The known causes of male infertility are:
Hormonal problems - sometimes the pituitary gland does not send the right messages to the testes. This can cause low testosterone levels, which means that sperm are not produced. Hormonal causes are uncommon, and affect less than one in 100 infertile men.
Sperm production problems - Low numbers of sperm are made or the sperm that are made do not work properly. This is the most common cause of male infertility, with about two thirds of infertile men having sperm production problems.
Blockage of sperm transport - Blockages in the tubes leading sperm from the testes to the penis (vas deferens) can cause there to be no sperm in the ejaculate. This is the second most common cause of male infertility and affects about one in five infertile men (including those who have had a vasectomy). Some men are born without vas deferens and have no sperm in their ejaculate.
Sperm antibodies - In some men, sperm antibodies can develop which can reduce sperm movement and block egg binding during fertilisation. About one in every 16 infertile men has sperm antibodies.
Sexual problems - Difficulties with sexual intercourse, such as erection or ejaculation problems, can also stop couples from becoming pregnant.
Other reasons for male infertility include:
· Failed vasectomy reversal
· Retrograde ejaculation
· Mumps in adulthood which can cause inflammation in the testicles and destroy sperm production
· Undescended testes in childhood
· Exposure to toxic chemicals
· Exposure to excessive heat
· Sexually transmitted diseases (perhaps)
Lifestyle can affect fertility. Being obese and smoking can reduce a man’s fertility. It is recommended that men quit smoking if they are trying to have children because a greater number of birth defects has been found in the children of men who smoke heavily. Other drugs, such as marijuana, may also affect fertility. Moderate alcohol intake (one or two standard drinks per day) does not affect sperm production. However a large amount of alcohol may cause liver problems, which can affect general and reproductive health. Men’s fertility declines with increasing age but the decline starts later and is less dramatic than that of women.
STIs
Sexually transmitted infections such as gonorrhoea and chlamydia can damage the epididymis and stop sperm passing from the testes into the ejaculate.
Heat
It is recommended that men who are trying to father a child avoid hot environments such as hot baths, spas and saunas, as these can reduce sperm production.
Steroids
Men who want to father a child and are taking anabolic steroids for body building or sporting purposes should stop because these drugs reduce sperm production.
See www.andrologyaustralia.org for more information about male infertility.
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Jean Hailes, VARTA (above), Andrology Australia and the Robinson Institute have just launched Your Fertility - a campaign to increase Australians' (both men's and women's) knowledge about the factors that affect their ability to conceive and have a healthy baby.
A man's age, being over- or underweight, smoking, heavy alcohol consumption, sexually transmitted infections, environmental toxins, some medical treatments (including certain drugs, cancer treatments and some complementary therapies) and genetic conditions such as Klinefelter's syndrome can all reduce their fertility.
Test your knowledge with our Fertility Quiz at http://yourfertility.org.au
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