Understanding Male Infertility: Causes and Solutions

Grace Fertility

Authored & Verified by:

Dr. Reubina Singh

MS (OB/GYN), MBBS - Senior Infertility Specialist

Male infertility is a common condition among couples attempting to conceive and accounts for approximately 50% of all infertility cases. Male infertility can have several underlying causes, including but not limited to structural problems, genetic factors, lifestyle habits, and environmental exposures. In this guide, we will discuss some of the most common causes of male infertility as well as solutions to increase your chances of fertility.

What is Male Infertility?

Male infertility is when the male reproductive system is unable to produce enough healthy, mobile sperm that can fertilize an egg. The ideal sperm count is an adequate quantity of well-formed sperm that has good motility. If there is a disruption at any step in this process, a person may become infertile.

Factors That Can Cause Infertility in Men

This is primarily due to four causes of male infertility and how this impacts fertility:

Varicocele: Most Common Cause of Male Infertility

What is a Varicocele?
Varicocele is swelling of the veins within the scrotum and is one of the most common causes of male infertility. Scrotal veins transport blood away from the testicles and toward the body. If the valves in these veins don’t work correctly, blood can become stagnant and create swelling that increases the temperature in the scrotum. This raised temperature can impact hormone levels and reduce sperm production and quality.

Symptoms and Treatment:

Symptoms may include pain, swelling of the testicles, or an obvious twisted vein in the scrotum.
Varicoceles can usually be surgically treated with a minor operation known as varicocelectomy, which can return blood flow to normal and possibly increase sperm production.

Azoospermia: No Sperm in a Man’s Semen

What is Azoospermia?
Azoospermia means that there is no measurable amount of sperm in the semen. This condition can occur due to blockages in the reproductive tract or problems with sperm production. If there’s a blockage, sperm are created but not able to travel to the semen due to a barrier. It can occur due to genetic factors, congenital anomalies, inflammation, cysts, trauma, or injury. Azoospermia may also be caused by testicular conditions or hormonal disorders that decrease sperm production.

Symptoms and Treatment:

Azoospermia usually does not cause symptoms and is often found during fertility testing.
Management strategies may involve surgical procedures to clear obstructions, hormone replacement therapy to reestablish equilibrium, or assisted reproductive methods, such as in vitro fertilization (IVF) using retrieved sperm.

What Role Do Environmental Factors Play in Male Infertility?

Some environmental exposures can compromise sperm quality and production. Long-term exposure to pesticides, chemicals, radiation, or excessive heat can damage sperm production or the shape and movement of sperm.

Lifestyle Factors Affecting Sperm Health:

Drinking alcohol on a regular basis, smoking, and using drugs (including marijuana) can all negatively affect sperm health. Alcohol, for example, can reduce testosterone levels, which are necessary for sperm production.

Strategies to Mitigate Environmental Influences:

Minimize exposure to harmful substances such as pesticides and radiation.
Avoid high-heat environments (e.g., saunas).
Smoking cessation, reducing alcohol consumption, and avoiding recreational drugs may also improve sperm quality and production.

Genetic Conditions: Genetic Causes of Infertility

Which Genetic Disorders Cause Male Infertility?
Many genetic disorders of male fertility are due to mutations in the genetic coding — much like a glitch in a computer program. These disorders may affect sperm production, structure, or other components of reproductive function.

Key Genetic Disorders:

Klinefelter Syndrome: A genetic condition in which individuals assigned male at birth have an additional X chromosome, affecting testicular growth and leading to lower sperm production.
Kallmann Syndrome: A rare condition that may result in a lack of puberty and inadequate hormone production necessary for producing sperm.

Treatment and Management:

While genetic disorders may not be curable, individuals with genetic infertility may sometimes father biological children using hormone replacement therapies or assisted reproductive techniques, such as intracytoplasmic sperm injection (ICSI).

Other Contributing Factors

Male infertility can also be caused by hormonal abnormalities (like low testosterone), sexual dysfunctions, infections, and prior medical treatments (like chemotherapy). Treating underlying factors often involves a holistic reproductive health approach, lifestyle modifications, and medical or assisted reproductive treatments.

Enhancing Fertility: What You Should Do

If you’re struggling with fertility, here are a few practical things you can do to help increase your chances of conceiving:

Have a Complete Assessment:

A fertility specialist will run checks on your semen and hormones, as well as potentially perform genetic screening, to find out if there is an underlying issue.

Think About Lifestyle Changes:

Eating a balanced diet, exercising regularly, smoking and drinking less, and managing stress can promote general reproductive health.

Manage Existing Health Conditions:

If you have a medical condition that impacts fertility (such as diabetes, obesity, or thyroid imbalance), managing it adequately will enhance fertility outcomes.

Limit Environmental Exposure:

Minimizing exposure to environmental toxins, radiation, and high temperatures can safeguard sperm health.

Seek Support and Counseling:

Managing infertility can be emotionally straining. Counseling and support groups can assist in managing stress and providing emotional support throughout the fertility journey.

Frequently Asked Questions about Male Infertility

Can Male Infertility Be Reversed?
Most causes of male infertility, such as lifestyle problems or varicoceles, can be treated and improved with the right treatments. Genetic conditions are generally irreversible, but reproductive technologies can assist with the conception process.

How Does Age Affect Male Fertility?
Even though men produce sperm throughout their lives, sperm quality diminishes with age. With advancing age, sperm motility decreases, and the chances of DNA mutations in sperm increase, which can affect fertility.

Is Male Infertility a Permanent Condition?
Not always. Temporary factors such as stress, an unhealthy diet, or heat exposure can often be reversed through lifestyle changes. Medical treatments or assisted reproductive techniques may offer options for more permanent conditions.

Final Thoughts

It can be overwhelming to visit a doctor and discuss your situation, but many people have successfully had children despite infertility challenges. Discovering the cause of infertility and diagnosing the reason behind it is the surest way to find effective solutions. If men are experiencing infertility, there is hope: working closely with fertility specialists and making healthy lifestyle choices can increase a man’s chances of being able to father a child.