, and obesity, which can impair fertility in several ways.

Diagnosis of Male Infertility

The first step in evaluating male fertility typically involves an initial examination that includes⁵:

A medical history to identify any underlying health conditions that may contribute to infertility.
A physical examination to check for abnormalities in the genitals, such as varicoceles or blockages in the ejaculatory ducts.
General hormone tests to measure levels of testosterone and other hormones that are important for male fertility.
One or more semen analyses evaluate the volume of semen, sperm count, motility (ability to move spontaneously), and morphology (shape and structure) of sperm. These tests can help identify potential issues with sperm production or function that may be contributing to infertility.

Treatments for Male Infertility

When the cause of male infertility is unclear, doctors can still recommend treatments or procedures that may help with conception. It is also important to check the female partner for potential issues and consider assisted reproductive techniques if necessary⁶.

Treatments for male infertility can include⁶:

Surgery to correct issues such as varicoceles, obstructed vas deferens, or prior vasectomies.
Antibiotics are used to treat infections of the reproductive tract.
Medications or counseling to address sexual intercourse problems.
Hormone treatments or medications to correct hormone imbalances.
Assisted reproductive technology (ART) such as in vitro fertilization or intracytoplasmic sperm injection, involves obtaining sperm through various means and using it to fertilize the female partner’s egg.

Lifestyle Changes and Prevention of Male Infertility

Reducing or avoiding recreational drug use, smoking, and alcohol consumption can be one of the most beneficial lifestyle choices to make when trying to conceive⁷.

In Brief

Male infertility is a common issue that can significantly impact a couple’s ability to conceive and start a family. There are numerous causes of male infertility, including medical conditions, lifestyle factors, and environmental exposures. Fortunately, there are many effective treatments available for male infertility, including surgery, medications, and assisted reproductive technologies. Additionally, making healthy lifestyle choices such as reducing or avoiding drug use, smoking, and alcohol consumption can significantly improve fertility outcomes. By addressing male infertility, individuals and couples can exercise their fundamental human right to determine the number, timing, and spacing of their children and fulfill their aspirations of starting a family.

It is important for men to prioritize their reproductive health and seek help if they suspect they may have fertility issues. If you are struggling to conceive with your partner, don’t hesitate to talk to your doctor about your concerns and undergo an evaluation to identify any potential underlying issues. Early diagnosis and treatment can significantly increase the chances of successful conception and help you achieve your family goals. Remember, seeking help for male infertility is a proactive step towards exercising your fundamental right to start a family and fulfilling your dreams of parenthood. So, take action today and prioritize your reproductive health!