During the ovulation period of a woman, an egg is released from the ovary which will then travel to the fallopian tube waiting for a healthy sperm cell to unite and fertilize the egg. Millions of sperm cells which then travel from the vaginal canal as a result of ejaculation during sexual intercourse will compete from one another to fertilize the ovum. It only takes one healthy sperm cell to fertilize the egg. When the egg is fertilized, now called a zygote, it will travel down to the inner muscular layer of the uterus called the endometrium where it will be implanted. This process is called implantation. When the fertile egg is successfully implanted, the process of conception starts which will take 9 months to have a fully grown and develop baby.
Infertility is the inability to conceive a baby due to some reasons. Both the male and female are examined to identify who has a problem. In males, there are several factors that can cause infertility but the most common of them has something to do with the sperm cells.
The Sperm Cell
As you can see in the normal process of reproduction, starting from the coitus or sexual intercourse of a man and a woman, from the fertilization of the egg, implantation and then the conception itself, the sperm cells and the egg cell play their role to have a successful pregnancy. If however, any unwanted incident occurs during these processes, pregnancy may be interrupted. Now, let’s focus on the vital role of the sperm cell.
The sperm cell is the reproductive cell of the males. They are found in the semen, a whitish, thick fluid that is being ejaculated during sexual intercourse. To impregnate a woman, these sperm cells must be ejaculated inside the vagina (for a normal process) to allow them perform their duty: to hunt the egg cell and fertilize it. As you have learned before, these sperm cells will travel a certain distance coming from the place where they were ejaculated up to the location of the egg cell. With this, mobility is a great a factor.
The sperm cell’s physical characteristics under the aid of a microscope revealed that it is similar to a tadpole: it has a head and a tail. The head contains the necessary material to fertilize the egg while the tail is responsible for the movement of the sperm. There are millions of cells that will swim and try to overrun each other to reach the egg and the fastest egg who will reach the egg will triumph. Thus, the tail of the sperm is a very important part in the process. In some conditions, the sperm cells don’t have tails or even though they have tails, they are not completely developed so they are not that motile to move across the reproductive environment of the woman and they can’t reach the egg.
The vagina and the reproductive tracts have an acidic environment. If the acidity of the tracts where the sperm cells need to travel on is too high, the sperm cells will just die making conception impossible. The acidity serves as a protection to the system and also acts as a “quality-control” measurement to ensure that only the best among the millions of sperm cells will fertilize the egg. The egg itself also has a protective layer or shield. These coverings will then be dissolved by the head of the sperm cells to penetrate the egg. If the sperm cell is not that healthy to penetrate the egg, pregnancy again is impossible.
Causes of Male Infertility
The main cause of infertility in males is the quality of the sperm cells. The sperm cell is the primary key to have a successful pregnancy. If there is any abnormality or failure on the part of the sperm cells, infertility can take place. Having abnormal sperm cells like no tails or incomplete tails, unhealthy sperm cells and having a low sperm count are just some of the factors affecting the sperm cells that can cause male infertility.
Other causes of male infertility are the following:
- Genetics- the presence of genetic issues like chromosomal problems can cause male infertility.
- Hormonal- hormones that are produced by the pituitary gland stimulates the production of sperm cells. If there are low levels of these hormones, the production of sperm cells will also be low.
- Age- as the male ages, the quality and quantity of sperm cells decreases.
- Drugs- some drugs can affect the production and the functions of the sperm cells. Some hypertensive drugs, antibiotics, anti-arthritis, chemo drugs and anti-depression have effects on the sperm cells.
- Smoking- tobacco smoking can kill the sperm cells.
- Wearing too tight underwear- too tight underwear can cause the testes to be too warm by pressing it against the body. Too warm temperature can kill the sperm cells.
- Trauma- biking, horse riding and other activities that can cause trauma or pressure to the testes may cause infertility.
- Blockage/Obstruction- any obstruction present in the urethra, vas deferens and other tracts that the sperm cells will pass can cause infertility. Infections and recent surgical procedure like vasectomy can cause obstruction to these passages.
- Retrograde ejaculation- retrograde ejaculation is the backward ejaculation of sperm cells to the bladder instead of going to the urethra. This can be a cause of a muscular or nerve issue that causes the bladder neck to close during ejaculation. This sphincter should close during ejaculation to facilitate the movement of semen to the penis and not back flow to the bladder. Some drugs and operation can cause this condition to the nervous system that controls the closing of the bladder neck during orgasm.
