Infertility

Understanding male infertility and its causes

By Michael Russell

The fact that infertility is on the increase among couples in both developed and developing countries of the world is definitely not contentious. However, the role that the male factor plays in infertility has consistently been debated. In the past, it was considered unthinkable to suggest that the male was the sick party when conceiving becomes a problem. Although things have changed a lot, people now understand that male infertility, too, is a factor to be considered when a couple suffers infertility. There is still not as much information and/or knowledge about male infertility as there is about female infertility—at least among the general population.

Generally, it is believed that 15 percent of couples meet with failure when attempting their first pregnancy, since 80-–85 percent of couples achieve pregnancy within 12 months of unprotected sexual intercourse. There is evidence from clinical data to show that in 30 percent of cases of infertility, the problem is with the man alone. While in another 20 percent, the man and the woman both share the "reason" for the couple’s infertility. Therefore, in 50 percent of infertility cases, the problem is wholly or partly from the man. This fact might be too much for persons to believe, but it should be understood that the male reproductive system is almost as complex as that of females. Also, from conception to menopause, the male stands almost the chance of reproductive malfunction or abnormality as the woman.

Of course, unlike the woman, the primary organs of reproduction of the male sex include just the penis and the testes. But these organs, especially the testes, are under a complex cycle of hormonal and chemical influences. Problems with any of these could result in infertility or poor fertility.

The testis is the primary organ of male reproduction while the spermatozoa, or simply, sperm, is the product of the reproductive activities of the testes. The sperm is produced in the testes through a cycle/processes known as spermatogenesis and is stored in the epididymis. This process of spermatogenesis takes about 74 days from the primitive cells called spermatogonia to the matured sperm cell. The development throughout this cycle is greatly influenced by a number of hormones, such as luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, and others. Finally, the matured sperm cells in the testis are non-motile and incapable of fertilization until they get to the epididymis for storage and distribution, where they undergo the final maturation to become motile and fully capable of fertilization. It should also be understood that although the adult testis is located in the scrotum behind the penis, it actually develops, during fetal life, in the abdomen and only descends to its final position just before birth.

It is apparent that, contrary to common beliefs, the male reproductive system is complex. An anomaly anywhere in the cycle of spermatogenesis, for example, could result in low-quality sperm; unhealthy or non-motile sperm cells are incapable of fertilization. Also, undescended testes (cryptorchidism), a relatively common condition, could negatively affect the quality of sperm a male produces. In serious cases, this condition can cause cancer of the testes.

Furthermore, several other conditions can affect male infertility. It has been shown that some medications such as cimetidine, spironolactone, sulfasalazine and nitrofurantoin affect male fertility. Illicit drug use, excessive consumption of alcohol, and history of exposure to occupational and environmental toxins, excessive heat, and/or radiation could all negatively affect male fertility. The bottom line is that infertility is a problem that equally affects both males and females; heaping the blame on the female sex only leaves the problem half solved. The male reproductive system is as vulnerable to anomalies as the female’s. A comprehensive understanding of male fertility problems could be of great help to any couple still having problems with conception.