Name: Causes of Male Infertility
Brand: Ferty9

Male infertility is any health issue in a man that lowers the chances of his female partner getting pregnant. It usually comes down to one of three things:

Categories of Causes

The reasons behind male infertility can be grouped into a few main categories:

Medical Causes: These include physical problems, hormonal imbalances, genetic conditions, and past illnesses.
Lifestyle & Environmental Causes: These relate to your daily habits, diet, and exposure to certain elements in your surroundings.
Unknown Causes: Sometimes, even after a thorough check-up, the exact reason remains unclear. This is known as idiopathic or unexplained infertility.

How Common Each Cause Is

The most common identifiable causes are physical issues like a varicocele. However, a large number of cases are due to a combination of factors, including lifestyle choices. In about 30-40% of cases, no specific cause is found. The good news is that even without a clear cause, effective treatments are available.

Physical & Anatomical Causes

These are problems related to the structure and function of the male reproductive organs.

Testicular Disorders

The testicles are the “factories” that produce sperm. Any damage to them can affect sperm quantity and quality.

Undescended testicles (cryptorchidism): When one or both testicles fail to move down into the scrotum before birth.
Testicular trauma or injury: A direct injury to the testicles can permanently damage sperm production.
Testicular cancer: Cancer and its treatments (surgery, chemotherapy) can severely impact testicular function.
Testicular atrophy: The shrinking of testicles, which can be caused by hormonal issues, infection, or varicocele.
Hydrocele: A buildup of fluid around the testicle, which can sometimes be associated with underlying issues.

Varicocele

What is a varicocele? This is a condition where the veins inside the scrotum become enlarged, similar to varicose veins in the legs.
How it affects sperm production: These swollen veins can raise the temperature inside the scrotum, creating a poor environment for sperm production and damaging the sperm that is made. Varicocele is one of the most common reversible causes of male infertility.

Sperm Transport Blockages

Sometimes, sperm is produced normally but gets blocked on its way out. This is like a plumbing problem in the reproductive tract.

Blocked vas deferens: The tubes that carry sperm from the testicles can be blocked due to past infections or surgery.
Congenital absence of vas deferens (CBAVD): Some men are born without these tubes, a condition often linked to the cystic fibrosis gene.
Epididymal obstruction: A blockage in the coiled tube at the back of the testicle where sperm matures.
Ejaculatory duct blockage: A blockage near the prostate gland.
Post-vasectomy effects: A vasectomy is a surgical procedure to block the vas deferens for permanent contraception.

Sexual Function Issues

Problems with intercourse or ejaculation can prevent sperm from reaching the partner.

Retrograde ejaculation: Semen enters the bladder instead of emerging from the penis during orgasm.
Premature ejaculation: Ejaculation occurs too quickly.
Erectile dysfunction: Difficulty getting or keeping an erection firm enough for sex.
Anejaculation: The inability to ejaculate at all.

Hormonal Causes

Hormones are chemical messengers that control sperm production. An imbalance can disrupt the entire process.

Low Testosterone (Hypogonadism)

Primary hypogonadism: The testicles don’t produce enough testosterone due to a direct problem with the testicles themselves.
Secondary hypogonadism: The problem starts in the brain (pituitary gland or hypothalamus), which doesn’t send the right signals to the testicles to produce testosterone.

Pituitary & Hypothalamic Problems

Low FSH/LH causes: Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) are key hormones from the pituitary gland that tell the testicles to make sperm and testosterone. Low levels lead to poor testicular function.
Kallmann syndrome: A rare genetic condition that affects the brain’s ability to produce fertility hormones.
Pituitary tumors: A benign tumor can interfere with hormone production.
Hyperprolactinemia: Too much of a hormone called prolactin can lower testosterone levels.

Other Hormonal Imbalances Disorders of other glands can also affect fertility.

Thyroid disorders: Both an overactive or an underactive thyroid can disrupt the hormonal balance needed for sperm production.
Elevated estrogen: High levels of the female hormone estrogen can suppress sperm production.
Growth hormone deficiency: Can be linked to poor testicular development.
Cortisol excess (Cushing’s syndrome): High levels of the stress hormone cortisol can negatively impact fertility.

Genetic Causes

These are conditions a man is born with, caused by issues in his chromosomes or genes.

Chromosomal Abnormalities Chromosomes carry our genetic blueprint.

Klinefelter syndrome (XXY): Men with this condition are born with an extra X chromosome, which severely affects testicular development and sperm production.
Y chromosome microdeletions: Tiny missing pieces of the Y chromosome, which contain important genes for sperm production.
Robertsonian translocations: A structural problem where parts of chromosomes get rearranged, which can affect fertility.
Other chromosomal disorders: Various other genetic rearrangements can impact sperm health.

Single Gene Mutations

Cystic fibrosis gene mutations (CFTR): Men can be carriers of this gene without having the full disease, but it often causes the absence of the vas deferens (CBAVD).
Androgen receptor defects: Problems with how the body uses testosterone.
5-alpha reductase deficiency: A rare condition affecting male hormone development.
Mutations affecting sperm production: Specific gene defects that directly interfere with the process of making sperm.

Lifestyle Causes

Your daily habits and environment play a significant role in your fertility. The good news is that many of these factors can be changed.

