Causes of infertility

Age

Healthy men in their 70s and beyond can still father children however the time taken to cause a pregnancy is longer from middle-age onward. The potential reasons for this include a decrease in sexual activity, semen volume, sperm motility (movement), the total number of motile sperm and possibly sperm

function and DNA quality.

Obstructive problems

Blockage in a sperm-carrying tubes due to –

– Groin surgery (including hernia repair and fixation of undescended testicles).

– Trauma to the scrotum sack covering the testicles (even fairly minor sporting injuries).

– Infection (particularly chlamydia, gonorrhoea and tuberculosis).

– Previous vasectomy (a form of contraception that involves tying the sperm-carrying tubes).

Congenital problems

– Absence of the vas deferens on one or both sides. (The vas deferens is the tube that conducts the testicular component of semen to the urethra, which then carries semen through the penis to the outside world.)

– Absence of seminal vesicles (where other semen components are made)

Other obstructive cause

– Berry-Perkins-Young syndrome, in which sufferers have a chronic chest disease (bronchiectasis), chronic sinusitis and obstructive infertility.

Testicular injury and disease

– A blow to the testicles, which may occur in sport or during a fight, can cause swelling of the testicles, or bleeding in or around them. This probably causes the blood supply to the testicles to fail, resulting in permanent damage to the sperm production mechanism.

– Torsion of the testicles (twisting of a testicle on its cord) can have a similar effect if it is not treated very quickly with surgery.

– Viral infections can cause inflammation of the testicles (orchitis, which usually appears as painful swelling of the testicles) and failure of sperm production.

– Mumps affect fertility if it causes orchitis.

– Undescended testicles (cryptorchidism) may lead to failure of sperm production.

Varicocele

Varicocele is dilation of the testicular veins in the spermatic cord that leads from the testicles to the abdomen. Varicocele may be either one sided or occurs both sides, but more common on the left.

Varicocele either heats up the testicles or impairs their blood supply thus affecting fertility. The co-existence of other risk factors, such as smoking, with varicocele seems to have a greater effect on the risk of infertility.

Sperm disorders

– Azoospermia

Absence of sperms, In case of azoospermia homoeopathic treatment is highly hopeful.

– Oligospermia

Meager number of sperms.

– Astheno sperm

Sperms with feeble mobility. This may be sometimes due to the dilated and tortuous condition of the veins of the testis- varicocele. This can be managed very well with homoeopathic medicines by evading surgery.

– Teratospermia

Structural malformations of the sperms.

Genetic disorders

– Chromosome disorders

Can affect their fertility in various ways:

– affect the development of the testicles.

– Klinefelter’s syndrome

In this disorder, instead of having 46 chromosomes, including one X and one Y chromosome (46XY), the man has an additional X chromosome (47XXY).

– can disrupt cell division and sperm production.

Problems with erection and ejaculation

– Erectile dysfunction (inability to attain or maintain an erection adequate for intercourse)

– Premature ejaculation

– Failure to ejaculate

– Inability to achieve vaginal penetration

Hormonal problems

– Testosterone deficiency

It can reduce fertility and may be caused by problems with testicular testosterone production, or problems with the pituitary gland or hypothalamus in the brain, which control testosterone production.

– Overproduction of prolactin (hyperprolactinaemia),

A hormone produced by the pituitary gland, may also reduce fertility.

General medical disorders that reduce fertility

There are several conditions that may reduce fertility:

– Fever

Influenza (flu), pneumonia, or even a severe cold can cause a high fever, which will adversely affect sperm production and quality. These changes usually recover over a few weeks.

– Diabetes

It can cause problems with erection and ejaculation through causing damage to the function of the ‘automatic nervous system’.

– High blood pressure

Hypertension (high blood pressure) can cause problems with erection, either directly or as a side effect of medication.

– Coronary artery disease

Coronary artery disease can cause problems with erection. This could be due to generalized hardening of the arteries, in the penis as well as the heart, or to drugs used in the treatment of heart problems.

– Neurological disorders

Multiple sclerosis, stroke, and spinal cord injury and disease can all cause problems with erection and ejaculation.

– Kidney disease

Chronic renal failure, which results in a build up of waste products in the body, can adversely affect sperm quality and fertility. It can also cause erection problems.

– Cancer

Cancers that affect the genital tract or endocrine (hormone-producing) systems may directly reduce fertility. Otherwise, drugs and radiation used to treat cancer may severely reduce sperm production or even stop it altogether. Stress (see below) may also have an effect.

– Alcoholism

Alcohol is toxic to sperm and overuse of alcohol can reduce sperm quality and fertility.

– Stress

Stress causes several hormonal changes in the body that can affect fertility. Stress can have many causes, including anxiety over fertility problems.

– Bad habits

Alcohol – Reduces sperm count and quality

Tobacco – May reduce sperm motility

Marijuana – affects hormone production

Opiates (heroin, morphine) – Affects hormone production

– Medicine

Anabolic steroids – Affect hormone production

Amiodarone – Inflammation of the testicles and epididymis (epididymo-orchitis) leading to problems with sperm production

Cancer chemotherapies – May severely reduce sperm count, quality and motility. Effects may be permanent

Colchicines – May severely reduce sperm count

Digoxin – Affects hormone production Heart failure

Erythromycin – May reduce sperm count

Gentamicin – Reduces sperm count

Hormonal therapies – May disrupt other hormone production

Ketoconazole – Reduces sperm count

Methotrexate – Reduces sperm count

Nitrofurantoin – Reduces sperm count

Phenytoin – Reduces sperm quality and motility

Spironolactone – Affects hormone production

Sulphasalazine – Reduces sperm count and quality

– Environmental toxins and radiation

Environmental toxins that may affect fertility

Alkylphenols, Dioxins, Organochlorine pesticides (Lindane, DDT) etc.

Signs or symptoms of male infertility

In most cases, there are no obvious signs of an infertility problem.

Intercourse, erections and ejaculation will usually happen without difficulty. The quantity and appearance of the ejaculated semen generally appears normal to the naked eye.