Male Infertility and its causes - Part 2
Hi, and welcome to the second post covering this topic.
Last time, we looked at some of the conditions that can be linked to infertility as a result of problems with the male partner rather than the woman.
Those are conditions which, if reversed, can improve fertility.
This time around, we'll look at some conditions that fundamentally cause a man to be infertile; the objective being, as usual, to increase awareness of the problem, highlight some of the symptoms and help people realise when to seek medical advice.
Causes of Infertility
In many cases, the problems with fertility will commonly be a challenge with producing sperm or transport of the sperm from where they are produced.
Other causes are related to infections, problems with libido, ejaculatory or hormonal problems,etc.
Problems with sperm production can arise from:
Chromosomal or genetic abnormalities such as occur in a condition known as Klinefelter’s syndrome, a condition where boys are born with 3 sex chromosomes instead of the usual pair of 1 X and 1 Y sex chromosome.
Every man and woman has 46 chromosomes arranged in 23 pairs.
The chromosome contains genetic material that determines what each person becomes. One chromosome from each pair is inherited from your mother, and the other chromosome from your father.
One of these 23 pairs is referred to as the sex chromosomes. In women there are 2 X sex chromosomes that make up the pair, while in men a Y chromosome must be present.
In Klinefelter's syndrome, there is an extra X chromosome and instead of XY, they have XXY.
Men with XXY have a number of physical characteristics among which are:
female type physical appearance with enlarged breasts,
female type pubic hair appearance and
a small penis and testicles - because their testes do not work properly,they are unable to have children naturally.
• Next is a condition known as Undescended Testes. During development of the male child in the womb, the testes (like ovaries in the woman) are located in the abdomen (tummy), though by the time of birth they will naturally have travelled down into the scrotal sacs. In Undescended Testes, the testes fail to descend at birth.
It is believed that if the testes remain in the abdomen i.e. undescended, rather than outside the body in the scrotum, their ability to produce sperm by the time of puberty is significantly affected.
In many cases, if it has not happened at birth, the movement of the testes will naturally occur within the first 3-6 months.
However if this has not happened by 6 months of age, treatment will usually be advised: this is because boys with untreated undescended testes can have fertility problems in later life and an increased risk of developing testicular cancer.
• Infections can affect the production of sperm.
In childhood, infection with Mumps can (rarely) lead to a swelling of the testicles that can lead to infertility.
More commonly, the infections are sexually transmitted infections like
Chlamydia – this infection can damage an important part of the testis called the epididymis which can lead to infertility; and Gonorrhoea – gonorrhoea can cause painful infection in the testicles and prostate gland, which may lead to reduced fertility in a small number of cases.
•Testicular Torsion (twisting of the testis in scrotum) - is a very painful condition but essentially the testis twists on its cord and in so doing can damage its blood vessels which will lead to damage of the epididymis that produces the sperm.
• Varicocele (varicose veins of the testes); again,in this condition, the blood supply to key parts of the testes is affected which means that they will be damaged and unable to produce sperm.
• Medicines and chemicals - Environmental chemicals can affect the sperm producing tissues in the testes which can affect their quality and quantity.
Examples can include chemicals used in agricultural and industrial industries, as research has shown. Medication such as those used in treatment of cancer can also affect the testes in a similar way.
• Radiation damage – this includes radiation for treatment of cancer, or exposure to X- rays during tests.
• Unknown cause - in some cases, the causes for failure in production is not clear.
Causes that affect Sperm Transport
In these cases the man is able to produce sperm of good quality and quantity however for some of the reasons listed below, sperm is unable to move from the production factory within the testes to the penis for ejaculation.
Infections can damage the tract through which the sperm will pass en route the penis.
Surgery like vasectomy will divide/separate the vas deferens which is the tube that allows sperm to be carried from the testis to the penis in the ejaculatory fluid (semen) and result in infertility.
The tubes that transport sperm and semen run through the prostate gland which is a small organ that sits behind the bladder in men.
Infection in the prostate gland can lead to a blockage in the route through which sperm gets to the penis. The same can arise from a change to its structure – such as occurs in Benign Prostatic Enlargement or Prostate Cancer.
Sexual Problems which lead to Male infertility also include sexually transmitted infections which have already been mentioned.
Problems with ejaculation and erection can lead to infertility, as can infrequent intercourse (which may be from physical illness or mood problems causing loss of libido or sexual desire).
Injury to the spinal cord – from trauma and accidents will damage the nerve supply to the penis and other male reproductive structures.
A complication of prostate surgery (which is one possible treatment for Prostate Cancer) is infertility as there may be injury to the nerves and other close by structures of the penis.
As you can see, there are many causes that can lead to male infertility - some are more common than others.We'll look at a few more in the next segment of this topic.
The main take-away from all this is - there is no single cure for male infertility problems. There are many claims about certain treatments that offer a cure for infertility, Diabetes and some other medical conditions thrown in for good measure.
The discussion above should help us realise that a clearer idea of the cause will lead to better chances of cure.
So, next time, we look at a few more causes of male infertility and the Sperm Report - what does it actually tell your doctor and if abnormal - what can you do??
I appreciate your comments on this topic; and if you need clarification on any of the issues addressed - please send them in through the contact details below.
Till then,stay well!
Editing by AskAwayHealth Team Disclaimer All AskAwayHealth articles are written by practising Medical Practitioners on a wide range of health care conditions to provide evidence based guidance and to help promote quality health care. The advice in our material is not meant to replace management of your specific condition by a qualified health care practitioner. To discuss your condition, please co
