Men Infertility

Men Infertility

Causes of infertility or reproductive problems include disease and aging. Male infertility is as common as female infertility. Infertility or reproductive problems are often treatable with infertility drugs and high-tech procedures.

Male infertility has many causes–from hormonal imbalances, to physical problems, to psychological and/or behavioral problems. Moreover, fertility reflects a man’s “overall” health.  Men who live a healthy lifestyle are more likely to produce healthy sperm.  The following list highlights some lifestyle choices that negatively impact male fertility:-

  • Smoking–significantly decreases both sperm count and sperm cell motility.
  • Prolonged use of marijuana and other recreational drugs.
  • Chronic alcohol abuse.
  • Anabolic steroid use–causes testicular shrinkage and infertility.
  • Overly intense exercise–produces high levels of adrenal steroid hormones which cause a testosterone deficiency resulting in infertility.
  • Inadequate vitamin C and Zinc in the diet.
  • Tight underwear–increases scrotal temperature which results in decreased sperm production.
  • Exposure to environmental hazards and toxins such as pesticides, lead, paint, radiation, radioactive substances, mercury,  benzene, boron, and heavy metals
  • Malnutrition and anemia.
  • Excessive stress!

Modifying these behaviors can improve a man’s fertility and should be considered when a couple is trying to achieve pregnancy.

The most common problems for Men’s Infertility:

A small percentage of male infertility is caused by hormonal problems. The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm. Several things can go wrong with the hypothalamus-pituitary endocrine system:

  • The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly. GnRH stimulates the hormonal pathway that causes testosterone synthesis and sperm production. A disruption in GnRH release leads to a lack of testosterone and a cessation in sperm production.
  • The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone (FSH) to stimulate the testes and testosterone/sperm production. LH and FSH are intermediates in the hormonal pathway responsible for testosterone and sperm production.
  • The testes’ Leydig cells may not produce testosterone in response to LH stimulation.
  • A male may produce other hormones and chemical compounds which interfere with the sex-hormone balance.

Varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.

A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development. Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility. Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound. Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery.

Seven percent of infertile men cannot transport sperm from their testicles to out of their penis. This pathway may be blocked by a number of conditions:

  • A genetic or developmental mistake may block or cause the absence of one or both tubes (which transport the sperm from the testes to the penis).
  • Scarring from tuberculosis or some STDs may block the epididymis or tubes.
  • An elective or accidental vasectomy may interrupt tube continuity.

Several sexual problems exist that can affect male fertility. These problems are most often both psychological and physical in nature: it is difficult to separate the physiological and physical components.

Erectile Disfunction (ED):
Also known as impotence, this condition is common and affects 20 million American men. ED is the result of a single, or more commonly a combination of multiple factors. In the past, ED was thought to be the result of psychological problems, but new research indicates that 90 percent of cases are organic in nature. However, most men who suffer from ED have a secondary psychological problem that can worsen the situation like performance anxiety, guilt, and low self-esteem. Many of the common causes of impotence include: diabetes, high blood pressure, heart and vascular disease, stress, hormone problems, pelvic surgery, trauma, venous leak, and the side effects of frequently prescribed medications (i.e. Prozac and other SSRIs, Propecia). Luckily, many treatment options exist for ED depending on the cause–these will be discussed in the treatment section.

Premature Ejaculation:
Is defined as an inability to control the ejaculatory response for at least thirty seconds following penetration. Premature ejaculation becomes a fertility problem when ejaculation occurs before a man is able to fully insert his penis into his partner’s vagina. Premature ejaculation can be overcome by artificial insemination or by using a behavioral modification technique called the “squeeze technique” which desensitizes the penis.

Ejaculatory Incompetence:
This rare psychological condition prevents men from ejaculating during sexual intercourse even though they can ejaculate normally through masturbation. This condition sometimes responds well to behavioral therapy; if this technique does not work, artificial insemination can be employed using an ejaculate from masturbation.

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