Until recently, it was usually the women who were assumed to be the origin of any fertility issues. Most of the treatments revolved around women. However, recent studies as conducted by the International Committee for Monitoring Assisted Reproductive Technology, World Health Organization, show that nearly 50% of infertility is related to the reproductive anomalies or disorders in the male.
In couples presenting with fertility issues, in about a third (30%) of couples, subfertility/infertility is because of a low sperm count or problem in the male. In another 25%, there are fertility problems in both the male and female contributing to infertility. Hence in approximately 50% of the couples, there is a cause in the male contributing to the infertility problem. Many couples are not aware of this and hence it is important to assess both the male and female to identify the problem so that treatment can be directed towards the problem.
Semen analysis is a very simple test to assess the fertility in the male.
Here are some of the most common causes that could be related directly to infertility in men:
- Lifestyle issues such as smoking, alcohol, stress, and obesity can all have a negative influence on the sperm count.
- Hormonal imbalances too can be a cause of infertility in men.
- Tubal blockage – spermatic cord is a tube-like structure which carries sperm from the testis and their blockage could cause infertility. These blockages could be a result of – an infection-either a sexually transmitted infection or tuberculosis, surgery or a genetic/inherited condition.
- Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis or some sexually transmitted infections, including gonorrhea or HIV.
- Congenital or genetic causes such as Klinefelter’s syndrome (chromosomal abnormality) or genetic conditions related to deletion of genes from Y chromosome (male chromosome) may also give rise to male infertility.
- Long-term use of steroids or treatments for cancer can cause impairment of sperm production leading to subfertility.
- However about 40% of men with infertility present with abnormal semen analysis for idiopathic reasons and for these men no specific treatment is available and Assisted Reproductive Technologies such as IUI/IVF are the way forward.