A man is said to be suffering from infertility when he is unable to contribute to the conception of a child. In the United States, infertility is said to affect one in 25 men.
According to a study published in the New York Times, a staggering 90% of infertility cases in men are caused due to sperm abnormality, a condition that includes low sperm count, low quality of sperm, or both. The remaining 10% can be attributed to factors such as retrograde ejaculation, structural defects, hormonal disorders, and genetic problems.
Sperm-related problems can be caused by a variety of reasons. Apart from congenital defects and disease, it has also come to include lifestyle as one of its possible causes. One of the most common forms of sperm abnormality is the low sperm count. Low sperm count, known as ‘oligozoopermia’ in the medical parlance is when the man’s body produces a sperm count less than 20million/mL. Some men also suffer from ‘azoospermia’. In this case, the sperm cells are missing from the ejaculation. This condition alone accounts for 10-15% of infertility cases. Infertility in men is also at times, related to the poor movement of the sperm. Medical experts refer to this condition as ‘asthenospermia’. The sperm may have difficulty in getting inside the outer shell of the egg, if the sperm is not moving in a straight or is moving slowly. Such sperms are unable to fertilize the egg, leading to infertility. A case where less than 40% of the sperm count is moving in a straight line is considered problematic. In order to successfully fertilize an egg, the sperm should be shaped right. An oval head with a long tail is the normal shape of the sperm. However, more than 40% of irregularly-shaped sperms may cause infertility.
Retrograde ejaculation is another cause of infertility. In case of retrograde ejaculation, the muscles of the bladder wall do not function well during orgasm, forcing the sperm into the bladder instead of towards the urethra. Diseases such as diabetes or multiple sclerosis may lead to retrograde ejaculation. It could also be caused by surgery of the bladder, prostrate. Aging is also one of the factors leading to retrograde ejaculation.
Also, any structural defects affecting the testes can also cause infertility. There are cases where the testicles of an infant do not descend from the abdomen into the scrotum. This is known as ‘cryptorchidism’. In another structural defect caused at birth, the urinary opening may be on the underside of the penis. Such a defect prevents the semen from reaching the cervix. Referred to as ‘hypospadias’, this defect can be rectified surgically. In some men, the tube that carries sperm from the testicles to the penis may be missing. In others, there may be a blockage in the ejaculatory duct.
Hormonal deficiencies such as ‘hypogonadism’ may hamper fertility in men. Here, there is a deficiency in the gonadotropin-relasing hormone, the hormone that leads to the release of testosterone to the reproductive hormones in the male’s body.
Genetic diseases such as, polycystic kidney disease, where large cysts are formed on the kidneys may lead to infertility. This is because cysts may be formed in the reproductive tract as well. A rare disease known as Kartagener syndrome, which refers to a reversal in the positioning of the major body organs, may also cause infertility. In this case, fertility is affected due to the irregular shape of the sperm.