Male factor infertility is very common and can be the result of many influences
Infertility affects both men and women equally. Male factor infertility accounts for 40% of all couples struggling to conceive, while female factor infertility is the cause of another 40% of cases[1]”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1240129″.
In the remaining 20% of instances, there are problems on both male and female sides. Male factor infertility can be a result of range of issues and in many cases, of a combination of influences. The main causes fall within the following categories:
Conditions causing male infertility
Sperm disorders
The most common causes of male factor infertility relate to problems associated with the production and development of sperm cells. This may include abnormal shape, poor motility or simply a low sperm count, which may be abnormally low (oligospermia) or zero (absent sperm = azoospermia).
This can be a result of a range of different factors including:
- Inflammatory conditions or infectious diseases, such as the virus that causes mumps
- (Auto-)immunological disorders, where sperm is attacked
- Pituitary, hormonal or endocrine disorders
- Lifestyle and environmental factors such as a poor diet
- Genetic disorders that are indirectly or directly related to sperm abnormalities. Conditions such as sickle cell disease, Noonan syndrome, myotonic dystrophy, and hemochromatosis can lead to testicular dysfunction and spermatozoa abnormalities. Other conditions such as cystic fibrosis, sex reversal syndrome, and other chromosomal abnormalities can cause azoospermia or oligospermia.
Primary ciliary dyskinesia (PCD)
This is a genetic disorder whereby sperm count is normal, although the sperm are non-motile. Kartagener’s syndrome is an example of this condition.
Anatomical abnormalities
Genital tract obstructions can partially or fully block seminal fluid movement and lead to infertility. The abnormalities can be congenital or caused by inflammation or infection of the urogenital tract.
Scar tissue following genital surgery can also result in blockages, as well as scrotal varicoceles.
These blockages can usually be surgically removed.
Mitochondrial deletions
The mitochondria includes a set of genes that differ from the normal chromosomes in the nucleus. Research has shown that if these genes inside the mitochondrial DNA are absent or altered, it can cause infertility[2]Kao, S. et.al. (1995). Mitochondrial deoxyribonucleic acid 4977-bp deletion is associated with diminished fertility and motility of human sperm. Biology of Reproduction, Volume 52, Issue 4, (pp. … Continue reading.
Secondary conditions
Diabetes, liver disease, and renal disease can lead to secondary infertility (the inability to conceive a second child). There are also certain medications and treatments for other medical conditions that may result in male infertility.
Erectile dysfunction can also statistically decrease conception chances.
What is idiopathic infertility?
Although there are many causes of male factor infertility, the exact cause is sometimes difficult to diagnose with certainty. This unexplained infertility is called idiopathic infertility.
Semen parameters may be abnormal, yet the cause(s) is undetermined. There may be no identifiable reproductive abnormality, yet there is failure to conceive. Approximately 30% of infertile men are classified as idiopathic.
Males with idiopathic infertility typically exhibit an unexplained decline in semen quality in relation to sperm motility, count, and morphology, despite normal endocrine function and physical examination. In many instances, making positive lifestyle adjustments can help to improve fertility.
Avoiding excessive alcohol consumption, smoking and other drugs is important. Ensuring adequate exercise and a healthy bodyweight can improve fertility. Meeting the body’s nutritional needs to support reproductive health is also particularly important.
Dr. Kooner is Deputy Director of The Advanced Fertility Center of Chicago and has been a Specialist in Fertility Treatment since 1999.
As well as the areas that the clinic specialises in general, he is particularly interested in managing oocyte donation, female same-sex couples, single women having sperm donation and those considering egg freezing.
Dr. Kooner regularly speaks at fertility meetings. He has published in national journals and constantly contributes to the fertility research and publications from Advanced Fertility Center of Chicago.
References
| ↑1 | ”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1240129″ |
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| ↑2 | Kao, S. et.al. (1995). Mitochondrial deoxyribonucleic acid 4977-bp deletion is associated with diminished fertility and motility of human sperm. Biology of Reproduction, Volume 52, Issue 4, (pp. 729-36).” |
| ↑3 | ”Nikolova, V. et.al. (2007). Sperm parameters in male idiopathic infertility after treatment with prelox. Akush Ginekol (Sofiia), Volume 4, Issue 5, (pp. 7-12).” |
