Male Infertility

Sperm Disorders

The most common problems are with making and growing sperm. Sperm may:

• not grow fully
• be oddly shaped
• not move the right way
• be made in very low numbers (oligospermia)
• not be made at all (azoospermia)

Sperm problems can be from traits you’re born with. Lifestyle choices can lower sperm numbers. Smoking, drinking alcohol and taking certain drugs can lower sperm numbers. Other causes of low sperm numbers include long-term sickness (such as kidney failure), childhood infections (such as mumps) and chromosome or hormone problems (such as low testosterone).

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Damage to the reproductive system can cause low or no sperm. Some men with total lack of sperm (azoospermia) have an obstruction (blockage) within the tubes the sperm travel through. A birth defect or a problem such as an infection can cause a blockage.

Varicoceles

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Varicoceles are swollen veins in the scrotum. They are more common in infertile men. They harm sperm growth by blocking proper blood drainage. It may be that varicoceles cause blood to flow back into your scrotum from your belly. The testicles are then too warm for making sperm. This can cause low sperm numbers.

Retrograde Ejaculation

Retrograde ejaculation is when semen goes backwards in the body. They go into your bladder instead of out the penis. This happens when nerves and muscles in your bladder don’t close during orgasm (climax). Semen may have normal sperm, but the semen does not come out of the penis, so it cannot reach the vagina.

Retrograde ejaculation can be caused by surgery, drugs or health problems of the nervous system. Signs are cloudy urine after ejaculation and less fluid or “dry” ejaculation.

Immunologic Infertility

Sometimes a man’s body makes antibodies that attack his own sperm. Antibodies are most often made because of injury, surgery or infection. They keep sperm from moving and working normally. It is not yet known exactly how antibodies lower fertility. Antibodies can make it hard for sperm to swim to the fallopian tube and enter an egg. This is not a common cause of male infertility.

Obstruction

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Sometimes the tubes through which sperm travel can be blocked. Repeated infections, surgery (such as vasectomy), swelling or developmental defects can cause blockage. Any part of the male reproductive tract can be blocked. With a blockage, sperm from the testicles can’t leave the body during ejaculation.

Hormones

Hormones made by the pituitary gland tell the testicles to make sperm. Very low hormone levels cause poor sperm growth.

Chromosomes

Sperm carry half of the DNA to the egg. Changes in the number and structure of chromosomes can affect fertility. For example, the male Y chromosome may be missing parts.

Medications

Certain drugs can change sperm production, function and delivery. These drugs are most often given to treat health problems like:

• arthritis
• depression
• digestive problems
• anxiety or depression
• infections
• high blood pressure
• cancer

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