Common Causes of Male Infertility

Common Causes of Male Infertility

Sterility or inability to conceive is a problem that is well-known to affect most couples who are willing to start a family. Infertility can be a result of factors that affect either of the couples, but according to different research, it is known that male infertility explains roughly half of all cases. Knowledge of the possibilities of male factor infertility is crucial in the process of treatment and increasing fertility rates. In this blog, we will look at 8 of the possible factors that can cause infertility in males and the effects that they come with. We will briefly discuss certain aspects of male fertility, such as what makes sperm watery and how to find a male infertility treatment doctor in Istanbul.

1. Varicocele A varicocele is a condition whereby the convection of blood to the veins associated with the testicle is compromised. It is considered the most frequent, untreated, and reversible factor that affects male infertility. This makes the temperature in the scrotum rise, hampering sperm development as well as their performance. Clinically significant varicoceles are reported in about 15 percent of all men and 20 percent of men with primary infertility. They are even more common in men with secondary infertility; they are detected in 15-20% of cases of the given category. Varicoceles are usually acquired during puberty and progress with time.
2. Sperm Production Problems Disorders that affect sperm production capability are also a common cause of infertility among men. This can manifest in several ways:
   • Oligospermia / Azoospermia: Absence of sperm count or absence in the semen sample. This occurs in about 1% of the male population and in 10-15% of male infertility cases.
   • Oligospermia: A low number of sperm in the ejaculate. Sperm concentrations lower than 15 million per milliliter are considered reduced.
   • Asthenozoospermia: Spermatozoa demonstrate poor progressive forward movement. At least 32% of infertile men receive this diagnosis.
   • Teratozoospermia: A high number of abnormally shaped sperm present in the semen. This occurs in approximately 10% of the infertile male population.

Factors leading to low sperm production include genetic factors, hormonal imbalances, varicoceles, infections, problems with ejaculation, and exposure to toxins or radiation. Often, no specific reason can be identified for the condition.

3. Ejaculation Problems Another common cause of male infertility is erectile dysfunction, through which a man is unable to ejaculate. These include:
   • Retrograde ejaculation: Semen goes into the bladder instead of coming out through the penis. This may be a result of diabetes, surgery, medications, or spinal cord injuries.
   • Anejaculation: No ejaculation occurs at all. Causes include spinal cord injury, certain drugs, or surgical removal of lymph nodes for testicular cancer.

Erectile dysfunction hinders semen from being placed into a woman’s reproductive system, making natural conception impossible. Some of these problems are treatable with medical intervention.

4. Hypogonadism Testosterone and other male sex hormone reduction are termed hypogonadism. This condition can induce testicular failure and a low rate of sperm production. Primary hypogonadism results from testicular failure, Klinefelter syndrome, failed testicular descent, and testicular trauma or infection. Secondary hypogonadism results from a defect in the hypothalamus or pituitary gland affecting testosterone synthesis. Symptoms include weakness, low sexual drive, infertility, and more. Management includes hormone replacement or drugs to encourage spermatogenesis.
5. Genetic Defects Certain genetic defects and chromosomal abnormalities can lead to male infertility. These include:
   • Klinefelter syndrome: An extra X chromosome causing incomplete male sexual development and small, firm testicles. It affects about 1 in 500 to 1,000 men.
   • Cystic fibrosis: A genetic disorder causing congenital absence of the vas deferens. It affects about 1 in 3,000 men.
   • Y chromosome microdeletions: Missing genes on the Y chromosome critical for sperm production, accounting for 5-10% of severe oligospermia or azoospermia cases.
   • Autosomal translocations: Rearrangements of chromosomes other than sex chromosomes, occurring in 0.6% of infertile men.

Genetic testing can help identify these underlying causes. Assisted reproductive technologies like IVF with intracytoplasmic sperm injection (ICSI) may be used to achieve pregnancy.

6. Immunologic Infertility Sometimes a man’s own body develops antibodies that attack sperm, making it unable to penetrate an egg. This is known as antisperm antibodies and is present in approximately 10% of infertile men. Factors include vasectomy, testicular torsion, testicular biopsy, prostatitis, or testicular carcinoma. While having antisperm antibodies doesn’t automatically render someone infertile, it can affect sperm quality and motility. Therapeutic approaches are limited, but IVF with ICSI may help.
7. Medications and Drugs Certain medications and drugs can negatively impact male fertility:
   • Chemotherapy and radiation therapy for cancer
   • Anabolic steroids used for bodybuilding
   • Testosterone replacement therapy
   • Some blood pressure medications
   • Certain antidepressants
   • Alcohol and illicit drugs like marijuana and cocaine

The effects of these substances on fertility can range from temporary to permanent. Discontinuing the medication or drug may help restore fertility in some cases.

