In the past, when a couple had problems conceiving, it was believed it was the woman’s fault. Today we know that almost 40% of infertility cases are cause by male infertility factor.
There are various causes of male infertility, which is usually assessed by sperm analysis (spermogram). When a spermogram is performed, indicators such as sperm concentration, motility and morphology are evaluated by a specialist. Slight deviations in the indicators are not necessarily equal to infertility. Instead, the spermogram helps determine if and how male factors contribute to infertility and points to a specific treatment for the problem.
In this article we will summarize most of the causes of infertility in men:
TESTICULAR FUNCTION DISORDERS
- Varicocele, a condition in which the venous vessels of the testicles dilate, leading to blood stasis and a correspondingly elevated temperature in the scrotum. Heat can affect the number or morphology of sperm. This explains why testicles need to be outside of the abdominal cavity.
- Injuries to the testicles can affect sperm production, leading to a reduced concentration of sperm in the semen.
- Harmful habits such as the use of alcohol, cigarettes or anabolic steroids lead to reduced sperm production.
- Treatment of oncological diseases, including the use of certain types of chemotherapy, radiation therapy or surgical removal of the testicles. Today, oncology patients have the option of cryopreservation of their sperm.
- Diseases such as diabetes, cystic fibrosis, certain types of autoimmune disorders and certain types of infections can cause testicular failure.
HORMONAL DISORDERS
Infertility can be caused by disfunctions of the hypothalamus or pituitary gland. These are structures in the brain that produce hormones, some of which are required for proper testicular function. The production of too much prolactin, a hormone produced by the pituitary gland (usually due to the presence of a benign tumor), can significantly reduce sperm production.
Other hormonal causes may include congenital adrenal hyperplasia, exposure to too much estrogen or testosterone, Cushing’s syndrome, and chronic corticosteroid use.
GENETIC ANOMALIES
Genetic conditions such as Kleinfelter’s syndrome, Y-chromosome microdeletion, myotonic dystrophy, and other, less common genetic disorders can lead to reduced to absent sperm production. Some congenital anomalies of the reproductive system, such as congenital agenesis of the vas deferens, interfere with the transport of sperm to the seminal fluid.
If you are worried that you will fall into any of these risk categories, do not delay your consultation with an urologist. They will asses your case and explain to you what your options are.