Causes of male infertility

What causes male infertility

The traditional perception that the causes of a couple’s failure to conceive were attributed to women exclusively, has greatly delayed investigation of men’s fertilising potential, as it only started 15-20 years ago.

Nowadys, even though knowledge on the causes relating to male infertility has sufficiently advanced, it is still not possible to clearly identify them. In a high percentage of cases, around 40%, the causes to the problem remain unclear. We thus refer to cases of “idiopathic infertility” or “unexplained infertility”.

Thorough analysis of the medical history, combined with complete clinical and laboratory examination, has led to the identification of general categories of factors causing male infertility, mainly related to a variety of conditions.

Approximately 2/3 of infertile men are unable to produce sufficient number of and/or functionally qualitative spermatozoa. Several factors may affect the process, such as:

Genetic factors
Chromosomal or genetic abnormalities
Clinical factors
Testicular torsion
Medical factors
Environmental factors
High temperature
Chemical substances
Unidentified factors

Around 3 out of 20 infertile men manifest inability to transfer sperm from the testicles to the exit of the genital tract due to obstruction that may relate to:
• Inflammation
• Prostate problems
• Absence of vas deferens
• Severance of vas deferens (vasectomy)

The presence of anti-sperm antibodies reduces sperm motility as well as their ability to bind to the egg. This phenomenon occurs in around 1 out of 16 infertile men and may relate to:
• Severance of vas deferens (vasectomy)
• Injury or inflammation of the epididymis
• Unidentified aetiology

The phenomenon of male infertility arises, less frequently, as a side effect of a condition associated with sexual dysfunction. This case concerns 1 out of 100 infertile men and relates to:
• Retrograde or premature ejaculation
• Failure of ejaculation
• Non-systematic intercourse
• Injury of the spinal cord
• Prostate surgery
• Nervous system damage
• Intake of special medication (antidepressant, antihypertensive)

It is a rather rare case of male infertility, affecting around 1 in 100 infertile men. It is caused by an abnormality in the function of the hypothalamus-hypophysis-testicles axis, resulting in abnormal secretion of the hormones that regulate spermatogenesis. Therefore, the spermatozoa production process is disrupted. It mainly relates to:
• Neoplasia of the hypophysis
• Congenital deficiency of LH and FSH hormones
• Use of anabolic steroids