All over world, approximately 40% of infertility originates in men; just as much as it comes from women. However, this important cause of Infertility does not get the attention that it deserves.
Male Reproductive Function
Testes are the main reproductive organs in males and perform two main functions:-
1. Producing sperms
2. Producing male sex hormones mainly testosterone .
Sperms are produced in small tubules inside the testis and once the sperms are mature they are stored in epididymis, a tubular storage structure lying adjacent to the testis. They are exported through the ductal system to the outside, along with the other components of semen, when there is ejaculation.
To ensure good male reproductive function, it is important to have excellent quality of sperms and good supporting system which provides the other components of semen for good motility and viability of sperms.
1. ABNORMALITIES IN SPERM PRODUCTION / FUNCTION
A. Abnormally placed testis.
Normally in fetal life the testis are placed in the abdomen and gradually they descend down to scrotum by 7 months of fetal age. However, if the testicles fail to move down to scrotum they can remain stuck in the abdomen or groin. This abnormal location of the testes affects its function of shown production and increases the risk of testicular cancer.
B. Genetic defects
Many conditions like the following can affect shown quality:-
*Y chromosome fractional mutation (one of the more common generic cause for male infertility)
Infections like gonorrhea, syphilis, chlamydia and HIV can directly or indirectly block the sperm transportation pathway thereby affecting fertility.
Mumps is anothe common childhood infection of salivary glands that can reduce the quality and quantity of sperms. It can block the vas deferens preventing the outflow of sperms making the person completely unable to reproduce naturally. In severe cases it can completely destroy the sperm production by testis causing complete infertility and currently there is no definitive treatment for this damage.
D . Varicose veins of testis (Varicocele)
This is a medical condition in which the dilated veins of testis cause congestion of blood supply, increase the temperature of testis thereby affecting the sperm production.
Testis are very sensitive to temperature variation.
A rise in 2 degree temperature can impair the function completely. However this condition can be cured with surgical interventions.
2. EJACULATION DISORDERS
A. Premature ejaculation
It is one of the conditions of erectile dysfunction. With increasing severity a man can ejaculate without contact with vagina. Hence sperms are not deposited in vagina causing infertility even though the sperms quality is normal.
B . Reverse ejaculation
It can be psychological or may result from surgical injuries to the urinary tract. In this condition semen gets released back into the urinary bladder instead of release to the outside through penis. No sperms may be seen in the semen but sperms may be harvested from urine which can be used to give pregnancy by medical assistance.
Ç . Diseases and injuries of the reproductive organs causing functional vasectomy .
Blockage of vas deferens (a tube which causes the sperms from testis to the outside world) causes infertility as the sperms are not able to come out.
D. Environment, Lifestyle and Medicines
Nature has placed testis in scrotum to keep the temperature between 35 to 36 degree Celsius. Sperm production is adversely affected if the temperature is elevated. Wearing of tight underwear, bathing in very hot water, working in very high temperature like in coal mines and blast furnaces can raise the temperature of the testes causing impaired shown production by testes.
Toxic environment, radiation and electromagnetic waves can also be adversely affecting the fertility of a male.
Use of tobacco, stimulants, alcohol and substance abuse not only causes erectile dysfunction but also adversely affects the quantity and quality of sperms.
Many medicines used to treat infection, diabetes and hypertension can affect sperm production. It’s advisable to consult the concerned specialist rather than taking off the counter prescription to avoid such complications.
Cancer patients who need to receive radiation or chemotherapy are also prone for infertility due to destruction of sperm production or due to development of genetic defects in the sperms. So, before these therapies are used in cancer patients, it is best to freeze the sperms for future use.
1. Regular exercise to maintain a reasonable weight
2. Diet rich in green vegetables , fresh fruits, vitamins, minerals and proteins is good.
Avoid canned food. Some food items like garlic, oysters, vitamin C rich foods are good to improve quality of sperms.
3. Restricting stimulants like drugs, alcohol and tobacco is good for sexual health.
4. Prevention of diseases like STDs and getting a mumps vaccine in childhood is good to ensure your reproductive health.
5. Avoid overheating of testis.
6. Get enough sleep as sleep plays an important role in hormonal control and stress level can affect sperm count.
7. Avoid self medication
Only one partner’s examination is not sufficient. Both partners must be evaluated simultaneously so that doctor can give the best treatment for both husband and wife.