What is male infertility?
According to the World Health Organization and the International Committee Monitoring Assisted Reproductive Technologies (ICMART), clinical infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Often, the male partner contributes to the reproductive challenges of the couple. He must be assessed and treated along with the female partner.
How common is male infertility?
About 15% to 25% of all infertility is due only to male factors – problems with sperm (as well as the woman) are often the reason in an additional 20% to 40% of cases.
Male infertility is more common in environments with high levels of environmental pollution, including water contaminants, pesticides and herbicides. Some recent population studies have shown that sperm counts have been declining universally even though infertility has not been increasing substantially.
What Causes Male Infertility?
In at least half of male infertility cases, doctors cannot identify an exact cause. For the remaining 50% of cases, infertility is either due to environmental, genetic or other factors.
Environmental Causes of Male Infertility
- Excess heat, for example due to the male’s occupation, such as truck drivers, welders, or firefighters, or habits, such as excessive use of the hot tub or tight clothing.
- Drugs, including certain antibiotics and prescription medicines, anabolic steroids, alcohol, marijuana.
- Toxicants, such as pesticides, herbicides, heavy metals, lead, mercury, or paint
- Excess exercise, including bicycling
- Chronic disease, such as anemia, malnutrition, cancer, neurological disease, or diabetes
- Dietary deficiencies, such as zinc, vitamin C, folic acid
- Varicocele, a condition in which the veins enlarge inside the scrotum
- Diseases of the male genital tract, including infection, cancer, trauma, or retrograde ejaculation
- Surgery on the male genital tract, such as for the treatment of undescended testicle, or hernia
Genetic Causes of Male Infertility
- Mutations inside the genes that determine the male sex, called the Y-chromosome
- Other irregular changes in the genes. For instance, some men have a condition called Klinefelter’s XXY syndrome in which they have an extra copy of the female-sex determining genes (the X chromosome)
- Hormonal issues, such as: diabetes, high levels of the milk-producing hormone prolactin, or problems with the hormone-producing organs like the thyroid or adrenal gland
Treatment for Male Infertility
- Avoiding damaging environmental factors, such as smoking, heat exposure, heavy exercise, toxicants, certain drugs, or excessive alcohol
- Reducing stress
- Taking medications,which include antibiotics (if an infection is suspected); fertility medications (Clomiphene, Human Chorionic Gonadotropin (hCG) or LH/FSH injections)
- Vitamins, such as folic acid, zinc, or L-carnitine
- Alternative medicine. However, certain types of herbs may be harmful. Acupuncture is generally not harmful or helpful.
- Surgery, such as reversing a vasectomy or repairing a condition called varicocele, in which the veins inside the scrotum become enlarged
- In vitro fertilization, which is usually done via a process called Intra-Cytoplasmic Sperm Injection (ICSI)
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