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MALE INFERTILITY: CAUSES & MANAGEMENT

Introduction

Male infertility refers to the inability of a couple to achieve conception after one year of unprotected sexual intercourse. Studies have shown that 40% of infertility is caused by man. The semen is the milky fluid, which is released from a man’s penis during orgasm. It consists of sperm and fluid. Most causes of infertility in men are due to sperm issues.

Causes

Infertility in men can have numerous causes but with the right help, a couple can still achieve conception. The patient’s medical history will first be reviewed by a fertility doctor to see what is the cause of the problem. Causes of poor sperm quality include:

  • Sperm abnormalities: low sperm count, poor sperm motility or abnormally shaped sperm can reduce the ability of the sperm to fertilize an egg. W.H.O. ranges for average sperm count is 15 million sperm cells per milliliter of ejaculate or 39 million in the entire sample (1.5 - 6ml average volume).

  • Hormonal causes: if you have a condition, which has lowered your luteinizing hormone (LH) or FSH levels, this can result in low or no sperm production and low testosterone levels. This can be corrected by lifestyle modifications e.g., regular exercise of at least 30 mins daily, getting enough sleep 6 – 8 hours, and taking the right supplements (antioxidants).

  • Age: men above 40 years of age tend to have reduced testosterone level, which leads to poor semen quality and subsequent fertility issues or delay in achieving conception,

  • Anatomical issues: any trauma, illness or infection and subsequent treatment, including surgery may have blocked either the testes, the vas deferens (tube through which the semen is delivered) or other primary structures within the male anatomy can cause infertility.

  • Smoking/alcohol consumption: can cause low sperm count or low motility.

  • Steroid consumption: has a negative effect on the testes and can prevent production of testosterone (male sex hormone) leading to disruption of the spermatogenesis (sperm production) process.

  • Excess weight: being obese (more than 30kg/m2) can reduce the male body’s ability to produce testosterone or it can convert it to oestrogen, which will adversely affect sperm production leading to low sperm count, low motility, and malformed sperm cells.

  • Retrograde ejaculation: this refers to when the semen produced is being discharged backwards into the bladder.