Substance Use Causes

Smoking: Reduces sperm count, motility (movement), and can damage sperm DNA.
Alcohol: Heavy consumption lowers testosterone levels and sperm production.
Recreational drugs: Marijuana, cocaine, and others can negatively affect sperm quality.
Anabolic steroids: Often used for bodybuilding, these can cause testicles to shrink and shut down sperm production completely.

Physical & Environmental Causes

Excessive heat: The testicles need to be cooler than the rest of the body. Frequent use of saunas, hot tubs, or even placing a laptop directly on your lap for long periods can harm sperm.
Obesity: Being overweight can disrupt hormones and negatively impact sperm quality.
Extreme exercise: While moderate exercise is good, over-exercising can lower testosterone.
Prolonged sitting/cycling: Can increase scrotal temperature and pressure.

Occupational Exposure Causes: Working in certain environments can be a risk.

Chemicals: Exposure to industrial chemicals, solvents, and paints.
Radiation: X-rays and other forms of radiation can damage sperm-producing cells.
Heavy metals: Exposure to lead or mercury.
Pesticides: Common in agricultural work, these can mimic hormones and disrupt sperm production.

Medical Condition Causes

Other health problems can have a direct or indirect impact on male fertility.

Infection Causes

Sexually transmitted infections (STIs): Chlamydia and gonorrhea can cause inflammation and blockages in the reproductive tract.
Mumps orchitis: Mumps infection after puberty can sometimes lead to testicular inflammation and permanent damage.
Epididymitis: Inflammation of the epididymis.
Prostatitis: Inflammation of the prostate gland.
Urinary tract infections (UTIs): Severe or recurrent infections can affect the reproductive organs.

Chronic Disease Causes

Diabetes: Can cause nerve damage affecting erections and ejaculation (retrograde ejaculation).
Kidney & Liver disease: Affects hormone balance and overall health.
Autoimmune disorders: The body’s immune system may mistakenly attack its own tissues, including the testicles.
Celiac disease: A digestive disorder that can be linked to poor sperm quality.
Sickle cell anemia: Can affect blood flow to the testicles.

Neurological Causes

Spinal cord injury: Can interfere with nerve signals needed for erections and ejaculation.
Multiple sclerosis: A disease affecting the nervous system.
Diabetic neuropathy: Nerve damage from diabetes.
Previous pelvic surgery: Can damage nerves involved in sexual function.

Medication & Treatment Causes

Treatments for other health conditions can sometimes have side effects that affect fertility.

Cancer Treatment Causes

Chemotherapy: Can severely damage or destroy sperm-producing cells.
Radiation therapy: Radiation directed at or near the pelvic region can harm the testicles.

(Note: If you are about to undergo cancer treatment, Ferty9 strongly advises discussing fertility preservation options like sperm freezing beforehand.)

Prescription Medication Causes

Antidepressants (SSRIs): Can sometimes affect libido and ejaculation.
Blood pressure medication: Certain types can cause erectile dysfunction.
Anti-seizure medication: May affect hormone levels.
Long-term antibiotic use: Some can affect sperm production.
Testosterone replacement therapy: Can shut down the body’s natural sperm production signals.

Surgical Causes

Hernia repair surgery: Can sometimes damage the vas deferens.
Prostate or bladder surgery: Can affect ejaculation.
Previous testicular surgery: Can cause scarring or damage.

Age-Related Causes

Natural Aging Effects. While men can remain fertile for much longer than women, age does have an impact.

Sperm quality decline: Sperm motility and shape tend to worsen with age.
DNA fragmentation: The genetic material inside the sperm is more likely to be damaged in older men.
Hormonal changes: Testosterone levels naturally decline with age.
When age becomes a factor: These changes typically become more significant after the age of 40-45.

Immune System Causes

Anti-sperm Antibody Causes Sometimes, a man’s own immune system mistakenly identifies his sperm as foreign invaders and creates antibodies to attack them. This can happen after:

Previous infections
Testicular trauma or surgery (including vasectomy)

Autoimmune Causes In men with systemic autoimmune diseases, the immune system can cause inflammation that affects the testicles or sperm-producing cells.

Nutritional Deficiency Causes

A healthy diet is essential for producing healthy sperm.

Mineral Deficiencies

Zinc: Crucial for sperm formation and testosterone metabolism.
Selenium: An antioxidant that helps protect sperm from damage.

Vitamin Deficiencies

Vitamin D: Important for hormone production and overall sperm health.
Folate: Plays a role in sperm DNA synthesis.
Vitamins C & E: Powerful antioxidants that protect sperm cells.
Vitamin B12: Important for sperm count and motility.

Unknown Causes (Idiopathic)

Unexplained Male Infertility In many cases, a man’s semen analysis may appear normal, and no clear medical or lifestyle cause can be identified. This can be frustrating, but it does not mean there is no hope.

When no cause is found, this is called idiopathic or unexplained male infertility.
Possible hidden causes: The issue may be at a molecular or genetic level that standard tests cannot yet detect.

Even when the cause is unknown, our experts at Ferty9 can still recommend effective treatments like IUI and IVF to help you achieve your dream of parenthood.