8. Environmental and Lifestyle Factors Environmental and lifestyle factors can also contribute to male infertility:
   • Exposure to toxins like pesticides, lead, or heavy metals
   • Excessive heat exposure to the testicles from hot tubs, laptops on the lap, or tight underwear
   • Obesity
   • Smoking cigarettes
   • Excessive alcohol consumption
   • High stress levels

While less severe than medical causes, these factors can negatively affect sperm production and function. Lifestyle changes to reduce exposure and improve health may help boost fertility.

What Causes Watery Sperm?

Watery or thin sperm is common and often not a cause for concern. Causes include:

• Infrequent ejaculation: Long periods without ejaculation can make seminal fluid more watery.
• Medications: Some medications like antidepressants, blood pressure drugs, and antibiotics can affect semen quality.
• Retrograde ejaculation: Semen entering the bladder instead of emerging through the penis can cause watery semen.
• Infection: Infections in the prostate, seminal vesicles, or testicles may cause watery, discolored semen.
• Varicocele: Enlarged veins can impair semen quality, making it appear watery.
• Stress: High stress levels can temporarily affect semen consistency and volume.

In most cases, watery sperm is not a sign of infertility. However, if accompanied by pain, swelling, or difficulty urinating, consult a doctor to rule out an underlying condition.

Male Infertility Treatment Doctor in Istanbul

If you’re experiencing fertility issues, it’s important to see a male infertility treatment doctor who specializes in diagnosing and treating male reproductive problems. Here are a few tips for finding the right doctor in Istanbul:

• Look for a urologist or andrologist like Dr. Cem İpek who has specific training and experience in male infertility. Many urologists have additional subspecialty training in male reproductive medicine.
• Ask about the doctor’s success rates with different fertility treatments. Reputable doctors should provide data on pregnancy rates with procedures like IVF, ICSI, and varicocele repair.
• Consider the doctor’s communication style and whether you feel comfortable discussing sensitive topics related to sexual and reproductive health. A good doctor should make you feel at ease.
• Make sure the doctor’s clinic is equipped with the latest diagnostic tools and treatment technologies for male infertility. This may include semen analysis, hormonal testing, genetic testing, and minimally invasive surgical procedures.
• Ask if the doctor works closely with a team of fertility specialists, including reproductive endocrinologists, embryologists, and nurses. Coordinated care is important for successful outcomes.

Finding a doctor you trust and feel comfortable with is essential. Don’t hesitate to get a second opinion if you have any concerns. With the right treatment from an experienced specialist, many men with infertility can achieve their goal of starting a family.

Does Hernia Affect Male Fertility?

Hernias are common and involve an organ or fat developing a bulge in the muscle or connective tissue. Hernias themselves do not cause infertility; however, depending on the type and location, they could pose a threat to fertility.

The main ways a hernia may impact male fertility include:

• Testicular torsion: Characterized by a twist of the testicle due to an inguinal hernia, cutting off blood supply. This is a medical emergency requiring immediate treatment to avoid testicular damage and impotence.
• Varicocele: Men with inguinal hernias are more likely to have varicocele, a common cause of male infertility.
• Postoperative risks: Surgery for hernia repair could affect the vas deferens or blood supply to the testicles, impacting fertility.
• Psychological factors: Painful hernias can cause anxiety and stress, affecting sexual activity and fertility.

Most hernias don’t lead to infertility. However, proper treatment, often minimally invasive surgical repair, usually alleviates fertility issues. Men with hernias planning to father a child should consult with their urologist or andrologist.

Conclusion

Male infertility is multifactorial, with various causes such as varicocele, sperm production disorders, ejaculation problems, genetic abnormalities, and environmental factors. Understanding these causes helps in appropriate treatment. For those facing fertility problems, consulting a male infertility treatment doctor in Istanbul is recommended. With proper diagnosis and management, many men can achieve their desire for a family. Remember, male infertility is a common issue affecting an estimated 70 million men worldwide.