The Truth Behind Male Infertility

When we speak about infertility, what’s the first thought that comes to our mind? Do we still assume it could be a woman’s problem? But, isn’t the sperm as important as an egg when it comes to conception? Evidence suggests that, 9% of couples struggle with fertility problems worldwide, out of which male infertility accounts for 50% of the issues.¹

Despite this fact, in some communities, a woman is blamed for infertility. Discrimination, social exclusion, and abandonment are a few consequences they have to face. But, we all know that it takes two to make a baby, don’t we?^2,3      

So, as a couple, if you are being treated for infertility, knowing the right diagnosis and treatment can be helpful.⁴

“The first step toward change is awareness. The second step is acceptance”

- Nathaniel Branden

In this article, we will discuss the causes of male infertility, diagnosis and treatment options, as well as some tips to improve your sperm health.

Understanding Male Infertility: Causes, Diagnosis, And Treatment

One of the main infertility symptoms is the inability to conceive after one year of unprotected sex. And, when it comes to evaluating male infertility, it usually starts with a complete look at an individual’s medical, sexual, and personal history that include:⁵

• Family history
• History of significant trauma on the pelvis
• Reproductive history
• Occupation
• Alcohol intake
• Smoking habits
• History of previous chemo/radiotherapy
• Surgical history 
• Previous exposure to toxic chemicals
• Sexually Transmitted Infections (STIs) ⁵ 

Problems with male fertility can be due to a combination of various factors such as hormonal, physical, genetics, or environmental.⁶ We will now learn about them in detail:

Causes Of Male Infertility

Hormonal Defects

The hypothalamic-pituitary-gonadal network needs to work in coordination to provide the right concentration of hormones for normal testicular function in males. This network is made up of:^6,7 

• Gonadotropin-releasing hormone (GnRH) secreted from the hypothalamus i.e. a part of your brain
• Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) produced by the pituitary gland i.e. located at the base of your brain
• Testosterone produced by the gonads

These hormones are required for optimal development and functioning of the male reproductive system. Any dysfunction in the process of hormone secretion can lead to infertility in men. Hence, a hormonal evaluation is one of the many important parameters in assessing male infertility.^6,7

Physical Reasons

Disturbed sperm production and blocked ejaculatory path have been observed to affect male fertility. ⁶ And, this could be due to the following reasons:

1. Varicocele (when veins inside the scrotum become enlarged) affects about 40% of men who are facing infertility issues.⁶ 
2. Testicular torsion (when a testicle rotates and twists the spermatic cord) can cause testicular damage due to the pressure on sperm vessels.⁶ 
3. Chronic and acute genital tract infections can also lead to infertility in men.⁶
4. Sexually Transmitted Diseases (STDs) such as chlamydia and gonorrhea can also cause male infertility problems. This is often a result of an obstruction in the epididymis (a tube that stores and carries sperm).⁶

Environmental Factors

Environmental factors such as exposure to radiation or solvents hamper sperm production and affect fertility. Occupations that need prolonged sitting or exposure to high temperatures can also negatively affect male fertility. Additionally, excessive intake of saturated fats and high glycemic index foods can also be one of the triggers for male infertility.^6,9

Genetic Factors

Research suggests that genetic factors are the reasons for 15% of male infertility cases and can be classified as chromosomal abnormalities (a disorder or alteration in chromosomes) or single-gene mutations (DNA changes in a specific gene). Absence or unusual rearrangement of genetic material at the chromosomal level can cause infertility in men.⁶

Cancer And Cancer Treatments

Men diagnosed with cancer or undergoing cancer treatments are concerned about their ability to have a child. This is because cancer therapies such as chemotherapy and radiation therapy can impair fertility.¹⁰

Diagnosis And Tests For Male Infertility

Semen analysis is a simple test that assesses sperm concentration, motility, volume, count and morphology. The following are some of the main factors that help in evaluating sperm health: 

• Quantity - At least 16 million or more sperm every milliliter (ml) of semen is required in the quantity ¹²
• Movement - The sperms need to wriggle and swim. Hence, we need strong swimmers for you to be fertile
• Structure - A healthy sperm has an oval head and strong long tail

Furthermore, here are the lower reference limits of semen parameters according to the World Health Organization (WHO) based on which sperm analysis is done:¹²

• Sperm volume = 1.4 ml to 6.2 ml
• Sperm concentration = 16 million to 208 million
• Total sperm count = 39 million to 701 million per ejaculate
• Sperm vitality = 54% to 97%
• Progressive motility = 30% to 77%
• Non-progressive motility = 1% to 32%
• Total motility = 42% to 90%
• Immotile sperm = 20% to 58%
• Normal shaped sperm = 4% to 39%

There are also some other additional tests recommended to determine specific factors affecting male fertility. They include:

Hormonal Tests

If there is any abnormality in the hormone secretion process by the hypothalamic-pituitary-gonadal network, it may lead to male infertility. In such cases, hormonal tests might be recommended for men who have a low sperm count or concentration. Serum Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), prolactin, and testosterone are the hormones that may be evaluated to determine male infertility.^5,6

DNA Integrity Test

A DNA integrity test is recommended for those who have experienced recurrent miscarriages. This test helps to assess the degree of sperm DNA fragmentation (where sperm quality is measured) in the provided sample.⁵

Genetic Testing

There is also an increased chance for  sperm concentration to be affected as a result of  underlying genetic causes. In such instances, genetic testing might be recommended for males with severe oligozoospermia (< 5 million sperm/ml) or azoospermia (absence of spermatozoa in the ejaculate).⁵

Treatment Options For Male Infertility

Depending on the cause of male infertility, appropriate treatment options may be suggested such as - 

Medications

Some issues related to male infertility like hormonal imbalances or erectile dysfunction can be treated through recommended antibiotic treatments.¹³ 

Surgery

To improve male fertility, surgical treatments can be helpful in repairing the damage to male reproductive organs. Surgery can be effective to treat varicocele (enlargement of the veins within the scrotum) and also if there is a blockage in tubes that transport sperm affecting the fertility potential. ¹³

Assisted Reproductive Technology (ART)

ART such as In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI) might be helpful if other treatment options are not able to restore fertility in males.^5,13

Now that we’ve explored the causes, diagnosis, and treatment options, 

let us see ways to improve your sperm health.

Ways To Improve Your Sperm Health: Diet & Nutrition

 Nutritional intervention is an important parameter in the treatment of male infertility. It can both negatively and positively affect the quality of semen.⁹  

Improper dietary patterns such as skipping meals and insufficient intake of antioxidants have been observed in infertile men. So, it is advisable to consume a balanced diet that consists of:⁹

• Fish and seafood
• Lots of fruits and vegetables
• More nuts and seeds
• Low-fat dairy products
• Olive and canola oil

Additionally, there are also a few lifestyle changes recommended to help with infertility such as: avoiding hot baths and tight-fitting clothes, limiting alcohol intake, and managing stress.⁵

LifeCell Wishes To Support You In Your Parenthood Journey

Dealing with infertility could be challenging, but being informed and aware of your fertility potential can help. Focus on yourself, understand the cause of male infertility and decide the next step. 

So, are you ready to give your fertility journey a positive kickstart? Then visit any nearby laboratory to test your semen or order an at-home test kit! Among all the at-home test kits, LifeCell’s SpermScore test kit is one of a kind. That’s because it tests for 11 sperm health parameters and 14 sperm health conditions.