Male infertility refers to a man’s inability to cause pregnancy in a fertile female.

Infertility affects an estimated 15% of couples globally with male infertility accounting for 40–50% of the cases of infertility. At least 30 million men worldwide are infertile. Infertility rates are highest in Africa and Central/Eastern Europe.

In a Nigerian study, it has been found that male factors as a cause of infertility amongst couples is about 42.4% while female factors accounted for 25.8%. About 20.7% of the couples studied had infertility due to both male and female factors.

Common causes of male infertility include;

Testicular problems such as;

  • Varicocele; enlargement of the veins within the scrotum
  • Hydrocele
  • Undescended testis
  • Genetic and chromosomal abnormalities; Klinefelter syndrome
  • Infections such as poorly treated mumps, urinary tract infection and sexually transmitted infection
  • Previous trauma to the testis
  • Testicular torsion
  • Testicular cancer

Sexual problems such as;

  • Retrograde and premature ejaculation
  • Failure of ejaculation
  • Erectile dysfunction
  • Spinal cord injury
  • Prostate surgery

It can also be due to sperm antibodies which attack the sperms.

Other causes include;

  • Hypogonadotropic hypogonadism; this is an impairment in the release of hormones responsible for testicular stimulation. Obesity can increase the risk of having hypogonadotropic hypogonadism.
  • Smoking
  • Alcohol
  • Drugs; chemotherapy, anabolic steroids used by weight lifters, cimetidine, spironolactone, phenytoin etc.
  • Exposure to chemicals such as; cadmium and lead, mycotoxins such as aflatoxins, pesticides, industrial chemicals
  • Medical conditions such as cystic fibrosis, diabetes

Treatment

The treatment of infertility depends on the severity of the underlying disease.

Hormonal supplements can be taken to improve hormonal balance.

Medications can be taken to improve hormonal balance.

Antibiotics can be taken to treat infection.

Avoid heat exposure to genital region.

Avoid taking hot showers in hot bath tubs.

Artificial insemination can be done for couples in cases of low sperm count.

In-vitro fertilization can also be done to aid fertility in men with low sperm count.

Genetic problems and chromosomal abnormalities are however irreversible.

In cases of no sperm count with no obvious obstruction in the outflow tract and no sperm count from testicular aspirate, a sperm donor can be used to achieve conception in an infertile couple.