Infertility in Men refers to any health problem that makes it more difficult for a man’s female partner to conceive. When the female spouse is known to be fertile, male infertility is utilized to categorize infertility.

When a woman’s egg is fertilized by a man’s sperm, new life is born. The ejaculate must include around 20 million sperm per milliliter (ml), with enough mobility and strength to swim the distance to the fallopian tube, where conception occurs.

With unprotected sex, about 13 out of 100 couples are unable to conceive. Infertility affects both men and women for a variety of reasons. More than a third of infertility cases have a male factor. Most of the time, this is due to issues with his sperm production or delivery.

Symptoms of Infertility in Men

If your female spouse has not become pregnant after a year of trying, you may have male infertility. There could be no other visible symptoms or indicators.

However, in other situations, signs and symptoms are caused by an underlying problem such as an inherited ailment, hormonal imbalance, dilated veins around the testicle, or a condition that prevents sperm from passing through. You may notice the following signs and symptoms:

• Issues with sexual function, such as difficulties ejaculating or ejaculating tiny amounts of fluid, decreased sexual desire, or problems maintaining an erection (erectile dysfunction)
• Swelling, pain, or a lump in the testicle
• Respiratory illnesses that recur
• Inability to smell • Breast growth that is abnormal (gynecomastia)
• A lower than normal sperm count (less than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate) or other indicators of a chromosomal or hormonal problem

Causes of Infertility in Men

Several factors influence natural male reproduction. The following events must occur in order for your spouse to become pregnant:

• Healthy sperm must be produced.
• Sperm must be transported into the sperm.
• There must be sufficient sperm in the sperm.
• Sperm must be able to migrate and be functional.

If you have issues with one of these, you may be experiencing infertility. Some of the most common reasons for male infertility are listed below.

Sperm abnormalities: Male infertility is most commonly caused by issues in producing healthy sperm. Sperm that is immature, irregularly shaped, or unable to swim are all possibilities. You may not have enough sperm in various instances. Alternatively, you might not be able to produce any sperm. Many various illnesses might cause this difficulty, including infections and inflammatory conditions. Infection with the mumps virus after puberty is one case.

Medical causes: Problems with male fertility can be caused by a number of health issues and medical treatments such as; Varicocele, Infections, Ejaculation issues, Tumors, Antibodies that attack sperm, Hormone imbalances, etc.

Environmental causes: Overexposure to certain environmental elements such as heat, toxins, and chemicals can reduce sperm production or sperm function. Specific causes include Industrial chemicals, Heavy metal exposure, Radiation or X-rays, and Overheating of the testicles.

Health, lifestyle, and other causes: Some other causes of male infertility include: Drug use, Alcohol use, Tobacco smoking, and Weight.

Risk factors

Risk factors tied to infertility in men include:

• Smoking tobacco
• Using alcohol
• Using certain illicit drugs
• Being overweight
• Having certain past or present infections
• Being exposed to toxins
• Overheating the testicles
• Having experienced trauma to the testicles
• Having a prior vasectomy or major abdominal or pelvic surgery
• Having a history of undescended testicles
• Being born with a fertility disorder or having a blood relative with a fertility disorder
• Having certain medical conditions, including tumors and chronic illnesses, such as sickle cell disease
• Taking certain medications or undergoing medical treatments, such as surgery or radiation used for treating cancer.

Diagnosis of Infertility in Men

Male fertility issues might be difficult to diagnose. Your doctor will usually conduct a semen analysis or a blood test to assess your hormone levels in order to figure out what’s causing your infertility. The most common issues are with sperm production or delivery. A complete medical history and physical examination are required to make a diagnosis. Blood testing and sperm tests may also be recommended by your doctor.

In order to investigate possible infertility, both the man and his partner must undergo tests. The following tests may be used to diagnose male infertility:

• Physical examination and medical history: Examining your genitals and asking questions about any genetic disorders, chronic health problems, illnesses, injuries, or operations that may impair fertility are all part of this process. Your doctor may also inquire about your sexual activities and how you developed sexually during adolescence
• Semen analysis: Samples of sperm can be collected in a variety of methods. By masturbating and ejaculating into a designated container at the doctor’s office, you can submit a sample. Some males prefer an alternative technique of sperm collecting due to religious or cultural beliefs. In such instances, semen can be collected during intercourse by using a specific condom.

Your sperm is then transported to a laboratory to be counted and checked for any abnormalities in the shape (morphology) or movement (motility) of the sperm. The lab will also examine your sperm for signs of infection or other issues.

Sperm counts might vary dramatically from one specimen to the next. To achieve accurate results, many semen analysis tests are usually performed over a period of time. If your sperm analysis is normal, your doctor will most likely recommend that you test your female companion thoroughly before doing any more male infertility tests.

• Hormonal Profile: Your hormones may be tested by your doctor. This test will determine how successfully your testicles produce sperm. It can also be used to rule out major health issues. Follicle-stimulating hormone (FSH), for example, is a pituitary hormone that instructs the testicles to produce sperm. High levels could indicate that your pituitary gland is attempting but failing, to get your testicles to produce sperm.
• Testicular biopsy: A testicular biopsy may be required if a sperm test shows a very low amount of sperm or no sperm. This procedure can be performed under general or local anesthetic. In the scrotum, a tiny cut is made. It can also be performed in a clinic with the use of a needle inserted into the numbed scrotal skin. A little bit of tissue from each testicle is extracted and examined under a microscope in each situation. The biopsy is used for two purposes. It can assist in determining the cause of infertility and collect sperm for assisted reproduction (such as in vitro fertilization; IVF).

• Ultrasound scans: In your rectum, a small, lubricated wand is inserted. It enables your doctor to examine your prostate for obstructions in the channels that transport sperm.

Prevention

Male infertility isn’t always preventable. However, to help improve your fertility, do these:

• Don’t smoke.
• Limit or abstain from alcohol.
• Steer clear of illicit drugs.
• Maintain a healthy weight.
• Don’t get a vasectomy.
• Avoid things that lead to prolonged heat for the testicles.
• Reduce stress.
• Avoid exposure to pesticides, heavy metals, and other toxins.

Treatment

In many cases, the exact cause of infertility cannot be determined. Even if the exact cause is unknown, your doctor may be able to suggest medications or procedures that will help you become pregnant.

In cases of infertility, it’s also a good idea to investigate the female spouse. It’s possible that your companion will require special attention. Alternatively, you may discover that using assisted reproductive procedures is the best option for you.

Treatments for male infertility include:

• Surgery. A varicocele, for example, or an obstructed vas deferens can often be surgically rectified. Vasectomies that have already been performed can be reversed. When there are no sperm in the ejaculate, sperm retrieval procedures can often be used to obtain sperm directly from the testicles or epididymis.
• Treating infections. Antibiotic treatment may cure a reproductive tract infection, but it does not necessarily restore fertility.
• Treatments for sexual intercourse problems. In diseases like erectile dysfunction or premature ejaculation, medication or counseling can help improve fertility.
• Hormone treatments and medications. In cases when infertility is caused by high or low levels of specific hormones, or difficulties with the way the body processes hormones, your doctor may offer hormone replacement or drugs.
• Assisted reproductive technology (ART). Depending on your personal condition and needs, ART treatments may include collecting sperm by natural ejaculation, surgical extraction, or donor persons. The sperm are then either injected into the female vaginal tract or used in in vitro fertilization or intracytoplasmic sperm injection procedures.