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Reproduction (or making a baby) is a simple and natural experience for most couples. However, for some couples it is very difficult to conceive. Male infertility is diagnosed when, after testing of both partners, reproductive problems have been found in the male partner.
What causes male infertility?
Male infertility can be caused by problems that affect sperm production or the sperm transport process. With the results of medical tests, the doctor may be able to find a cause of the problem.
Known causes of male infertility can be:
Sperm production problems: The most common cause of male infertility is due to a problem in the sperm production process in the testes. Low numbers of sperm are made and/or the sperm that are made do not work properly. About two thirds of infertile men have sperm production problems.
Blockage of sperm transport: Blockages (often referred to as obstructions) in the tubes leading sperm away from the testes to the penis can cause a complete lack of sperm in the ejaculated semen.
This is the second most common cause of male infertility and affects about one in every five infertile men, including men who have had a vasectomy but now wish to have more children.
Sperm antibodies: In some men, substances in the semen and/or blood called sperm antibodies can develop which can reduce sperm movement and block egg binding (where the sperm attaches to the egg) as is needed for fertilisation.
About one in every 16 infertile men has sperm antibodies.
Sexual problems: Difficulties with sexual intercourse, such as erection or ejaculation problems, can also stop couples from becoming pregnant. Sexual problems are not a common cause of infertility.
Hormonal problems: Sometimes the pituitary gland does not send the right hormonal messages to the testes. This can cause both low testosterone levels and a failure of the testes to produce sperm.
Hormonal causes are uncommon, and affect less than one in 100 infertile men. Unfortunately, medical scientists do not yet understand all the details of sperm production and the fertilisation process. As a result, for many men with a sperm production problem, the cause cannot be identified.
Treatments
When the cause of the male infertility problem can be treated, a couple can try to achieve a pregnancy naturally. Many men will still be able to father children naturally even though they may have a lowered sperm count.
Treatable causes of male infertility include:
- blockages of sperm transport (for example, vasectomy)
- hormone problems
- some sexual problems (for example, problems with getting and keeping an erection)
- some reversible conditions (for example, use of anabolic steroids).
In some cases, the doctor will recommend that the couple seek assisted reproductive technologies (such as IVF) in order to become pregnant. These techniques do not cure or treat the cause of the male infertility problem, but they may help the couple conceive even if the man’s sperm count is very low.
Male infertility is completely untreatable when a man has no sperm in his semen (azoospermia) or in the testes, because the sperm producing cells in the testes either did not develop or have been permanently destroyed. The only options for such couples who want to have a family are to think about adoption, foster parenting or donor insemination.