Male causes of infertility

Male causes of infertility are usually poor sperm quality.

Poor sperm quality can be caused by:

  • Lacking sperm production in the testicles
  • Non-descended testicles
  • Infections
  • Fewer
  • Testicle cancer
  • Antibodies in the sperm cells


Lacking sperm production in the testicles

Lacking sperm production in the testicles is the most frequent cause of poor sperm quality. Usually the man has no symptoms of his poor sperm quality, besides from being infertile. On closer examination we often notice that the testicles are somewhat smaller than normal in these men, and that the superior sex hormone FSH has an increased level. If you have a too low FSH level, a series of hormone injections will restore the sperm quality.

We do not know any treatment that will restore a normal production of sperm cells when the harm is done. We know very little about why some men have a poor sperm quality. One theory is that the man has a defect in the Y-chromosome; another theory is factors in the environment.

If you work with for instance crop sprays or heavy metals this can affect your sperm quality. If you work within such areas and you have a poor sperm quality, it is advisable to avoid crop sprays and heavy metals.


Non-descended testicles

If boy children’s testicles are not descended to the scrotum at birth, these boys run the risk of having poor sperm quality later in life. This condition should be treated as early as possible, because the more years the testicles have been exposed to an increased temperature, the bigger the chance of poor sperm quality.


Infections

Infections like chlamydia or gonorrhoea can result in a stop of the passage for the sperm cells in the epididymis or the sperm duct. Mumps in grown-up men can lead to sterility because the sperm producing tissue is destroyed. In some cases the sterility can be solved through an operation or through extraction of the sperm cells directly from the epididymis or from the testicle.


Fever

Even shorter periods of high fever can reduce the sperm quality in men for up to three months. Similarly, very long and frequent visits to a sauna can reduce the quantity of sperm cells because of the effect of the heat.


Testicle cancer

Men with testicle cancer will often have, or get, reduced sperm quality after irradiation or chemotherapy. For some it will only be for a period of time, whereas other men never will restore their sperm quality. It is therefore important that men with testicle cancer carefully consider having sperm cells frozen prior to irradiation or chemotherapy.


Antibodies in the sperm cells

Some men produce antibodies in the semen, which makes the sperm cells clot. We do not always know why the man produces antibodies, in some cases it is because the man has been sterilised and the sperm ducts have been cut. If you have been sterilised and want to have the sperm ducts restored, some men will remain infertile, as antibodies against the sperm cells have been produced during the period of sterilisation.


About the treatments availeble

There are various forms of treatment, depending on how poor the man’s sperm quality is. At moderately reduced sperm quality insemination (IUI) is often used. At reduced sperm quality in vitro fertilisation is used. At very reduced sperm quality Micro insemination (ICSI) can be used. If there are no sperm cells in the man’s semen, the sperm cells can be extracted directly from the epididymis – this procedure is called TESA.

Finally, some couples choose to make use of sperm donation.


Here you can read more about the treatments:

 

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