Male infertility: What couples need to know and could it happen to you?
Understanding infertility in men is the first step in finding a solution.
You are not alone; infertility is an issue for couples worldwide, with about 15% of the global population experiencing infertility. In fact, in 2010, nearly 50 million couples worldwide were unable to have a child after five years of trying. You may be surprised to know that around 40% of infertility cases are due to problems in the man’s reproductive system. Another forty percent are related to the woman’s reproductive health and the remaining 20% is due to either a combination of female and male factors or unknown causes. One thing is known for sure: for both men and women, fertility typically decreases with age.
Male factor infertility falls into two categories: known causes (about 50% to 70% of all cases) and unknown causes, also called idiopathic (approximately 30-50% of all the cases).
Here are some of the most important male infertility considerations.
1. Physiological factors
Men may experience infertility because of physical issues, which include:
Varicocele: an abnormal enlargement of veins in the scrotum
Congenital (since birth) disorders that can affect physical development or hormones
Urinary and/or genital (urogenital) conditions acquired after birth, such as secondary effects of disease, medical treatment or viruses, such as zika
Endocrine (hormone) disorders
Immune system factors (immunologic infertility), such as the presence of antisperm antibodies in the semen, man’s blood or vaginal fluids that act against the sperm
Sexual inadequacy: erectile inadequacy, ejaculatory inadequacy, premature ejaculation, low sexual drive and other conditions
2. Abnormal sperm characteristics
Deficient sperm may not be able to travel to the fallopian tubes or fertilize an egg. These abnormalities include:
Low sperm concentration (low total sperm count): Less than 15 million per milliliter of semen
Reduced sperm motility (movement): Less than 40% of sperm that have forward progression
Abnormal sperm morphology: Fewer than 4% have normal shape and size
Poor sperm parameters can be caused by a range of problems. Studies have shown that men with micronutrient deficiencies are more likely to have sub-optimal sperm characteristics than those with healthy levels of vitamins and minerals. In addition, men with seminal fluid containing high levels of reactive oxygen species (which are reactive molecules that can damage cell components), have higher levels of infertility than men with lower levels of these molecules.
Six out of ten people suffer from stress. Dr. Chloe Carmichael, a psychologist specializing in relationships, explains that stress can have a major impact on a couple’s ability to conceive, from the couple’s love-making encounters to the impact that stress can have on the body.
Research points to the possibility that mild-to-severe emotional stress in men depresses testosterone and may interfere with sperm production, which could cause male infertility.
4. Being overweight
According to the World Health Organization, 1.9 million people are obese and 600 million are overweight.
Fat tissue in the groin raises the temperature of the testes, which lowers sperm production.
Scientific publications show that obese men have reduced sperm quality and increased sperm DNA damage. Obesity can cause molecular and physical deformities in germ cells, the cells that give rise to sperm cells. Being overweight also causes oxidative stress, which, simply put, is a metabolic process that can destabilize healthy cells. Oxidative stress alters men’s hormone levels, which can raise estrogen (female hormone) concentrations in the blood.
5. Lifestyle considerations
Scientific studies have linked alcohol consumption, drug use and smoking to higher levels of infertility. The spokesperson for the Royal College of Obstetricians and Gynaecologists, Dr. Patrick O'Brien, highlights: “Excessive alcohol lowers testosterone levels and sperm quality in men. It can also reduce libido and cause impotence."
Studies have proven that anabolic-androgenic steroids, cocaine, marijuana, methamphetamines and opioid narcotics are detrimental to male fertility. Opioids and anabolic androgenic steroids affect the ability of the testes and/or brain to produce male hormones, which decreases produce sperm capabilities.
There is growing evidence showing the relationship between adequate nutrition (particularly vitamin and nutrient intake in different forms) and healthy sperm characteristics, fetal growth and pregnancy outcomes.
Today’s on-the-go diets and food sources can cause people to have micronutrient deficiencies. In men, these deficiencies are linked to significant reproductive risks, subfertility and infertility.
Antioxidants, such as vitamins A and C and zinc, are essential for maintaining cellular balance. As key parts of the sperm cell membrane, omega 3 and omega 6, which are fatty acids required for sperm production, are important for successful fertilization. In addition, omegas 3 and 6 are critical building blocks of anti-inflammatory molecules and help maintain a healthy, balanced immune system. The Western diet is deficient in omega 3 but abundant in omega 6. This skews the ideal one-to-one ratio of omega 6 to omega 3, which can impair semen quality.
7. Environmental factors
Air quality, environmental toxins and the use of chemicals can all impact men’s fertility. Brief exposure to x-rays and radiation can reduce sperm production temporarily, but high doses of radiation can potentially reduce sperm production permanently.
It is common knowledge that elevated testicle temperatures can impair sperm production and function. Common heat-increasing activities include wearing tight clothes or using a laptop computer on your lap for extended time. Science has not yet proven whether the use of hot tubs or saunas impair sperm.
A reason for optimism
While there may be a variety of causes of infertility, science has found doable solutions to the problem for many men, including medical treatment, nutritional supplements and lifestyle changes.
Learn more on how to optimize your fertility.