Causes of Male Infertility

In the medical field, infertility is generally defined as the inability of a couple to conceive after at least one year of regular, unprotected sexual intercourse. In recent years, the prevalence of infertility has been rising across all age groups.

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Male Infertility: A Common Yet Overlooked Issue

Infertility is not solely a female issue. In fact, male factors account for approximately 30–40% of infertility cases, a proportion comparable to that seen in women. Therefore, it is crucial to evaluate both partners when investigating the causes of infertility.

Common Causes of Male Infertility

• Abnormal Sperm Production

Problems with sperm production may result from congenital abnormalities, such as chromosomal defects, undescended testicles, or infections affecting the testes (e.g., mumps orchitis). Other contributing factors include testicular torsion, trauma, or exposure to certain medications (such as antihypertensives), chemicals, or excessive heat. In many cases, however, the exact cause cannot be clearly identified.

• Obstruction in Sperm Transport

Obstruction may occur due to congenital absence of the vas deferens or as a result of a previous vasectomy, both of which block the normal passage of sperm from the testicles.

• Immune System Reactions Against Sperm

In some cases, the immune system produces antibodies that attack sperm. This condition may develop following a vasectomy, infections, or for reasons that remain unclear.

• Sexual Dysfunction and Ejaculation Disorders

Conditions such as erectile dysfunction, retrograde ejaculation (in which semen flows backward into the bladder), low libido, spinal cord injuries, or surgeries involving the testes can negatively affect fertility. Certain medications may also interfere with normal ejaculation or sperm production.

• Hormonal Imbalances

Hormonal disorders may arise from congenital hormone deficiencies, pituitary gland tumors, or the use of external hormones, such as anabolic steroids commonly used by bodybuilders. These conditions can suppress natural hormone production and reduce stimulation of the testes, leading to impaired sperm production.

• Symptoms and Diagnosis

In many cases, male infertility presents without obvious symptoms. However, some men may experience erectile difficulties, reduced semen volume, or have a history of testicular infections or injuries.

Once a potential cause is identified, a fertility specialist can develop an appropriate treatment plan—whether by correcting the underlying issue or improving sperm quality to support assisted reproductive techniques such as intrauterine insemination (IUI) or in vitro fertilization (IVF).

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