Infertility is when you and your partner have tried for repeatedly to have a child, but despite sexual intercourse without birth control, you’ve been unable to conceive a child.
If you’ve been trying to conceive for more than a year, there’s a good chance that something may be causing you to not conceive. Infertility, also known as sub fertility, is the inability to conceive a child within one year. Infertility may be due to a single cause in either you or your partner, or a combination of factors that may prevent a pregnancy from occurring or staying full-term.
Infertility differs from sterility. Being sterile means you’re unable to conceive a child. With sterility, you or your partner has a physical problem that precludes the ability to conceive. A diagnosis of infertility simply means that becoming pregnant may be a challenge rather than a feeling of hopelessness.
Symptoms
Most men with fertility problems have no signs or symptoms. Some men with hormonal problems may note a change in their voice or pattern of hair growth, enlargement of their breasts, or difficulty with sexual function. Infertility in women may be signaled by irregular menstrual periods or associated with conditions that cause pain during menstruation or intercourse.
Causes
The human reproductive process is complex. To accomplish a pregnancy, the intricate processes of ovulation and fertilization need to work just right. For many couples attempting pregnancy, something goes wrong in one or both of these complex processes and causes infertility. Because of the intricate series of events required to begin a pregnancy, many factors may cause a delay in starting your family.
The cause or causes of infertility can involve one or both partners. For many couples having problems with fertility, the male partner is either the sole or a contributing cause. Problems with female fertility are common as well, but present less often than those in the male partner. In both men and women, multiple factors can account for difficulty with fertility. Sometimes the problem isn’t really one of infertility, but a more general sexual problem such as erectile dysfunction. Other times, the problem may involve an abnormality in the structure of the reproductive hormones or organs. Certain infections and diseases also can affect fertility.
Causes of male infertility
Impaired shape and movement of sperm: Sperm must be properly shaped and able to move rapidly and accurately toward the egg for fertilization to occur. If the shape and structure (morphology) of the sperm are abnormal or the movement (motility) is impaired, sperm may not be able to reach the egg.
Absent sperm production in testicles: Complete failure of the testicles to produce sperm is rare, affecting very few infertile men.
Low sperm concentration: A normal sperm concentration is greater than or equal to 20 million sperm per milliliter of semen. A count of 10 million or fewer sperm per milliliter of semen indicates low sperm concentration (sub fertility). A count of 40 million sperm or higher per milliliter of semen indicates increased fertility.
Varicocele: A varicocele is a varicose vein in the scrotum that may prevent normal cooling of the testicle and raise testicular temperature, preventing sperm from surviving.
Undescended testicle (cryptorchidism): This occurs when one or both testicles fail to descend from the abdomen into the scrotum during fetal development. Undescended testicles can cause mild to severely impaired sperm production. Because the testicles are exposed to the higher internal body temperature compared to the temperature in the scrotum, sperm production may be affected.
Testosterone deficiency (male hypogonadism): Infertility can result from disorders of the testicles themselves, or an abnormality affecting the hypothalamus or pituitary glands in the brain that produce the hormones that control the testicles.
Klinefelter’s syndrome: In this disorder of the sex chromosomes, a man has two X chromosomes and one Y chromosome instead of one X and one Y. This causes abnormal development of the testicles, resulting in low or absent sperm production. Testosterone production also may be lower.
Infections: Infection may temporarily affect sperm motility. Repeated bouts of sexually transmitted diseases (STDs), such as chlamydia and gonorrhea, are most often associated with male infertility. These infections can cause scarring and block sperm passage. Mycoplasma is an organism that may fasten itself to sperm cells, making them less motile. If mumps, a viral infection usually affecting young children, occurs after puberty, inflammation of the testicles can impair sperm production. Inflammation of the prostate (prostatitis), urethra or epididymis also may alter sperm motility.
Sexual issues: Often treatable, problems with sexual intercourse or technique may affect fertility. Difficulties with erection of the penis (erectile dysfunction), premature ejaculation, painful intercourse (dyspareunia), or psychological or relationship problems can contribute to infertility. Use of lubricants such as oils or petroleum jelly can be toxic to sperm and impair fertility.
Retrograde ejaculation: This occurs when semen enters the bladder during orgasm rather than emerging out through the penis. Various conditions can cause retrograde ejaculation including diabetes, bladder, prostate or urethral surgery, and the use of psychiatric or antihypertensive drugs.
Blockage of epididymis or ejaculatory ducts: Some men are born with blockage of the part of the testicle that contains sperm (epididymis) or ejaculatory ducts. And some men who seek treatment for infertility lack the tubes that carry sperm (vasa deferentia).
No semen (ejaculate): The absence of ejaculate may occur in men with spinal cord injuries or diseases. This fluid transports sperm through the penis into the vagina.
Misplaced urinary opening (hypospadias): A birth defect can cause the urinary (urethral) opening to be abnormally located on the underside of the penis. If not surgically corrected, this condition can prevent sperm from reaching the cervix.
Anti-sperm antibodies: Antibodies that target sperm and weaken or disable them usually occur after surgical blockage of part of the vas deferens for male sterilization (vasectomy). Presence of these antibodies may complicate the reversal of a vasectomy.
Cystic fibrosis: Men with cystic fibrosis often have missing or obstructed vasa deferentia.
Male’s health and the way he lives can affect infertility
Emotional stress
– Malnutrition: Deficiencies in nutrients such as vitamin C, selenium, zinc and folate may contribute to infertility.
– Obesity
– Cancer and its treatment
– Alcohol and drugs. The use of certain drugs also can contribute to infertility
Other medical conditions that cause infertility include
– Severe injury
– Surgery
– Diabetes
– Thyroid disease
– HIV/AIDS
– Cushing’s syndrome
– Anemia
– Heart attack
– Liver
– kidney failure
– Age
Environmental Causes include
Environmental elements. Overexposure to certain environmental elements such as heat, toxins and chemicals can reduce sperm count either directly by affecting testicular function or indirectly by altering the male hormonal system.
Pesticides and other chemicals: Herbicides and insecticides may cause female hormone-like effects in the male body and may be associated with reduced sperm production. Exposure to such chemicals also may contribute to testicular cancer. Men exposed to hydrocarbons, such as ethylbenzene, benzene, toluene, xylen and aromatic solvents used in paint, varnishes, glues, metal degreasers and other products, may be at risk of infertility. Men with high exposure to lead also may be more at risk.
Testicular exposure to overheating: Frequent use of saunas or hot tubs can elevate your core body temperature. This may impair your sperm production and lower your sperm count.
Substance abuse: Cocaine or heavy marijuana use may temporarily reduce the number and quality of your sperm.
Smoking: Men who smoke may have a lower sperm count than do those who don’t smoke.
