Symptoms and causes

Male Infertility

Male Infertility Symptoms

Infertility is defined as the absence of spontaneous pregnancy after one year of sexual intercourse within a sexually active couple and in the absence of contraceptive treatment.

In half of the couples who unsuccessfully seek offspring, there is a male factor for such infertility, usually in the form of alterations in the semen analysis. For this reason, all men of infertile couples should be studied.

Causes of Male Infertility

The main causes of the alterations that can produce male infertility are:

• Congenital or acquired urogenital abnormalities, such as trauma, prostate problems, previous prostate surgery, vasectomy.
• Radiotherapy or chemotherapy. The history of radiotherapy on the genital area or retroperitoneum can produce alterations in spermatogenesis or dysfunctions in the sperm emission phase. Chemotherapy, on the other hand, can produce alterations in the seminogram or in the peripheral nerves that regulate sperm emission.
• Malignant tumors.
• Urinary tract infections. Infections can influence the quality and emission of seminal fluid and spermatozoa, which can decrease the probability of pregnancy.
• Increased scrotal temperature, for example as a consequence of a varicocele.
• Endocrine disorders. A decrease in testosterone production or hypogonadism may cause an associated decrease in sperm production.
• Genetic alterations. Some genetic diseases, such as Klinefelter's disease or cystic fibrosis, can worsen -even nullify- the possibility of pregnancy.
• Immunological factors.

In one third of cases there is no male factor that explains the worsening of semen parameters, which historically has been called idiopathic male infertility.

These men have no previous history of disease or infection that may affect fertility, along with a normal examination and normal laboratory results. However, semen analysis may yield abnormal results.

Increasing paternal age has been shown to be one of the main risk factors associated with the progressive increase in the frequency of male factor infertility. Similarly, maternal age has been shown to be one of the main risk factors associated with a progressive increase in the frequency of male factor infertility. In both cases, although it is difficult to draw a line, it appears that the age of either parent above 35 years is a risk factor for infertility.