Infertility is considered when a couple cannot achieve conception after 12 months of unprotected sexual intercourse. Various health conditions are known to cause infertility in men.

The conditions that could lead to infertility, are usually one-third of the time found in the male, one-third of the time found in the woman and the last one-third in both parties at the same time.

Types of Infertility

Infertility can be primary or secondary.

Primary infertility is when a man or woman has never been able to impregnate a woman or a woman never been able to achieve pregnancy despite unprotected and adequate sexual intercourse. 

Secondary infertility is when a man or woman has  been able to impregnate a woman or a woman has achieved pregnancy before, irrespective of how the pregnancy ended but for any known or unknown reasons is no longer able to impregnate or get pregnant despite unprotected and adequate sexual intercourse. 

Risk Factors Of Infertility In Men

Several conditions can pose as risk factors or causes of infertility in both males and females.

The following are examples of male factors that affect fertility: 

  • Pretesticular: Diseases of the hypothalamus, pituitary, or peripheral organs that affect the hypothalamic-pituitary axis, whether congenital or acquired. 
  • Testicular: Non-genetic or genetic 
  • Post-testicular: Factors that interfere with sperm transport through the ductal system, either congenital or acquired 

The following are some of the factors that affect both sexes’ fertility: 

  • Factors in the environment and at work 
  • Toxic consequences of cigarettes, marijuana, or other substances 
  • Excessive activity 
  • A poor diet is linked to rapid weight loss or increase. 
  • Advanced age

Common conditions that could lead to infertility in males:

  • Diabetes mellitus is a condition that could lead to neuropathy, neurogenic impotence, and retrograde ejaculation.
  • Obesity changes hormonal metabolism, resulting in increased peripheral testosterone to estrogen conversion and decreased luteinizing hormone (LH) pulse amplitude, as well as lower sperm concentration. Obesity has been linked to a drop in sperm quality in men.
  • Sickle cell disease is known to cause direct testicular ischemia (poor blood supply to the testicular) leading to infertility.
  • Thalassemia and also Sickle Cell disease usually require many blood transfusion. This can lead to excess accumulation of iron which could lead to inability to reproduce.
  • Cystic fibrosis seen in males comes with absence of vas deferens from birth. Vas deferens is an organ required for fertility; it’s absence leads to reproductive failure. 
  • Chronic kidney disease leads to Hypogonadism (under production of the reproductive hormones) and feminization, thereby causing male reproductory failure.
  • liver disease may lead to reduced development of the male secondary sexual traits as well as underdevelopment of the testicules which leads to male infertility.
  • Hemochromatosis– is an abnormal accumulation of iron in the body; this can cause poor development of the male sex organ development.
  • Post-pubertal mumps could cause shrinking of the testes.
  • Sexually Transmitted Diseases (STDs) e.g. – gonorrrhoea, syphillis, HIV, etc., and Tuberculosis can cause the blockade of the vas deferens and epididymis which are male reproductive organs, this blockage can lead to infertility in males.
  • Mycoplasma-is an organism with various variants, which when any of them gets attached to the sperm cells, inhibit their movement thereby causing infertility.
  • Exercise should be encouraged as a regular component of one’s daily routine. Compulsive exercise, on the other hand, is harmful, especially for long-distance runners. Endorphin secretion is stimulated by jogging; excessive endorphin secretion interferes with the regular generation of reproductive hormones. Exercise has been linked to oligospermia (low sperm production) in males.
  • Other conditions that could lead to infertility in males are- 
    • prostatitis, orchitis, seminal vesiculitis, and urethritis by interfering with the development of sperm cells.
    • Acute medical conditions like – Anesthetic application, surgery, hunger, myocardial infarction, hepatic coma, brain injury, stroke, respiratory failure, congestive heart failure, infection, and burns are all linked to gonadotropin (male sex hormone) suppression, and can negatively impact reproduction in males.
    • Cancers and their treatments- chemotherapy and radiotherapy are known to be a cause.
    • Excessive alcohol intake, cigarettes and marijuana smoking, chronic use of steroids, emotional stress, exposure to excessive heat, and some medications are have been implicated in male reproductive failure.

Accessing Care:

male infertility

The management of male infertility starts from proper history taking and examination from both the gynecologist and urologist. The predominant caregiver is based on the likely cause of the infertility.

Several Investigations are usually carried out by the management teams in order to make accurate diagnosis and pin point the management plan required. 


Management of male infertility could be 

  • Medical care 
  • Surgical care
  • Dietary management and 
  • Lifestyle modification involving.

To get help with fertility issues, we recommend a gynecologist visit. Depending on the underlying cause, treatment options range from medical therapy or surgical procedures to complex assisted reproduction techniques for optimizing sperm production and transportation. It is now possible to have a child with as few as one viable sperm and one viable egg, thanks to technological advancements.

References

https://emedicine.medscape.com/article/436829-overview

https://www.ncbi.nlm.nih.gov/books/NBK562258/