Male sterility plays a very important role in the sterile couple, since around 30% of the problems when it comes to getting pregnant correspond to the male.
The sterile man tends to present a low seminal quality in most cases, which means that his sperm do not have enough capacity to fertilize the ovum and lead to pregnancy.
Depending on the cause that causes this male infertility, it will be possible to apply a specific treatment that allows these couples to be parents.
Types of Male Sterility
Male sterility can be caused by different factors that are grouped as follows:
- Endocrine factor: hormonal alterations that affect testicular development and/or function.
- Testicular factor: direct involvement of the testicles.
- Post-testicular factor: alterations in the exit of sperm.
- Sperm factor: alterations in sperm quality directly.
Despite there being different causes, they all affect the quality of the ejaculated semen in one way or another. To consider that a male has a good seminal quality, he must comply with minimum values in terms of concentration, mobility, morphology and vitality of the sperm.
To make the diagnosis of what may be the cause of male sterility, it is necessary to perform some diagnostic tests, among which the semen analysis stands out. If you want more information about this, we recommend you visit the following article: Male fertility tests.
Next, we are going to comment in more detail on each of the types of male infertility:
Pretesticular or endocrine factor
This type of sterility is due to problems in the hormonal regulation of spermatogenesis, that is, the production of sperm.
The hormones secreted by the pituitary, LH and FSH, responsible for acting on the reproductive function of the male, can be altered for any of the following reasons:
- Unhealthy lifestyle habits
- Hypothyroidism and hyperthyroidism
- Hypogonadotropic hypogonadism
These alterations can be due to congenital problems or be caused by external factors such as some substances or drugs (eg anabolics ), which can alter the entire hormonal regulation system and cause fertility problems.
You can expand the information on this in the following post: Male sterility due to a pre-testicular factor.
When talking about a testicular factor, it refers to any alteration or defect that directly affects the testicles.
Male infertility due to a testicular cause can have occurred from birth or by external agents at any time in a man’s life. We discuss them below:
Congenital testicular factors: They are caused by genetic alterations at the chromosomal level (eg. in Klinefelter syndrome ). They can also occur at the genetic level, as in the case of Noonan syndrome, or if diseases caused by defects in genes of the Y chromosome appear.
Acquired defects at the testicular level: Here are the adverse effects produced by drugs, such as chemotherapy, drug use, radiotherapy, trauma, infection, etc. The best-known pathologies are varicocele, cryptorchidism, orchitis and hydrocele.
If you are interested in obtaining more detailed information on this subject, we invite you to continue reading here: Male sterility due to a testicular factor.
Male sterility due to post-testicular factors encompasses all those cases that are due to obstructions or alterations in the seminal tract.
The seminal tracts are the epididymis, the vas deferens and the urethra, which must be crossed by sperm to exit to the outside once they have been produced by the testicles.
The causes of this obstruction can be diverse, for example, infections, trauma, anti-sperm antibodies, hypospadias or cystic fibrosis.
The inability to ejaculate is also considered a post-testicular disorder.
If you are interested in this topic, you can continue reading in the following article: Male sterility due to a post-testicular factor.
Male sterility due to sperm factor is the most common. This category includes alterations of the sperm that directly affect its morphology, mobility, vitality or concentration.
To analyze seminal quality, a Semen Analysis test is performed to diagnose the following alterations:
- Oligozoospermia: low concentration of sperm.
- Asthenozoospermia: poor mobility in sperm.
- Teratozoospermia: a high number of sperm with abnormal morphology.
- Necrospermia: a high number of dead sperm.
- Azoospermia: the absence of sperm in the ejaculate.
Male infertility does not cause symptoms that can be perceived by men. This can only be known when, after a long period of time having unprotected sex, it has not been possible to achieve pregnancy and the couple begins to undergo tests.
On the other hand, if the man has already been diagnosed with another disease such as hypogonadism, he may already suspect that he will have difficulty having children.
