Male infertility is a condition that prevents a man from naturally impregnating his partner, even after 12 months of trying. Learn how to treat it.
Male infertility is a delicate issue. Whether it’s about the inability to fulfill a dream, the social pressure to produce an heir, or the feeling of being “less manly,” receiving this diagnosis is challenging.
Men going through this should keep in mind that infertility can be temporary, depending on the causes. However, there are cases where he will not be able to have children, and considering alternatives to fatherhood might be part of the process.
Causes of Male Infertility
Male infertility is a complex condition influenced by one or more physical, environmental, and even emotional factors. Check out:
Hormonal Changes
Hormonal imbalances, especially low levels of testosterone, can lead to a decrease in sperm production or even cease it.
Hypothalamic-pituitary dysfunction is also concerning. It affects the adequate production of hormones necessary for the functioning of the male reproductive system, such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are essential for stimulating testosterone production and the process of formation and development of sperm in the testicles.
Cancer
Treatments for most types of cancer do not usually prioritize preserving fertility, which is temporarily or permanently compromised.
Chemotherapy, radiotherapy, surgery, or hormone therapy can result in damage to the testicles, a decrease in sperm production, or an interruption in sperm production. They can also affect the glands responsible for producing sexual hormones, such as the pituitary gland and testicles.
Cryptorchidism
Just as with varicocele, cryptorchidism also causes an increase in the temperature of the scrotal region, impairing sperm development.
However, the condition, also called “undescended testicles,” occurs when one or both testicles are absent from the scrotal sac, a congenital alteration. Most of the time, it is resolved by the first year of age, but if untreated, it can prevent the chances of conception.
Erectile Dysfunction
By making ejaculation during penetration difficult or impossible, erectile dysfunction prevents conception.
If a man cannot ejaculate inside his partner so that the sperm can reach the female reproductive system’s fallopian tubes to fertilize the egg, conception is prevented.
Advanced Age
Advancing age is a risk factor for male infertility, as it naturally leads to a decrease in the number of sperm and the quality of sperm, as well as increasing the chances of genetic problems in the sperm.
Men over 40 are also more prone to erectile dysfunction, which makes penetration difficult or impossible.
STIs
Sexually transmitted infections (STIs) such as chlamydia and gonorrhea, which among the symptoms, inflame the testicles and the vas deferens, have consequences for fertility, from reducing the number of sperm to obstructing the path for them to exit through the tip of the penis.
Other STIs such as herpes and HPV, which cause lesions on the genital organs, affect sperm production and quality.
Medications
The use of certain medications can interfere with sperm production, impairing their quality or affecting hormonal function. Some examples include:
- Antihypertensives
- Anabolic steroids
- Chemotherapy medications
- Ulcer medications
The damage can be temporary and resolved with the suspension of the medication or permanent.
Orchitis
Orchitis is an infection in the testicles that can leave a man infertile due to the damage caused to the testicular tissues and the reduction in sperm production.
The infection inflames the vas deferens, which carry sperm from the testicles out of the body during ejaculation. If not treated, this functioning is compromised and, consequently, fertility as well.
Genetic Problems
There are some genetic problems that can cause male infertility, such as:
- Klinefelter Syndrome, which decreases testosterone production
- Y chromosome microdeletion, which can cause sperm production failure
- Cystic fibrosis, which can block the vas deferens, transporting sperm through the reproductive system
- Cushing’s Disease, which causes testicular dysfunction
Smoking
Not just smoking, but also other unhealthy habits such as poor diet, being sedentary, and excessive alcohol consumption can contribute to male infertility.
These factors can damage the blood vessels that supply the testicles and affect the production of reproductive cells. Toxins can damage the DNA of sperm. Additionally, this combination leads to hormonal imbalances that reduce the quantity and quality of sperm.
Use of Anabolic Steroids
The use of anabolic steroids tends to suppress the body’s natural production of testosterone. This can cause sperm count to decrease, as well as the quality of sperm.
If use is prolonged, the natural hormonal balance will be disrupted, which will affect the function of the testicles and, consequently, sperm production, resulting in temporary or permanent infertility, depending on the time and frequency of use of anabolic steroids.
Varicocele
Varicocele is an abnormal dilation of veins within the scrotum. As a consequence, there is an increase in local temperature, which impairs sperm production and affects its quality.
The condition can lead to male infertility precisely because of this reduction in the quantity and quality of reproductive cells.
What are the symptoms of infertility in men?
The main symptom that may indicate male infertility is the lack of success in impregnating the partner after a year of regular attempts.
However, it is possible to notice before that, especially if the man is attentive to his health.
Symptoms such as erectile dysfunction, premature or delayed ejaculation, pain, swelling, or discomfort in the testicles, change in the appearance of the scrotum, decreased libido, and hormonal changes should be investigated as possible origins of infertility.
Furthermore, it is essential to check the man’s medical and family history.
Risk Factors
These are risk factors, i.e., those that can increase the chances of a man presenting infertility:
- Advanced age
- Smoking
- Excessive alcohol consumption
- Use of illicit drugs and certain medications
- Obesity
- Exposure to toxic chemicals
- Exposure to radiation
- STIs
- Testicular surgery
- Testicular injuries
- Underlying medical conditions (diabetes, high blood pressure, hormonal or genetic disorders)
Exams for Infertility Diagnosis
Exams to check a man’s fertility and prove or disprove whether he is infertile are of great importance for couples trying to have children.
The exams may be requested by a urologist or by a doctor specializing in assisted reproduction. They can accompany the couple’s journey and help if the suspicion of infertility is confirmed.
For this, the man will have to undergo some exams such as:
- Semen Analysis: from the collection of a semen sample, it is possible to analyze the quantity, quality, and mobility of sperm
- Hormonal Tests: they measure the levels of relevant hormones for sperm production, such as testosterone, LH, and FSH
- Sperm DNA Fragmentation Test: checks the integrity of the genetic material of sperm from a semen sample
- Imaging Test: an ultrasound is indicated to evaluate the presence of varicocele, testicular tumors, or other abnormalities in the male reproductive organs
Recommended Treatments Post-Diagnosis
To treat male infertility, it is necessary to identify the cause of the problem.
Simpler cases involving hormonal imbalances can be treated with medications prescribed by the doctor. They will help restore the appropriate hormonal levels so that the production and quality of sperm improve.
Varicocele, cryptorchidism, or obstructions in the vas deferens may require surgeries. The different surgeries will solve the problem and, consequently, restore the temperature and function of the testicles and ducts. This tends to treat male infertility.
When other treatment options are not successful, there are modern assisted reproduction techniques (ART). Intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection are some of them, and can benefit couples whose partner has a low sperm count, low motility, or morphological abnormalities.
Sperm storage has been another modern alternative for male fertility. Those who will undergo aggressive cancer treatment or who wish to have heirs later can arrange for the preservation of these cells in specialized clinics.
It is worth noting that, in many cases, simply improving lifestyle habits, such as quitting smoking, reducing alcohol consumption, adopting a healthy diet, and regularly exercising, can help improve male fertility.
Adopting these care measures also helps to ward off risk factors and ensure fertility for a longer time.
Regular medical exams and being aware of symptoms are essential to identify and treat early medical conditions that negatively impact male fertility. Count on our help to maintain your reproductive and sexual health.
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- Penile Prosthesis: Detailed Advantages and Disadvantages
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