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Male Infertility

Reasons For Male Infertility

Reasons For Male Infertility

Male Infertility causes Infertility tends to be thought of as a female problem but, in fact, only 30% cases can be traced back to the woman. In another 30%, the problem lies with the man. Both partners may be responsible in yet another 30% while 'unexplained infertility' - where no reason can be found - accounts for the rest (10%).

A number of causes exist for male infertility that may result in impaired sperm count or mobility, or impaired ability to fertilize the egg. The most common causes of male infertility include abnormal sperm production or function, impaired delivery of sperm, conditions related to a man's general health and lifestyle, and overexposure to certain environmental elements.

Abnormal sperm production or function

More than 90 percent of male infertility cases are due to sperm abnormalities, such as:

Impaired shape and movement of sperm
Sperm must be properly shaped and able to move rapidly and accurately toward the egg for fertilization to occur. If the shape and structure (morphology) of the sperm is abnormal or the movement (motility) is impaired, sperm may not be able to reach the egg.
Absent sperm production in testicles
Complete failure of the testicles to produce sperm is rare, affecting less than 5 percent of infertile men.
Low sperm concentration
A sperm count of 20 million per milliliter of semen or fewer indicates low sperm concentration (sub fertility).
Varicocele
Male infertility causes Varicocele is a varicose vein in the scrotum that may prevent normal cooling of the testicle and raise testicular temperature, preventing sperm from surviving. It is the most common surgically correctable abnormality noted in the infertile male population, occurring in up to 33% of them. All men with a varicocele will not be infertile, but some varicocele may be associated with defects in sperm concentration, motility or morphology. At this point in time, microsurgical varicocele ligation gives the best results. Improvement in semen quality following varicocele repair occurs in 50% to 80% of men.
Undescended testicle (cryptorchidism)
This occurs when one or both testicles fail to descend from the abdomen into the scrotum during fetal development. Undescended testicles can cause mild to severely impaired sperm production. Because the testicles are exposed to the higher degree of internal body heat, sperm production may be affected.
Testosterone deficiency (male hypogonadism)
Infertility can result from disorders of the testicles themselves, or an abnormality affecting the hypothalamus or pituitary glands in the brain that produce the hormones that control the testicles.
Klinefelter's syndrome
In this disorder of the sex chromosomes, a man has two X chromosomes and one Y chromosome instead of one X and one Y. This causes abnormal development of the testicles, resulting in low or absent sperm production. Testosterone production also may be lower.
Infections
Infection may temporarily affect sperm motility. Repeated bouts of sexually transmitted diseases (STDs), such as chlamydia and gonorrhea, are most often associated with male infertility. These infections can cause scarring and block sperm passage. Mycoplasma is an organism that may fasten itself to sperm cells, making them less motile. If mumps, a viral infection usually affecting young children, occurs after puberty, inflammation of the testicles can impair sperm production. Inflammation of the prostate (prostatitis), urethra or epididymis also may alter sperm motility.
In many instances, no cause for reduced sperm production is found. When sperm concentration is less than 5 million per milliliter of semen, genetic causes could be involved. A blood test can reveal whether there are subtle changes in the Y chromosome.

Impaired delivery of sperm

Problems with the delivery of sperm from the penis into the vagina can cause infertility. These may include:

Sexual issues
Often treatable, problems with sexual intercourse or technique may affect fertility. Difficulties with erection of the penis (erectile dysfunction), premature ejaculation, painful intercourse (dyspareunia), or psychological or relationship problems can contribute to infertility. Use of lubricants such as oils or petroleum jelly can be toxic to sperm and impair fertility.
Retrograde ejaculation
This occurs when semen enters the bladder during orgasm rather than emerging out through the penis. Various conditions can cause retrograde ejaculation including diabetes, bladder, prostate or urethral surgery, and the use of psychiatric or antihypertensive drugs.
Blockage of epididymis or ejaculatory ducts
Some men are born with blockage of the part of the testicle that contains sperm (epididymis) or ejaculatory ducts. An estimated 2 percent of men who seek treatment for infertility lack the tubes that carry sperm (vas deferens).
No semen (ejaculate)
The absence of ejaculate may occur in men with spinal cord injuries or diseases. This fluid transports sperm through the penis into the vagina.
Misplaced urinary opening (hypospadias)
A birth defect can cause the urinary (urethral) opening to be abnormally located on the underside of the penis. If not surgically corrected, this condition can prevent sperm from reaching the cervix.
Antisperm antibodies
Antibodies that target sperm and weaken or disable them usually occur after surgical blockage of part of the vas deferens for male sterilization (vasectomy). Presence of these antibodies may complicate the reversal of a vasectomy.
Cystic fibrosis
Men with cystic fibrosis often have missing or obstructed vas deferens.

11th December, 2011
The Telegraph, Kolkata
Modern-day technology has allowed us to create an environment outside the body which is almost as good as the environment inside the body.
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Dear Dr. Rajeev Agarwal,
Thank you so much for all the care, concern and support you have given me.
We shall eternally be grateful for your kindness.

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