The Basics
Infertility isn't just a women's health issue. According to the American Society for Reproductive Medicine, male factors and female factors contribute about evenly to infertility. In about a third of infertility cases, the issue is unknown or is a product of both partners.
So what are the most common causes of male infertility? The simple answer is low sperm count, or not enough sperm in the semen. Physical causes or lifestyle causes both can account for the low sperm count.
Physical Causes
Some rare genetic conditions can cause men to not produce sperm, or to produce so few sperm they are unable to fertilize an egg. Very rarely, some men are born without the vas deferens, or the tube that carries sperm to the penis. But genetic and anatomical conditions are not common.
A more common physical cause is variocoele. Doctors at the Cornell Institute for Reproductive Medicine state that variocoele is the most common physical cause for male infertility. Variocoele is similar to varicose veins in the legs, but the enlarged veins are located in the scrotum. Blood collects and pools in the enlarged veins and sperm production is lowered. Surgical treatments are available for variocoele.
Other physical causes of male infertility include hormone imbalances, sexually transmitted disease, prostate problems, and physical-behavioral issues like erectile dysfunction and premature ejaculation.
Lifestyle causes
One of the most studied lifestyle causes of male infertility is smoking. Smoking has been shown to decrease sperm count and mobility. Mobility refers to sperm's ability to travel through the uterus to the egg. Long-term alcohol use and recreational drug use have also been shown to contribute to male infertility.
Heat is another common cause for low sperm count. When the scrotum is too hot, or too close to the body, sperm production is reduced. Men who are trying to conceive are often told to switch from briefs to boxers, because tight pants and underwear can reduce sperm count.
Some activities can reduce sperm count by lowering testosterone. It may not seem obvious, but leading a high-stress lifestyle or working out excessively can alter the body's hormonal balance enough to affect sperm production. Even a vitamin C deficiency can contribute to low sperm count.
Whether the cause is physical or lifestyle, male factor infertility can be treated. A semen analysis is the first step toward finding that treatment.
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