What causes male infertility?
The leading causes of male fertility are:
Low quality sperm
If you have a low sperm count, sperm with reduced motility, or sperm abnormalities, this can lead to male infertility. Essentially, your sperm needs to be healthy enough to move properly, it needs to be able to reach an egg, and there needs to be enough of it. Each of these factors can contribute to infertility if your sperm is low quality.
Problems with your testicles
Infection, injuries and medical conditions can all cause male infertility.
Side effects of medications and drugs
Certain medications and drugs have side effects that can affect your sperm health and fertility levels. These can include:
- testosterone replacement therapy
- long-term anabolic steroid use
- cancer medications (chemotherapy)
- certain ulcer treatments
- arthritis medication
If you are trying to conceive and you are concerned about a medication you are taking affecting your fertility levels, you should discuss this with your doctor.
If you are struggling to ejaculate or have problems with ejaculation, this can affect your fertility as you are less likely for your sperm to reach an egg for fertilisation. Retrograde ejaculation can cause infertility as this is when your semen enters your bladder instead of coming out of your penis. Health conditions that can cause this include diabetes, spinal injuries, and prostate, bladder and urethra surgery.
If you have ED and you are unable to get an erection that's hard enough to have sex, you are less likely to be able to conceive as you are not able to have penetrative sex. Because of this, ED isn't a direct cause of infertility, but it does make it a lot more challenging to conceive.
This is the most common but reversible cause of male infertility. It is a condition that causes swelling in the veins that drain your testicles. It's not known why this condition causes infertility, but it's thought to be related to abnormal blood flow. The condition can also lower your sperm count and quality.
Certain infections affect sperm health and production. These can also lead to scarring that can cause blockages for sperm. While some infections can cause permanent damage to your testicles, it's usually still possible to remove and store most of your sperm for future use.
Immune system cells can mistakenly identify sperm as something harmful to the body and produce antibodies to attack them.
Tumours can affect your reproductive organs as they affect how your body releases hormones. Often cancer treatments can also affect male fertility.
This is a condition you can develop before birth, where your testicles don't drop below your abdomen. People with this condition are usually less fertile.
Hormonal problems can have many underlying causes, and it's often hard to identify them. If you do have a hormonal imbalance, it can lead to reduced fertility as certain hormones are needed for better sperm health and quality, amongst other things that are necessary to conceive.
Sperm are carried by many different tubes to get where they need to - if these tubes are damaged from an infection, surgery or any other condition, your sperm are less likely to be able to reach an egg to conceive.
Any blockage within your testicles is likely to make it more difficult for your sperm to get where it needs to be. If your sperm can't travel, it can't reach an egg to conceive.
Certain genetic conditions like Klinefelter's Syndrome can cause male reproductive organs to develop abnormally, causing infertility. Cystic fibrosis and Kallmann's syndrome can also cause similar problems.
Celiac disease is caused by a sensitivity to a protein called Gluten, and the condition has been linked to male infertility.
Certain surgeries can prevent you from having sperm in your ejaculate. These include but are not limited to:
- scrotal or testicular surgeries
- prostate surgeries
- large abdominal surgeries (for testicular and rectal cancers)
Drugs like anabolic steroids may cause your testicles to shrink and reduce sperm production. Drugs like cocaine and marijuana can also cause a temporary reduction in your sperm count and quality.
Alcohol can lower testosterone levels, leading to less sperm production and erectile dysfunction. Liver disease, often caused by drinking too much alcohol, can also lead to fertility issues.
People who smoke have a lower sperm count. Second-hand smoke can also reduce your sperm count.
Obesity can affect your hormones causing changes that make you less fertile. It can also reduce the quality of your sperm.
It's important to remember that there isn't always a clear-cut reason or cause for infertility, and different people's fertility levels can be affected more by some things than others. The NHS reports that around 1 in 4 causes of infertility do not have an obvious cause, meaning they couldn't find one in either partner.
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