In addition, there are some signs that can alert the man of possible sterility. We discuss them below:
- Low libido and erection problems.
- Altered semen with abnormal colour, strong odour, very watery or very thick, etc.
- Having smaller than normal testicles.
- Changes in voice, loss of body hair or decreased muscle mass indicate possible hormonal changes.
- Changes in urine or pain when urinating that warns of a possible infection.
- The appearance of varicose veins in the testicles.
In case of appearance of these symptoms during the search for a pregnancy, the man should undergo a study that includes the necessary tests to confirm if it is a case of male infertility.
To address male infertility, you need to know the cause that prevents you from getting pregnant in the first place. In some cases, it is possible to regain male fertility after drug treatment or surgery. In the most serious cases, the only option will be to resort to assisted reproduction.
Next, we are going to discuss some possible treatments for male infertility:
- Natural treatment: a healthy lifestyle with a balanced diet combined with vitamin supplements can help improve seminal quality in milder cases. Above all, antioxidants such as selenium, carnitine and vitamins E, A, C and B12 are very important.
- Hormonal drugs: the gonadotropins and clomiphene citrate, for example, administered in men with hypogonadotropic hypogonadism.
- Surgical intervention: for testicular conditions such as cryptorchidism or varicocele.
- Assisted reproduction: when it is not possible to apply the above options or have not been successful. Faced with a severe male factor, the technique that offers the best success rates is ICSI (intracytoplasmic sperm microinjection).
Questions from users
What are the main symptoms of male infertility?
Male infertility usually occurs asymptomatic and the causes that produce it are diagnosed after taking a correct medical history of the patient with a personal and family history and requesting the indicated complementary tests.
What hormones are tested to determine the cause of male infertility?
Among the many causes of male sterility are those that depend on the interaction between the brain and the testicle, it is in those cases where it is interesting to request the hormonal study, through the hormone FSH (follicle-stimulating hormone) and LH (luteinizing hormone). Its determination will indicate the state of the pituitary-testicular axis.
Does age influence male fertility?
The age of the man can affect sperm quality, but there is not a decrease in fertility as marked as in the case of women. After the age of 40, a man’s fertility decreases. It has been observed that with age there is a slow but progressive reduction in seminal volume, a decrease in sperm concentration and an increase in oxidative stress.
In addition, the probability that the sperm have some genetic alteration is also increasing. However, a man can still be fertile at 50, 60 and even 70 years of age.
Can male sterility be temporary?
Yes. There are cases in which the man goes through periods of stress or anxiety that can cause temporary infertility. The same happens with flu processes that cause fever since the increase in body temperature affects the production of sperm. In these cases, fertility can recover after 3 months once the stage that causes infertility ends. This is because a complete spermatogenesis process takes 3 months.
Can male infertility be cured by eating?
A healthy diet, rich in antioxidants such as vitamins or omega 3, can sometimes help to improve seminal quality. However, in the most severe cases of infertility, no improvement will be observed with natural remedies and it will be necessary to resort to assisted reproduction treatments to achieve pregnancy.
For more information on increasing semen quality through feeding, you can visit this article: Improve sperm quality.
If I have received chemotherapy, am I sterile?
The effect of chemotherapy on semen quality depends on the drug used for treatment since not all drugs affect spermatogenesis in the same way. In addition, each patient may be affected more or less by the treatment. To know if a patient’s testicular function has been altered, it will be necessary to carry out a fertility study.
The result of the Semen Analysis indicates that I have azoospermia. Can’t I be the biological father of my children?
Azoospermia is the absence of sperm in the ejaculate, but it can have different causes. Depending on the reason for the azoospermia, the prognosis will be one or the other.
If it is due to a post-testicular factor ( obstructive azoospermia ), sperm production is not altered and they can be obtained directly from the testicle. However, if it is an alteration in sperm production ( secretory azoospermia ), it is very unlikely that sperm will be found in the testicle.