Causes of Male Infertility
When it comes to conceiving, most couples don’t realise that men are equally likely to experience infertility problems as women. Or ‘firing blanks’ as the football team may ‘sympathetically’ express the condition.
However, ‘Infertile’ can be a hard label to deal with. In reality it sounds a lot harsher than it really `is, because the cause of male infertility can often be treated. Despite this, it’s probably not the first topic of conversation you’ll embark on at your local pub tonight. It’s important to remember though, that being infertile can be simply a temporary state. But what is the cause of male infertility? Let’s take a look.
Male Infertility Investigated: Problems with Sperm
Not having healthy sperm, or not enough of them, is the leading cause of male infertility. They need to be physically up to scratch, with a DNA-filled head and a tail that will propel them all the way to the egg. Sperm should be able to navigate though the cervical mucus, into the womb and up the fallopian tubes to the egg. Sounds messy I know but someone’s got to do it!
Azoospermia, a relatively common condition as it effects around 20% of infertile men. Essentially it means not having a level of sperm significant enough to measure. It is treatable, often with ICSI. You can find detailed information in our azoospermia article on the topic. Azoospermia should not be confused with Aspermia, which is the complete lack of semen (we’re not referring to the nautical variety here). This is thankfully a very rare condition.
Sperm health will be one of the first things a doctor will assess as a potential cause of a man’s infertility. Sperm can have motility problems or be unusually shaped, caused by an inherited defect, hormone imbalances, or physical damage to the groin area. Almost brings a tear to your eye doesn’t it. Lifestyle factors and certain drugs can also be a cause of male infertility, which we’ll talk about later.
When low sperm count is the cause of male infertility, doctors regularly prescribe drugs to boost production with a 25 per cent success rate. IVF (in-vitro fertilisation) would be the next step. This may involve taking sperm samples and injecting them directly into the egg – intracytoplasmic sperm injection (ICSI). ICSI is often the cure for male infertility. 15 per cent of women become pregnant on the first attempt. Using donor sperm for artificial insemination has a success rate of 5-20 per cent on each cycle.
Blocked sperm pathways
Tiny tubes – the vas deferens, or epididymis – carry sperm from the testicles, much like tube trains in the London underground. A common cause of male infertility is when they become blocked, commonly caused by dilated or varicose veins. Some sexually transmitted diseases, including chlamydia or gonorrhoea, have been linked to this, or men can be born without these tubes. Another cause of male infertility is that these dilated veins may also slow blood flow and increase temperature, making it harder to produce sperm. (Again, very much like the tubes on the London underground!) Many men don’t even realise this is happening.
If a man is diagnosed with this cause of male infertility, it can often be resolved with surgery and statistically, 40 per cent are able to impregnate their partner within a year. 80% even enjoy the experience…….we’re only teasing!. Other experts recommend moving straight to artificial methods of conception, such as IVF
Aother cause of male infertility is hypospadias, where sperm exit from the underside of the penis rather than the end. Sperm is delivered lower into the vagina and therefore may not make the exhausting swim up to the egg. Some men are born this way and this cause of male infertility can be corrected with surgery or ICSI.
Problems with glands
The seminal vesicles and the prostate produce a slightly alkaline sugar and zinc-rich liquid to push the sperm out of the penis and energise them for the long swim ahead. With ejaculate, it’s all about quality, not quantity. Don’t panic, less than a teaspoonful is typical. Yes that was a ’teaspoon’ not ‘tablespoon’.
Prostatitis is when the prostate gland becomes inflamed. It’s a fairly common cause of male infertility and up to 50 per cent of men will experience this at some point. As the area becomes inflamed and infected, it can damage sperm. Men may notice increased urination, pain or aching. This reason for infertility in men can be treated by a specialist.
It often comes as a surprise that one cause of male infertility is men being allergic to their own sperm. This means that the immune system attacks the sperm as if they are foreign intruders, producing antibodies against them in the same way as it would for bacteria or viruses. You see, it is always useful avoid arguments with the neighbours. A less common cause of male infertility, it affects less than 10 per cent of men. Opinion is divided on the best way to deal with this cause of male infertility. Sperm washing and ICSI are popular. Some doctors will prescribe immunosuppressive drugs – a more controversial option, as they weaken the immune system.
Erectile dysfunction is a leading cause of male infertility and one that is often linked to emotional issues rather than physical ones. Stress and pressure to perform can cause testosterone levels to fall and confidence can be important. A demand to perform on the spot at the specific time of ovulation is actually no small task for any man. Medical issues such as diabetes can also cause erectile dysfunction. Viagra may work but it’s worth considering whether this cause of infertility runs deeper.
Male Infertility Caused by Lifestyle and Behaviour
Although they may not be able to hear it as well as women, men’s biological clocks tick too. Men generally continue producing sperm throughout their lives but as they age, hormone levels change, sperm production drops and abnormalities increase, all of which can be a cause of male infertility. So we shouldn’t always believe those tales you hear about Charlie Chaplin. Medical conditions and subsequent treatment may also be a cause of male infertility. Broadly speaking, men over the age of 35 will have a lower chance of conceiving than when they were younger. Over the age of 40, these odds reduce further. Sorry there’s no gentle way of putting it – ‘you’re getting on buddy’!
At last, here’s the good news: Having regular sex is important to keep sperm healthy and to improve the odds of conception. Abstaining from sex will mean that sperm will die off before it is released from the testicles, and this build-up of dead cells will release toxins that damage the newly developing sperm – contributing cause of male infertility. So sperm should always be refreshed at least three days before trying to conceive…… if you know what I mean.
Having a healthy diet incorporating more fruit and vegetables is important. Eating too much protein can cause ejaculate to be less alkaline, meaning it won’t make it through the acids in the vagina. And if you don’t eat breakfast your body’s metabolism won’t kick-start properly and it will try to save energy. At this point, making sperm isn’t a priority. Somewhat like, letting your shaving routine go at the weekend. Not great if you want to impress the mother-in-law.
Keeping an eye on the scales is also important, as developing diabetes can be a cause of male infertility. But equally don’t pump those muscles too much and divert testosterone from the testicles.
Smoking can affect the count, motility and shape of sperm, but it also damages sperm DNA and passes on a risk of cancer to your child. For the same reason, recreational drugs, caffeine and alcohol are also a cause of male infertility and MUST be avoided.
Dealing with male infertility
As summarised here, any cause of male infertility can most often be resolved either by simple surgery, fertility drugs, IVF & ICSI. IVF treatment often needs multiple cycles to succeed and any couple embarking on this procedure should try to look at it as a process, not a one-off event. Read more about this in our articles on ICSI and IVF.
Whatever is causing your male infertility, the reality is that most couples require two treatments or more before a successful pregnancy. The important thing is to remember that you’re NOT alone. This can be a stressful and expensive time but at InterTrust Fertility, we strive to guide you through it, making the process as comfortable and affordable as possible.
Topic: Male Infertility