Male Infertility: Causes & Treatment
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The dream of many couples is to have children and start a family when the time is right. However, sometimes, no matter how hard you try, you may not be able to make your dream come true. When it comes to not being able to have children, for some reason, people first come to mind that there is a problem with the woman. However, the situation is not as expected. Some studies show that the rate of infertility in men is at least as high as in women. This shows that when it comes to the inability to have children, the arrows should be directed not only at the woman but also at the man. So what causes infertility in men, what are the infertility treatment methods in men, let’s take a look at it all together.
Infertility is when a couple cannot get pregnant (conceive) despite having regular unprotected sex. Around 1 in 7 couples may have difficulty conceiving.
About 84% of couples will conceive naturally within a year if they have regular unprotected sex (every 2 or 3 days). For couples who have been trying to conceive for more than 3 years without success, the likelihood of getting pregnant naturally within the next year is 1 in 4 or less.
When can male infertility be mentioned?
Many people expect to conceive in the month when they stop being protected and do everything to the letter. However, in order to be able to talk about infertility in women or men, it is necessary that pregnancy has not been achieved after 1 year of regular intercourse, especially in couples where the woman is less than 35 years old.
If pregnancy has not occurred within this period, it is necessary to consider that at least one of the couples may have a health problem. In such a case, a number of examinations should be made in both men and women to determine whether there is any problem.
What are the Causes of Infertility in Men?
Male infertility can have many different causes. Sometimes congenital abnormalities can be the cause of infertility, as well as genetic problems, inflammatory diseases or previous surgical procedures can cause male infertility and these can be increased. Then what are the causes of male infertility, let’s examine in more detail:
Sperm Production Disorders
It is one of the most common problems that cause infertility in men. The man’s lifestyle, diet, use of harmful substances such as alcohol and cigarettes, or the drugs he uses directly affect sperm production. In addition to these, treatments such as chromosomal or genetic problems, hormonal disorders, or chemotherapy can also impair sperm production. Sometimes, some diseases such as childhood diseases or kidney failure can also negatively affect sperm production.
Undescended testicles usually occur during fetal development, and one or two of the testicles are in the scrotum, that is, the testicles are not where they would normally be, but are higher or in the abdomen. This can cause testicular cancer in the future, as well as infertility in men.
Sperm formation in men, just as in women, takes place thanks to hormones. Failure in the production of any of the hormones FSH, LH, testosterone, and estrogen, which play a role in sperm formation, may impair sperm production. Disruption of the balance between estrogen and testosterone hormones can reduce sperm quality and make it difficult to get pregnant, as well as cause infertility.
Anti-sperm antibodies are found in approximately 12% of men diagnosed with infertility. Antibodies are protein molecules that bind to sperm.
When they bind to sperm, they negatively affect their activities. This reduces sperm quality, motility, and the number of viable sperm, so it can cause infertility in men.
Cancers can cause infertility by negatively affecting the male reproductive organ or the pituitary gland, where hormones involved in reproduction are secreted. In some cases, radiation, surgery, or chemotherapy may be required for treatment.
Chromosomal disorders that occur during fertilization are also the cause of infertility. Normally, an X chromosome comes from the mother and an X or Y chromosome from the father during fertilization. If an X comes from a male, a baby girl is born as XX, and a baby as an XY if a Y is born. But sometimes there is a problem and a combination like XXY may occur.
This sex disorder, called Klinefelter syndrome, is one of the genetic causes of male infertility. In addition, genetic diseases such as cystic fibrosis and Kallmann can cause male infertility.
Previous operations such as inguinal hernia or prostate surgery may adversely affect the reproductive health of men.
Some studies have shown that celiac disease can cause reproductive dysfunction in men. However, there is very little research on this subject. However, men with sperm morphology defects were observed to improve their morphology after applying the celiac diet.
Gonorrhea, tuberculosis, and some bacterial infections can cause obstruction in the reproductive tract, causing male infertility. These infections can also negatively affect the motility of sperm. In addition, sexually transmitted chlamydia, mycoplasma and ureaplasma infections can also damage sperm and cause infertility.
It is a disorder that is detected in almost half of men with infertility complaints. This disease, which is defined as varicose veins around the ovarian bag called the scrotum, is not easily noticed because it does not usually cause any complaints. The enlarged veins cause an increase in temperature in the testicles, which negatively affects sperm production. In addition, the decrease in the amount of oxygen in the blood accumulated in the enlarged veins also negatively affects sperm production.
The use of drugs such as chemotherapy drugs used in cancer treatment, some antifungal drugs, stomach drugs, and some depression drugs can adversely affect sperm quality and production. In addition, occupational exposure to drugs can adversely affect reproduction. Insecticides, pesticides, or materials used in the battery and battery industry can also have a negative effect on sperm.
Being in a Hot Environment
Working in a hot environment, especially as a profession, can cause reproductive problems in men. It is more likely to be seen in people working in the hot production centers of bakeries, baths, or factories. In addition, taking a shower with extremely hot water, going to the bath frequently, or wearing tight clothes that will keep the testicles warm are among the causes of male infertility.
Sexual Relationship Issues
In some cases, even if there is no problem in sperm production, a boy may not be able to have a baby due to anatomical problems such as premature ejaculation, inability to get an erection, painful intercourse, or urethral opening.
Sometimes, semen, which should come out during orgasm in men, can escape into the bladder. This problem, which is called retrograde ejaculation and also called dry orgasm, can be the cause of male infertility.
Unhealthy lifestyles such as stressful life, depression, obesity, smoking, or alcohol use can also negatively affect men’s reproductive health and cause infertility in men.
How is Infertility Treatment in Men?
In order to determine the male infertility treatment method, first of all, a physical examination by the doctor, listening to the medical history, and semen analysis should be done. Depending on the situation, detailed tests such as hormone tests, genetic tests, testicular biopsy, transrectal ultrasound, or scrotal ultrasound may be requested. Necessary treatment procedures are applied according to the results of these tests.
- If problems such as varicocele or sperm duct obstruction, which constitute the majority of male infertility causes, are detected, these problems can be eliminated with surgery.
- If there is no sperm in the man, sperm can be obtained by taking tissue from the testicles with the micro TESE operation.
- If the number of sperm or motile sperm is low in the man, pregnancy can be achieved by the microinjection method.
- If the infection is detected, the person can be treated with antibiotic drugs, if the infection has not progressed too much, it can be possible to have a child.
- If there are imbalances in the hormone tests, the reproductive function can be restored with hormone drugs or hormone replacement therapy that the doctor will prescribe.
- If there is sexual dysfunction, this disorder can be eliminated with the help of psychological treatment or drugs with the guidance of the doctor.
- Sometimes, the reason why pregnancy cannot occur may be due to DNA damage in a large proportion of sperm in the man. It is thought that it is important to increase the success rate of couples who want to apply for IVF, to determine whether they have this problem or not. If DNA damage is detected by TUNEL and SCSA tests, the man can be asked to change his diet and lifestyle, and the damage rate can be reduced by administering some drugs such as vitamin E. In this way, pregnancy can be achieved naturally.
Infertility in men can often be treated by finding the causes of infertility and applying the right methods. However, sometimes no method can be a solution to male infertility. It is recommended that men choose a healthy lifestyle and exercise regularly so that they can increase their fertility. In this way, they can both have a healthy life and increase their fertility.