An Overview: Infertility In Men

The recent pandemic has taught us many lessons. But the most important one, perhaps, is that a disease or disorder, if neglected or ignored for way too long, spares none!

On the other hand, as the world continues to inch closer to gender equality, men and women have also started to relook at their priorities. Therefore, even men have begun to postpone their fatherhood plans for the future. However, the flipside is that they are unaware of male infertility issues that can plague them in future. This, coupled with low quality of life, stress over job deadlines, or harmful food habits, has already begun to negatively impact health on a deeper level^1,2,3. Not surprisingly then, a rise in infertility has also peaked in the last few years due to such lifestyle changes⁴. 

So, what is male infertility? When a man cannot help his healthy (fertile) partner conceive a baby even after practising unprotected sex for one year, then there’s a high chance that he has issues related to male infertility⁵. 

Also, a study suggests that males have about 50% of overall contribution to infertility in couples⁵.

What Is Infertility? 

Infertility is a disease that affects both males and females, wherein the reproductive system fails to reproduce (depending on the specific sexual health issue which may vary)⁶. Having said that, infertility in men is usually treatable except for some extremely rare cases⁷. 

Causes And Symptoms Of Infertility In Men

Causes 

Numerous causes can lead to infertility in men, major of which are listed below^8,9- 

• Absence or low number of sperms in semen
• Abnormal sperm, such as abnormal shape or movement of the sperm⁶
• Age
• Blockage or obstruction of the sperm passage
• Certain medications
• Chemotherapy or radiation for cancer treatments
• Consumption of tobacco and alcohol
• Exposure to environmental toxins
• Exposure to high heat
• Genetic diseases
• Hormonal imbalance
• Impotence (problems with having an erection)
• Obesity 
• Past surgeries
• Retrograde ejaculation (when semen goes back into the bladder)
• Smoking
• Trauma to testes¹⁰
• Varicoceles¹⁰ 
• Vasectomy or failed vasectomy surgery 

However, “sperm disorders” is yet another factor that causes infertility in men. Sperm disorders are the problems that affect an individual’s capability to produce healthy sperms. Furthermore, it also inhibits the growth of sperm cells, and negatively impacts the quality of sperm¹¹.

Now let’s discuss about 2 sperm disorders: 

• Azoospermia - It is a condition in which the ejaculate (semen) doesn’t consist of sperm. This disorder could arise due to hormonal problems, issues with testis, ejaculation difficulties and reproductive tract blockage¹². 

• Oligospermia - It’s a condition wherein the sperm count of an individual is very low (less than 15 million sperm in 1mL of semen)¹³. 

Symptoms

The most apparent symptom of infertility in men is that an individual is unable to have a child with his sexually fit partner. However, in some rare cases, an underlying condition like twisted and enlarged veins around testicles, hormonal imbalance, etc. can also cause similar symptoms (related to infertility)⁷.

Following are some warning signs to look out for⁷:

• Abnormal growth of breasts
• Inflammation or unfamiliar mass growth in the testicular area
• Decreased facial or body hair
• Abnormal sexual function, such as erectile dysfunction (difficulty in maintaining an erection), less libido (reduced sexual drive), little to no ejaculation

Reasons To Visit A Doctor

If you and your partner have been trying to conceive for an year (by engaging in unprotected sexual intercourse¹⁴) but have been unsuccessful, you both should consult a specialist. Also, if any of you are experiencing above mentioned symptoms, it could be a potential sign of an underlying reproductive condition.

Diagnosis 

Generally, a doctor, based on symptoms, recommends a series of assessments. Which are inclusive of⁷-

• Medical History And Physical Examination: In this assessment, the doctor examines the genitals and asks a list of questions. These questions involve medical history, past-surgeries, medications, illnesses, injuries, inherited health conditions, etc. They may also enquire about one’s sexual life. 
• Semen Analysis: As per WHO, the parameters for semen analysis includes the quality and quantity check of both the semen and sperm, which is done by analysing following:¹⁵
  - The volume of the semen
  - The total number of sperms in the semen
  - The number of sperm found per millilitres of semen
  - Morphology (shape or structure) of the sperm
  - Motility of the sperm
  - Presence or absence of white blood cells (if the semen has white blood cells then it could be a sign of infection)

The results of semen analysis may fluctuate. Therefore, the doctor can ask for multiple “semen analysis” tests to get coherent results⁷.

Treatment 

The treatment for infertility in men highly depends on the condition an individual may have. Though it is always advisable to the couple to get their respective reproductive health thoroughly checked. 

Some of the treatment options that have been widely used are⁷-

• Hormone therapy - If infertility is related to hormone production in the body, the doctor may suggest certain medications that will increase hormone levels. 
• Treatment for sexual problems - Appropriate medication and assisted counselling have proven to aid with conditions like erectile dysfunction and premature ejaculation.  
• Treatment of infections - Studies indicate that infections can lead to infertility in many cases¹⁶. Therefore, treating these infections can help with short-term sterility but cannot restore fertility in everyone. 
• Surgery - Many times, an impairment of varicocele (the vein that takes deoxygenated or poor oxygen blood away from the testicle) can be fixed by surgery. Surgery can also help with obstruction at vas deferens (a tube that delivers sperm to the urethra). 
• Assistive reproductive technology - Depending on your reproductive health , ART treatments may involve acquiring sperm by regular ejaculation, surgical extraction, or from donors. This technology consists of in vitro fertilization (when egg and sperm are fused under laboratory conditions), and artificial insemination (when the sperm is surgically inserted into a woman's genital tract).

Conclusion

Planning for a family is an exciting yet crucial step; therefore, it is important to take all the precautionary measures. LifeCell’s SpermScore test allows you to get a comprehensive sperm analysis in just one go. The test lets you know about your reproductive health and helps determine any underlying condition, if any, which in turn could be affecting your fertility.