Causes of Infertility
Male Infertility Issues
Nearly 40% of infertility is due to male factors including low sperm counts, low sperm activity and low sperm morphology. Morphology describes the percentage of normal-looking sperm.
There are many possible causes of male factor infertility:
- Excessive use of alcohol, tobacco, or other illicit drugs
- Infections of the genital organs such as the prostate or urethra, sexually transmitted diseases that can cause sperm blockage
- Testosterone supplementation or androgen boosters
- Exposure to toxins and chemicals in the environment
- Exposure to radiation
- Testicular exposure to overheating such as a prolonged high fever
- A genetic disorder such as Klinefelter’s syndrome, cystic fibrosis, or a defective gene on the Y chromosome.
Abnormal sperm may be caused by the following:
- Inflammation of the testicles from trauma or infection
- Twisted or swollen veins in the scrotum (varicocele)
- Abnormally developed testicles, undescended testes as a child
- Increased testicular temperatures, hernias, Mumps
Male infertility may also occur from physical or structural abnormalities such as retrograde ejaculation (semen forced back into the bladder,) erectile dysfunction, or any structural abnormalities that affect the testes, tubes, or other reproductive structures. Blockage of the duct that carries sperm or genetic defects called micro-deletions are also causes of male factor infertility. The effect of aging is not clear; however, there is some evidence of decreased sperm quality with advancing age, especially after age 65.
The effects of medications on sperm quality and count have not been extensively studied and many medicines are commonly prescribed without knowing whether they impair fertility. Known medications that may affect male fertility include:
- steroids; testosterone, DHEA, HCG
- cimetidine (Tagamet)
- sulfasalazine (Azulfidine)
- methotrexate (Folex)
- phenytoin (Dilantin)
- spironolactone (Aldactone)
- clonidine (Catapress)
- thioridazine (Mellaril)
- calcium channel blockers(for high blood pressure)
Other medical conditions, such as severe injury, major surgery, diabetes, HIV, thyroid disease, liver or kidney failure, heart attack, and chronic anemia may affect sperm quality.
Treatments for male factor infertility may include: antibiotic treatment for infection or hormone treatment if a hormone imbalance is identified; avoiding radiation and environmental toxins, chemicals, pesticides, and lubricants; avoiding excessive alcohol, smoking, and drug abuse; therapy to treat ejaculation problems; or surgery to correct structural abnormalities. Dietary supplements such as omega-3 fatty acids, Naturally Smart, and Proxeed are formulated to enhance male fertility and may improve overall sperm quality.
One way to overcome male factor challenges is through the use of artificial insemination. This is where a man’s sperm is inserted into a women’s vagina, cervix or uterus around the time of ovulation. An advanced technique called intra-cytoplasmic sperm injection (ICSI) in which a single sperm is injected directly into an egg to achieve fertilization has been shown to be highly effective. It is often used in cases with very low sperm counts. Even for men with no sperm, techniques to directly acquire the sperm from the testes or the ducts that deliver sperm can been used with great success. For men with extremely low counts or absent sperm, sperm donors represent another option.