Male infertility is a condition among men that lowers the chances of their partner getting pregnant. In other words, they cannot conceive a child even after having regular unprotected sexual intercourse.

According to several studies in about one-third of the cases, the problem is with the man. It is an issue that is growing among couples trying to conceive. 

As per WHO guidelines, an ideal sperm count is close to 40 million per sample of semen. Anything lower is unusual and implies male infertility. However, most cases of male infertility can be fixed using fertility treatments. 

Male infertility is often due to low sperm production, blockages that stop sperm delivery or abnormal sperm function.

Most men are not comfortable talking about this subject and the studies prove that only 20% of the men among couples who are struggling to conceive make infertility-related visits to a doctor.

What Causes Male Infertility?

Illnesses, chronic health problems, lifestyle choices, and injuries are some factors that play a role in triggering male infertility. Here is a list of some of the major causes of male fertility : 

1. Retrograde ejaculation:

When the muscles and nerves in your bladder do not close during orgasm, the semen may go backward. This condition is known as retrograde ejaculation.

2. Immunologic infertility:

There are instances when a man produces antibodies that attack his own sperm. These antibodies keep sperm from working properly, making it hard for sperms to enter the fallopian tube.

3. Environmental conditions:

Overexposure to toxic environmental conditions can impact male fertility. For instance, exposure to industrial chemicals, heavy metals, radiation, and heat can lower sperm production. 

4. Alcohol and drugs:

Consuming excessive alcohol and recreational drugs are some of the major reasons for low sperm count.

For instance, marijuana, anabolic steroids, cocaine, tobacco, and other prohibited drugs will reduce the quality and number of sperms.

Moreover, disproportionate alcohol consumption leads to erectile dysfunction.

5. Sperm disorders:

The primary reason for male infertility is sperm disorder. In this condition, the body struggles to produce enough sperms.

Some common sperm disorders include oddly shaped sperm, where the sperms do not move in the right direction and are partially developed.

6. Medical causes:

There are many functional factors that have a negative impact on sperm delivery and production.

One such factor is the swelling of veins that drain the testicle and lower sperm quality. Other factors include tumor blockages, infections, hormonal imbalances, and chromosomal defects.

However, you must note that these factors are treatable, or they do not restrict the ability to retrieve sperm for use with assisted reproductive techniques.

Diagnosis of Male Infertility

Male infertility is often diagnosed by carrying out a semen analysis. In this comparatively simple test, the man provides a sample of his semen to a lab for assessment.

The lab utilizes this sample to gauge the semen amount and the number of sperm to assess sperm movement and shape.

Often basic semen analysis is enough to diagnose male infertility. However, further testing might include the following:

1) Hormone testing:

Pituitary gland hormones, testicles, and hypothalamus play a major role in sperm production and sexual development.

Malformations in other organs or hormonal systems may lead to infertility. A blood test measures the level of hormones and testosterone.

2) Testicular biopsy:

Samples are removed from the testicle with a needle in this procedure. If the results show routine sperm production, the problem may likely be a result of a blockage or another problem with sperm transport.

3) Post-ejaculatory urinalysis to check for retrograde ejaculation:

Sperm in urine indicates that your sperms are moving back into the bladder instead of the penis at the time of ejaculation.

4) Ultrasound:

High-frequency sound waves are used to generate images in your body.

An ultrasound can help the doctor see if there are any problems in the testicles and supporting structure. Genetic karyotyping might also be carried out if a recurrent miscarriage is an issue.

5) Specialized semen analysis:

A sample of your semen is sent to a lab to evaluate the number of sperm present and check for any abnormalities in the shape and movement of the sperm.

6) A general physical examination by a urologist:

This involves an analysis of the genitals and informal queries about chronic health problems, inherited conditions, illnesses, injuries or surgeries that may affect fertility.

Treatment for Male Infertility

Often, the cause of infertility is hard to identify, but your doctor might recommend procedures or treatments that may lead to conception. The commonly available treatments for male infertility are as follows:

1. Assisted Reproductive Technology (ART):

ART treatments involve acquiring sperm through surgical extraction, donors, normal ejaculation, based on your wishes and specific case.

The sperms are subsequently placed in the female genital tract to carry out intracytoplasmic sperm injection or in vitro fertilization.

2. Hormone treatments and medications:

Your doctor may suggest medications or hormone replacement in cases where infertility is due to low or high levels of hormones or issues with the way the body responds to hormones.

3. Treatments for sexual intercourse problems:

Counselling or medication can help enhance fertility for conditions such as premature ejaculation or erectile dysfunction.

4. Treating infections:

Antibiotic treatment can cure the illness of the reproductive tract but may not always restore fertility.

5. Surgery: 

In the instances where sperms are not present in the ejaculate, they can be taken directly from the epididymis or testicles using sperm-retrieval techniques.

Speak to your fertility specialist about the steps you can take to improve the chances of generating healthy sperms. If you are having trouble conceiving, consult a fertility specialist.

There are several other options available that include making lifestyle changes. A fertility specialist will assess your sperm count and other factors that will help you in planning your future.