If a couple has been unsuccessful in trying to conceive for over a year, it is best to visit the doctor and look for issues in both partners that could be affecting fertility. Yes, both partners, as many cases of infertility involve problems with the male partner.
Though many men may put off getting tested citing embarrassment as a reason, but an early test can help narrow down the cause of problem faster and save the couple unnecessary expenses and discomfort.
So, what are the infertility problems men may face?
- Variocoele – It refers to enlarged internal spermatic veins that drain blood from the testicle to the abdomen (and back to heart). Damage to the valves in the vein can cause back flow of blood into the scrotum, affecting sperm development. It can be diagnosed by physical examination of the scrotum and scrotal ultrasound.
- Damaged sperm ducts – A blockage in the pathway that transports sperm from testicles to the penis may occur due to a genetic defect, scarring from tuberculosis or STD, or from vasectomy.
- Torsion – Testes may twist inside the scrotum due to a tissue abnormality; the torsion blocks blood supply to the testes, causing swelling and testicular damage.
- Infection or disease – Testicular atrophy or damage may result from infections like mumps, tuberculosis, typhoid, gonorrhoea, influenza, etc. or elevated FSH hormone levels or other hormonal issues.
- Klinefelter’s syndrome – It is a genetic condition in which each cell of the human body has an additional X chromosome. Men with this syndrome have one Y and two X chromosomes.
- Retrograde ejaculation – Semen is ejaculated into the bladder instead of the urethera due to a dysfunctional bladder sphincter.
Psychological or behavioural problems
Other problems that can affect male fertility include:
- Erectile dysfunction – Also known as impotence, this disorder may result from one or multiple psychological factors like performance anxiety, low self esteem, metabolic disorders like diabetes, heart disease, etc., hormonal problems, or a side effect of certain medications.
- Premature ejaculation – This is caused when ejaculation occurs even before a man inserts the penis into the vagina.
- Ejaculatory incompetence – This disorder prevents ejaculation during sexual intercourse, though the man can ejaculate normally in other conditions.
Certain hormonal disorders can affect male fertility:
- Hyperprolactinemia – Elevated prolactin levels reduces sperm production, libido and causes impotence.
- Hypothyroidism – Low thyroid hormone levels can reduce sperm quality, testicular function and libido.
- Hypogonadotropic Hypopituitarism – Low levels of FSH and LH produced by pituitary arrests sperm development and causes loss of cells from testes and testicular damage.
- Congenital Adrenal Hyperplasia – Increased levels of adrenal androgens may suppress pituitary gland, causing low sperm count and motility and increased number of immature sperm cells.
- Panhypopituitafism – This occurs when the pituitary gland fails to function, reducing levels of TSH, LH and FSH.
Getting tested for infertility involves a medical history, physical examination, hormone tests, semen analysis and urinalysis (to check for infection) to identify the cause of the problem. Treating male infertility involves reversing the effect of chemical, infectious or endocrine imbalances, as found during diagnostic tests.
“Infertility and Men,” WebMD.com, https://www.webmd.com/infertility-and-reproduction/male-fertility-test
“Infertility in Men,” UCSF Medical Center, https://www.ucsfhealth.org/conditions/infertility_in_men/
“What Causes Male Infertility?” Stanford.edu, https://web.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/causemal.htm