Infertility stands in the way of many couples seeking to start a family — age, lifestyle choices and hormonal imbalances being some of its primary contributors. When it comes to men, it is defined as their inability to get their partner pregnant even after a year of unprotected sexual intercourse. According to research, male factors — including reduced quantity or absence of sperm, varicose veins in the testes, ejaculatory issues and abnormal sperm morphology and motility — are responsible for around 30–50% of infertility cases.
Detecting the underlying cause of infertility is crucial to devising an appropriate treatment plan. Besides lifestyle modifications, surgical intervention and techniques such as in vitro fertilization (IVF) and cryopreservation of sperm can be implemented if the need arises.
Causes of infertility in men
The reasons for male infertility can be widespread; they can be broadly divided into three categories:
♦ Physiological factors
These include testicular dysfunction, urethral obstruction, erectile dysfunction, high testosterone levels, varicocele veins, STIs, UTIs and treatment for cancer.
♦ Genetic factors
Genetic disorders like Klinefelter syndrome (where a male’s born with an extra X chromosome) can lead to undescended testicles and reduced sperm production. In addition, cystic fibrosis — a condition where the tube connecting the testes and the prostate gland is either blocked or missing — can also cause fertility issues. Further, any abnormality in the Y chromosome (which is responsible for male gonad development) can also disrupt sperm production.
♦ Lifestyle factors
Stress, aging, a sedentary lifestyle, smoking and alcohol consumption can significantly contribute to male infertility. Additionally, underlying conditions resulting from a poor lifestyle, including diabetes, obesity and hypertension, can play a role in hindering sperm production.
Detecting the cause of infertility in men
To detect male factors, doctors start with an individual’s full medical history, progressing to examining the testicular size and then checking for varicose veins, infections or inflammation in the seminal passage; they also check if the seminal passage is fully developed.
Additionally, a semen analysis and blood tests are conducted to assess the testes’ ability to produce sperm. “We sometimes conduct a Doppler ultrasound of the scrotum to confirm varicocele,” says Dr Karthikeyan VS, microsurgical andrologist and urologist, Apollo Hospitals, Chennai.
“The normal sperm count ranges from 50–80 million sperm per milliliter (ml). Anything less than 50 million sperm requires medical intervention and lifestyle modifications,” notes Dr Mannan Gupta, gynecologist, Elantis Healthcare, New Delhi.
Addressing male infertility
Apart from lifestyle modifications, Dr Karthikeyan says antioxidant supplements and hormonal injections like hCG (human chorionic gonadotropin) and hMG (human menopausal gonadotropin) can help stimulate testosterone and sperm production, respectively. The primary techniques implemented to address male infertility include:
♦ Surgery
Microsurgical procedures are carried out to treat varicose veins; the goal is to seal off the affected vein to restore normal blood flow to the rest. The technique can improve sperm count and improve its quality for methods like IVF.
♦ IVF
This technique has helped many couples start families. In this method, mature eggs collected from the female are fertilized by sperm in the lab; the embryos (fertilized eggs) are then reimplanted into the uterus, says Dr Pallavi Prasad, a fertility consultant at Nova IVF Fertility Hospital, Bangalore. “Two out of 10 couples consulting me every day opt for IVF. These individuals fall in the age range of 30–40 years,” she adds.
♦ Cryopreservation
Cryopreservation is the process of freezing biological material such as cells, tissues or organs — typically below –140 °C — to maintain their viability for long periods; it’s used for fertility treatments, organ transplants and scientific research, among others. “The technique enables couples to preserve eggs, sperm or embryos. It also helps those dealing with cancer preserve their fertility,” says Dr Sneha Shetty, clinical director, chief fertility specialist & gynecologist, Vriksh Fertility, Bangalore.
♦ Psychological intervention
Men are often conditioned to show their stronger side and hide their vulnerability, especially due to the stigma associated with conditions like infertility. However, Dr Asfia Khaleel, consultant psychiatrist and director of Ummeed De-addiction and Rehab Centre, Bangalore, urges men not to overlook their mental well-being. “Such conditions can add to their emotional baggage, which can lead to addictions and affect their health. Hence, it’s imperative for men to address their emotional concerns,” she adds.
Takeaways
- Research states that male factors are responsible for 30–50% of infertility cases.
- The primary causes of male infertility include physiological issues (such as erectile dysfunction and varicose veins), genetic disorders and lifestyle factors (including stress, aging, smoking and an improper diet).
- Lifestyle modifications, including regular exercise, stress management, a balanced diet and smoking cessation, can help manage infertility.
- Techniques like IVF, cryopreservation, surgery and hormonal injections can also be implemented to address male infertility.
