Male infertility: causes and treatment

Male infertility has increased significantly in industrialized countries in recent decades. In western Europe, it is estimated that every sixth couple remains childless. The reasons for this lie just as often with the man as with the woman. In most cases, male infertility is due to poor semen quality or a blockage in the vas deferens. Find out more about male infertility and how it can be treated here.

Male infertility due to semen quality

One reason for male infertility can be improper production of sperm in the testicles. If the semen contains too few sperm, the existing sperm cells are not mobile enough or do not show certain characteristics, natural fertilization is unlikely. Observing these symptoms is often referred to as oligo-astheno-teratozoospermia syndrome (OAT syndrome) . A medical examination of the seminal fluid provides information about the quality of the sperm. From the resulting spermiogramthe seed quality can be inferred. However, the causes of low semen quality cannot be read directly from it. For most causes, further investigations are necessary. The problem can be caused by the following:

  • Undescended testicles : Problems with the quality of male sperm can be congenital. Nowadays every boy is examined thoroughly and early as part of the U-examinations. Unfortunately, this was not the case in the past, and up until a few decades ago around one to three percent of all newborn boys were born with undescended testicles. This means that the testicles of a newborn boy did not migrate into the scrotum during pregnancy and the first few days, but “got stuck” in the inguinal canals. If this is not treated in time, it will lead to a lasting disruption in seed production. Unfortunately, the temperature in the inguinal canals is not sufficient for sperm production. The perfect conditions can only be found in the scrotum.
  • Genetic causes : In very few cases, poor sperm quality can also be traced back to a genetic disposition. A rare genetic predisposition, for example, can be Klinfelter syndrome, in which the man has one X chromosome too many and therefore produces fewer male hormones that are urgently needed for sperm production. But other changes in the genetic material can also have an impact on male fertility.
  • Testicular varicose veins: In other rare cases, varicose veins form on the testicles in men. Doctors now assume that the large blood vessels of the varicose veins increase the temperature in the testicles and thus have a negative impact on an important component in semen production. Unfortunately, there are still no clear treatment recommendations for this case.
  • Globozoospermia : Another rather rare case is the absence of the acrosome. This is the front end of the semen, with the help of which the semen enters the ovum. An egg cell cannot be fertilized without the support of the enzymes formed by this “cone”. However, here, too, a couple can hope for the help of artificial insemination methods, albeit with lower chances of success than in other cases.
  • Mumps : Unfortunately, mumps can have far-reaching consequences for semen quality. If a man only develops mumps after puberty, the testicles can become inflamed, which unfortunately can completely destroy the production of spermatic filaments. In this case, too, the treatment prospects are unfortunately not very good.
  • Alcohol and nicotine : Some medical studies point to a clear link between heavy consumption of alcohol and nicotine and poor sperm quality. If you wish to have children, both should be avoided as far as possible in good time.

Infertility in men due to obstruction of the vas deferens

Blockage of the vas deferens can also be the reason for infertility in men. Such a closure can be caused by the following things:

  • Sterilization : The most common cases of sperm transport disorders occur after surgical sterilization ( vasectomy ). The vas deferens are severed and sometimes a piece is removed. A vasectomy can be surgically reversed. Or, as part of artificial insemination , sperm are taken directly from the testicles in order to fertilize an egg cell in the woman’s body or in a test tube.
  • Congenital diseases (eg cystic fibrosis) : With some hereditary diseases, such as cystic fibrosis, sperm transport can be impossible due to the absence of the vas deferens. This also applies to men who are only carriers of this disease without directly showing any symptoms. Here, too, it is possible in the context of artificial insemination to indirectly have the desired child by removing material from the testicles.
  • Inflammation : Inflammation can also lead to blockage of the vas deferens. It can often be the result of an infection with a sexually transmitted disease such as chlamydia. If the vas deferens are only stuck on one side of the testicle, some sperm will still get into the ejaculate. However, if both testicles are affected, there will be no more sperm in the ejaculate. Here, too, a couple’s desire to have children can perhaps still be fulfilled by extracting the sperm from the testicles.

Male infertility due to antibody formation

In rare cases, the male body mistakes its own sperm for foreign bodies and fights them. Similar to immunological incompatibility , which involves fighting the sperm in the woman’s body. Antibodies are formed that attach themselves to sperm when they come into contact with blood.

Further information

Further information about ” female infertility “, sterility diagnostics in women and men and much more can be found in the “infertility” section. We have summarized more about the possibilities of being able to have a child despite one of these sterility diagnoses in the “ Artificial Insemination ” section.

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