What Is Male Infertility?
Infertility is defined as the "inability to conceive after at least one year of having regular unprotected sex."
Many things can cause infertility in men. Illness, disease, injury, obstruction in the tubes of the testes, diet, weight and activity levels are only some of the causes of male infertility. Common causes of infertility are low sperm count (oligospermia), dysfunctional or immobile sperm, and impaired sperm delivery. Men can be born with some of these conditions, or they can develop them later in life.
To achieve its goal, sperm must have three things going for it: quantity, quality and motility.
Quantity - Low Sperm Count
Oligospermia, or low sperm count, is the primary cause of male infertility. Many sperm are killed by normal vaginal secretions or lost during their journey to the fallopian tubes. A man who begins with a lower than normal sperm count may find he has an infertility problem.
You're most likely to be fertile if you have more than 20 million sperm per milliliter of semen.
Some of causes believed to impact low sperm count are:
Age - Evidence is growing that it may be a factor. Fertilization rates are usually over 60% for men under 39 but for those over that age, the rates fell to slightly over half.
Emotional Stress - Stress may interfere with hormones involved in male fertility and thus reduce sperm count.
Testicular Overheating - Overheating (such as from high fever, saunas, and hot tubs) may temporarily lower sperm count. Some researches suggest that taking saunas and hot baths can cause overly high temperatures in the scrotal sac, an effect that may hinder sperm production for months.
Substance Abuse - Cocaine or heavy marijuana use appears to temporarily reduce the number and quality of sperm by as much as 50%.
Smoking - Smoking impairs sperm count, sperm motility, reduces sperm lifespan, and may cause genetic changes that affect the offspring.
Nutrition Deficiencies - Deficiencies in certain nutrients, such as vitamin C, selenium, zinc, and folate, may be particular risk factors for low sperm count in such cases.
Environmental - Over exposure to environmental assaults (toxins, chemicals, infections) can reduce sperm count either by direct effects on testicular function or on the hormone systems, although the extent of the effect and specific environmental assaults involved are often controversial. Some chemicals that affect sperm production men are : Oxygen-Free Radicals, Estrogen emulation pesticidal chemicals (DDT, aldrin, dieldrin, PCPs, dioxins, and furans ), plastic softening chemicals like Phthalates, hydrocarbons (ethylbenzene, benzene, toluene, and xylene)
Quality - It's not enough just to have enough
Researchers are finding that having healthy sperm (the quality) may be just as important as the total amount of sperm you produce. Of the millions of sperm in the ejaculated semen, only about 200 actually reach the egg in a woman's fallopian tube. But, just one is needed to fertilize the egg.
Sperm shape and structure (morphology) are equally important. You are most likely to be fertile if more than one third of your sperm are of normal shape and structure. A normal sperm has an oval head and a long tail that propel it forward. Sperm with large, small, tapered or crooked heads or kinky, curled or double tails are less likely to fertilize an egg.
Motility - Your sperm have to move
Riding the semen wave will only take the sperm so far. To reach the egg, sperm have to move on their own — wriggling and swimming the last few inches to reach and penetrate the egg. Sperm movement (motility) is an important characteristic of healthy sperm. You're most likely to be fertile if at least half of your sperm are moving.
When determining the cause of infertility in a couple, the man and woman should be examined. The procedures for examining male infertility are generally simple and non-invasive. Your doctor will check for sperm production, irregularities in the testes, and hormonal imbalances among other possible causes. A semen analysis will tell if the ejaculate has adequate seminal fluid to allow for sperm movement. The sperm will be checked for number of sperm, the shape and structure of the sperm, mobility, seminal fluid and total volume or amount of ejaculate.
If there is no sperm present in the seminal fluid, then it is termed azoospermia. This can be caused by a malformation in the testes or a possible obstruction in one of the ducts necessary to deliver the sperm effectively into the ejaculate. If sperm is present in the fluid, then it will be tested for abnormalities. If a significant number of sperm are abnormal, then they can be a cause for infertility. Your infertility specialist may wish to perform a sperm-mucus interaction test. This test will determine if the sperm are able to live within and move through cervical mucus and thus, through the female reproductive system.
Your doctor may also wish to conduct a sperm penetration assay. This will determine your sperm’s ability to latch on and penetrate an egg’s outer layer. Infection, disease and illness will be looked for. These things can affect your testosterone and sperm production.
About half of all male infertility cases can be treated through assisted reproduction. Your infertility specialist will determine which treatments will be best for you depending on your situation.