Male Infertility, Causes, Diagnosis And Prevention.


Infertility is the inability of couples to conceive through unprotected sex despite having careful timing for a period of one year or longer.

More than 75 percent of infertility in couples are always from the men, reason for increasing attention towards men’s lifestyle and environments.

Male infertility can be as a result of low sperm production, abnormal sperm structure, motility, function or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices, genetic and other factors may contribute to male infertility.

CAUSES OF MALE INFERTILITY


The cause of male infertility will be discussed under the following groups for easier understanding.

  • Genetic factors
  • Environmental factors
  • Lifestyle
  • Anatomical issues
  • Infections and other causes

GENETIC FACTORS


These are factors that affects man’s fertility which are inherited from the patents or as a result of errors during developmental processes. In most cases, genetic problems that cause infertility can not be remedied.

Chromosomes defects: Some genetic errors such as Klinefelter’s syndrome affects male fertility. Klinefelter’s syndrome is a genetic condition in which a male has two x-chromosome and Y-chromosome instead of normal X and Y chromosome.

Klinefelter’s syndrome isn’t inherited, but rather occurs only as a result of a random genetic error after conception.

Kallmann’s syndrome: Is a condition resulting from a lack of production of certain hormones that direct sexual development. These hormones are normally made in a part of the brain called the hypothalamus.

Males born with hypogonadotropic hypogonadism often have an unusually small penis (micropenis) and undescended testes (cryptorchidism).

At puberty, most affected individuals do not develop secondary sex characteristics, such as the growth of facial hair and deepening of the voice in males, the start of monthly periods (menstruation) and breast development in females, and a growth spurt in both sexes. Without treatment, most affected men and women are unable to have biological children (infertile).

Undescended Testicles: This is a case in males, during fetal development one or both testicles fail to descend from the abdomen into the sac that normally contains the testicles (scrotum). Decreased fertility is more likely in men who have had this condition.

  • Absence of the Vas deferense which the sperm pipeline

ENVIRONMENTAL FACTORS

The reason the sperm is not produced outside the body is because it needs a lower temperature that that of the body. Therefore, environmental factors that affects this temperature directly affects a man’s fertility.

Overheating The Testicles: Frequent Increase in temperature around the genital regions may impair sperm production and function. Although findings are limited about this.

Sitting for long periods, wearing tight clothing or working on a laptop computer on top of the lap for long stretches of time also may increase the temperature in your scrotum and may slightly reduce sperm production. But, the research isn’t conclusive.

Exposure To Chemicals: Industrial chemicals like herbicides, pesticides, insecticides, organic solvents may affect sperm count.

Exposure to X-ray and Radiation: Sperm production is impaired with exposure to radiation and eventually becomes permanent with prolonged exposure.

LIFESTYLES

Drug use: Anabolic steroids taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. Use of hard drugs like cocaine, marijuana etc may temporarily reduce the number and quality of your sperm as well.

Alcoholism: Drinking alcohol can lower testosterone levels, cause erectile dysfunction and decrease sperm production. Liver disease caused by excessive drinking also may lead to fertility problems.

Smoking: Men who smoke may have a lower sperm count than those who don’t smoke. All inhaling smoke from other sources can cause it.

Weight: Obesity can impair fertility in several ways, including directly impacting sperm themselves as well as by causing hormone changes that reduce male fertility.

ANATOMICAL ISSUES

Varicoceles: This is when the vain that drains the testicles swells up. It’s the most common reversible cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it may be related to abnormal blood flow. Varicoceles lead to reduced sperm quantity and quality.

Retrograde Ejaculation: this is when the sperm is released backwards into the bladder instead of forward through the penis. It could be as a result of previous surgery or structural problems.

Obstruction: A blockage can occur in the plumbing system between the testis and the penis.

INFECTION AND OTHER FACTORS

Infection: Infections in the testicle (orchitis), the prostate (prostatitis), or anywhere in the body that causes a fever and increased temperature of the body can tamper with sperm production.

Some sexually transmitted infections/disease including gonorrhea or HIV can cause testicular damage. Although some infections can result in permanent testicular damage, most often sperm can still be retrieved.

Immunologic Infertility: Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them

Hormonal imbalance: Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes.

DIAGNOSIS

The semen analysis is the cornerstone of the male infertility workup and includes assessment of the following:

Semen volume (normal, 1.5-5 mL)

Semen quality

Sperm density (normal, >15 million sperm/mL)

Total sperm motility (normal, >40% of sperm having normal movement)

Sperm morphology (sample lower limit for percentage of normal sperm is 4%)

Signs of infection – An increased number of white blood cells (WBCs) in the semen may be observed in patients with infectious or inflammatory processes

Other variables (eg, levels of zinc, citric acid, acid phosphatase, or alpha-glucosidase)

Other laboratory tests that may be helpful include the following:

Antisperm antibody test
Hormonal analysis (FSH, LH, TSH, testosterone, prolactin)

Genetic testing (karyotype, CFTR, AZF deletions if severe oligospermia (< 5 million sperm/mL

PREVENTION


Some male infertility problems may not be remedied but these precautions can help prevent them from occurring

  • Avoid smoking
  • Reduce alcoholism
  • Avoid exposure to radiation and high temperature
  • Avoid exposure to industrial chemicals
  • Moderate exercise
  • Maintain a healthy weight
  • Don’t get a vasectomy.



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