- Varicoceles- these are visible, palpable distended veins in the scrotum. They can cause male infertility for they prevent the drainage of blood. During physical examination, varicoceles are easily detected and they are the main cause of male infertility that can be corrected.
- Testicular problems- sperm cells are produced in the testes. Testicular cancer, trauma, infection and genetic conditions of the testes that can affect the production of sperm cells can cause infertility.
- Impotence- the inability to maintain erection during sexual intercourse is another reason of male infertility.
- Premature Ejaculation- ejaculation at the wrong time is another reason of failure to conceive a child. Early ejaculation even before penetration will cause a problem to impregnate a woman.
Diagnosis for Male Infertility
Unsuccessful pregnancy after several tries and being unable to conceive a child for a long time will trigger the male and woman couple to seek medical advice. On the part of the male, certain diagnostic procedures will be done to properly identify the main problem and to clearly diagnose the presence of male infertility.
- Medical History- a complete medical history taking is a necessary step in diagnosing male infertility. History of unsuccessful pregnancy from previous partners, sexual practice like usage of lubricants and other materials, history of drug taking, alcohol and smoking, history of infections and surgery are carefully investigated.
- Physical Examination- physical examination of the male organ includes inspection and palpation of the penis, scrotum, the testes and other components of the male gonad. The presence of lumps, cysts, distended veins in the scrotum is carefully noted. Presence of gynecomastia (male breast budding) and loss of body hair may indicate low levels of male hormones.
- Sperm Examination- A sperm cell exam may be an indicative test to reveal male infertility. Having low sperm cell count, unhealthy sperm cells, abnormal sperm cells (no tails), immotile sperm cells and low volume of seminal fluid may be revealed in the test.
- Blood tests- to reveal presence of genetic disorders that can cause male infertility and low levels of the male hormones.
Treatment for Male Infertility
Treatment for male infertility will focus on the alteration of the identified cause.
- If the cause of infertility is smoking, alcohol and drugs, the avoidance of these substances will or may cure the problem.
- Psychological problems like stress and depression will be corrected by relaxation, positive thinking and concentration.
- Wearing comfortable and loose underwear may promote proper circulation and temperature to the testes.
- Presence of abnormality to the physical aspects of the testes may require surgical procedures. Varicocele is one physical problem that can be corrected. Torsion or twisting of veins in the scrotum can also be treated surgically.
- Hormonal problems can be corrected by injecting the required hormones.
- Correcting impotence and premature ejaculation is another way to treat male infertility.
- Drugs can be used to treat retrograde ejaculation and other hormonal issues.
- Avoiding the use of steroid that can lower the production of sperm cells is also considered in the treatment of infertility.
- IUI- intrauterine insemination is the introduction of the sperm cell directly to the uterus bypassing the normal passage avoiding the acidic mucus of the cervix.
- In-vitro fertilization- is the growing of combined egg cell and a sperm cell in a Petri dish. After the required time, the ripe egg is then implanted to the uterus.
IUI as an Option for Male Infertility
IUI or intrauterine insemination is an option taken by couples if pregnancy through normal and natural way is not possible. It is the induction of the sperm cell directly to the uterus using a catheter, bypassing the cervix and avoiding its mucus. This procedure is also considered after the examination of the woman’s physical reproductive system. An absence of obstruction to the fallopian tubes may put a woman as a candidate for IUI. There are two fallopian tubes, the left and right and only one working tube is needed for this procedure. Cases like impotence ad premature ejaculation of the side of the male may trigger the need for IUI. Having unhealthy or immobile sperm cells and too acidic mucus on the cervix will also be considered for IUI.
Supplements for Male Infertility
The health condition of the sperm cells plays a critical role for pregnancy. There are available supplements in the market that offer to help in the production of healthy sperm cells. Some supplements have hormones that can treat hormonal causes of infertility. Some have antioxidants, Vitamins C and E that plays a part in the protection of sperm cells against free radical and other damaging conditions due to aging process. Others have L-Carnitine that is helpful in the production of sperm cells.
Libido increasing supplements can also be helpful against impotence and premature ejaculation. Supplements with selenium may help for the movement of the sperm cells. Zinc is another essential supplement that can increase the production of sperm cells by increasing the production of testosterone. Chinese herbs like astragalus and ginseng are used to increase the production of sperm cells by improving testosterone levels.