MEDICAL CAUSES OF MALE INFERTILITY

Epilepsy

Antiepileptic drugs may affect libido and sperm count in some men.

Mumps

If you contracted mumps after puberty or as an adult, you may have developed orchitis, or testicular inflammation, and this may have affected your ability to produce sperm.

Diabetes

This can cause erectile problems.

High blood pressure

Men with high blood pressure find it more difficult to get an erection.  In addition, certain drugs called calcium channel blockers which are used to treat this condition may impair the sperm’s ability to fertilize the egg.

Surgery, for example to repair an inguinal hernia

This can accidentally block the vas deferens and there can be resulting damage to the blood-testis barrier, which means that blood and testicular tissue come into contact.  This can then impact on sperm production.

Vasectomy reversal

A vasectomy reversal is not always successful and is not recommended after 5 years.  In addition, some men produce antibodies to the sperm following a vasectomy and these attack the sperm even after reversal.

Some sexually transmitted infections, such as chlamydia and gonorrhoea

These can cause conditions such as prostatitis, urethritis and epididymitis.  As a result, ducts such as the urethra, vas deferens or epididymis can become inflamed and subsequently get blocked, resulting in irreversible damage to a man’s fertility.

Varicocele

This is a condition that is similar to varicose veins and affects the testicular area.  It can affect sperm production as a result of reduced blood flow to the affected testicle.

Certain (rare) chromosomal abnormalities

These can cause infertility, either because they result in congenital problems (such as absence of vas deferens, which is associated with cystic fibrosis) or because there is an absence of sperm (azoospermia).  This latter condition may be caused, for example by Sertoli-cell-only syndrome or by Klinefelter’s syndrome (both of which result in the ability to produce sperm).

Retrograde ejaculation

Instead of being propelled through the urethra and out of the penis, the sperm is pushes back into the bladder.  Surgery can now be used to recover this sperm and, using assisted conception, fertilization of an egg can still take place.

Sporting injury

In a contact sport such as rugby or football, a bad accident involving a kick to the groin area can damage the testes’ ability to produce sperm.

Torsion or twisting of the testis

If the spermatic cord from which the testis is suspended in the scrotum becomes twisted then the blood supply to the testis can be cut off, causing severe pain.  The condition is potentially serious and, if it is not treated immediately, may result in permanent damage to the testis, thereby affecting production of sperm.  However, fertility should not be affected as the remaining testis is able to produce sufficient sperm.

{West Z, “Plan to get pregnant – 10 steps to maximum fertility”, Dorling Kindersley Ltd, 2008, 52-53}

Poor sperm production

Low FSH hampers sperm production.  Sperm needs testerone to mature, but modern lifestyles and stress interfere with consistent levels of testosterone needed to sustain 70 days worth of sperm production. 

Post-production damage to sperm

Healthy sperm may be damaged post-production by oxidation, infection, alcohol, acidity, high blood sugar levels and smoking.  Coffee, high sugar intake, red meat and beer also interfere with enzymatic and nutritive support of the prostatic fluid, which the sperm need to make the journey through the uterus to the fallopian tubes.

Age

Stress

Exposing the testes to high temperatures, which can affect the ability of

the sperm to move and to fertilize an egg.  For instance :

• Cryptorchism is a condition where the testes do not descend into the scrotum.  Although it does not usually affect the ability to have and sustain an erection, cryptorchism means that the testes are still inside the body cavity, which has a higher temperature than the external scrotum.

• Tight underwear – For some men, wearing tight underwear can also increase the temperature of the testes.

• Smoking, drugs and alcohol.

• Medications.

• Environmental toxins.

• Genetic syndrome such as Klinefelter syndrome;

• Other health problems.