Causes of Male Infertility

In about 33% of cases infertility is due to male partner fertility problem and in 33% of the case infertility is due to female partner fertility problem and in balance cases the problem exists in both cases. The cause may be due to hormonal imbalances, psychological problems or physical problems

There are many causes known or unknown which can effect sperm count, ability to sperm movement  or ability to fertilize the egg. The most common causes of male fertility includes:

Sperm production is not normal, it can be due to many reason like undescended testicles, repeated infection or genetic defects etc...

There could be various type of sperm abnormalities, which could be categorized by sperm movement, sperm count,  or sperm shape.

• Oligospermia means Low Sperm Count. If sperm count is less than 20 million/mL is said to be  low sperm.
• Azoospermia means complete absence of sperm cells while ejaculating. Approx 10% of cases of male infertility is Azoospermia or Oligospermia. Any kind of small obstruction in the passages while passing sperms, can also reduce sperm counts. Depends on other factors, sperm count varies widely from time to time. Never believe on single sperm count report from one laboratory.
• Poor Sperm Motility (Asthenospermia). Sperm motility is the sperm's ability to move. If movement is slow or not in a proper line the sperm may have difficulty in penetrating the hard shell of the female egg.
• Teratospermia means Abnormal Sperm shape and structure (Morphology). It is difficult for sperms to fertilize an egg. The perfect sperm shape is an oval head and long tail.

SECONDARY MALE INFERTILITY PROBLEM

Smoking can significantly reduce your sperm count and sperms motility.
Excessive stress can cause a lot or hindrance
Prolonged use recreational drugs like marijuana.
Excessive and regular alcohol intake.
Anabolic steroid use can causes infertility by testicular shrinkage.
Unguided intense exercise also produces high adrenal steroid hormones resulting in infertility.
Some Vitamin are important in regular diet like vitamin C and Zinc.
Sperm production can't happen in increased scrotal temparture, so tight underwear can also cause decreased sperm production.
Some environmental hazards such as pesticides, lead, radioactive substances, mercury, paint

Hormonal Problems:

There are lot of hormones and glands which are involved in sperm production and sperm health like hypothalamus-pituitary endocrine system which regulates hormonal events that enables testes to produce sperm. 

The brain is responsible to release gonadotrophic-releasing hormone (GnRH) properly.

The pituitary is reponsible to produce enough lutenizing hormone (LH) and follicle stimulating hormone (FSH) which stimulate the testes and sperm production.

The testes’ Leydig cells is also responsible to produce testosterone in response to LH stimulation.

Physical problems

Varicoele:

Enlargement of the internal spermatic veins which are responsible to drain blood from the testicle back to the heart

Damaged Sperm Ducts:

If ducts through which sperms need to be passed out of the penis, is not perfect can cause infertility. Obstruction in passage may be due to following reasons.

• A developmental or genetic problem may be one of the cause of one or both tubes absence.
• Tuberculosis or STDs may cause blockage in epididymis or tubes.
• Any hurt during accident to vasectomy may interrupt tube continuity.

Orsion: Orsion is one of the problem causing infertility caused by a supportive tissue abnormality which lets the testes to twist inside the scrotum, causing a swelling at that area.

Infection and Disease:Some diseases like tuberculosis, brucellosis, Mumps, typhoid, gonorrhea, influenza, smallpox, and syphilis may also cause testicular atrophy.  These diseases can cause low sperm count or low sperm motility. 

Retrograde Ejaculation: In very rare cases semen can be ejaculated into the bladder rather than coming out through the urethra as the normaly bladder sphincter should close during ejaculation. In this case ejaculate volume is small and urine may include some sperms resulting in cloudy urine after ejaculation.

Causes of Female Infertility

To be a pregnant, each part of complex reproduction system should work properly. Ovary should produce good eggs, eggs should be fertilize properly and growth should occur properly in the uterus. Female infertility can be caused by following factors.

Hormonal Problems

These are the most common causes of infertility where ovulation does not happen properly. The process of ovulation is a complex balance of hormones and its interactions, and any problem in this process can hinder ovulation. 

• Failure to produce mature eggs

Approx 45% cases of anovulation, the ovaries is not producing normal follicles in which the eggs can mature.  Ovulation can hardly happen if the eggs are immature and there are hardly any chance of fertilization. Polycystic ovary syndrome is one of the most commonly found disorder, it includes symptoms such as anovulation , amenorrhoea and infertility. This problem can result into reduced production of FSH, and also increase LH levels, testosterone  and oestrogen hormones.  The increased level of oestrogen can also cause chances of breast cancer.

• Malfunction of the hypothalamus

The hypothalamus is the portion of the brain responsible for sending signals to the pituitary gland, which, in turn, sends hormonal stimuli to the ovaries in the form of FSH and LH to initiate egg maturation.  If the hypothalamus fails to trigger and control this process, immature eggs will result.  This is the cause of ovarian failure in 20% of cases.  

• Malfunction of the pituitary gland

One of the most important gland, pituitary gland, its responsibility lies in producing and secreting FSH and LH.  In case of deficiency or excess of FSH and LH, the ovaries will be unable to ovulate properly. This can occur due to tumor, injury, or chemical imbalance in the pituitary.

Premature Menopause:

In some cases cease menstruation and begin menopause before normal age can also result into infertility.  One of the main cause for this is women with a long history of low body weight and too much exercise.  Another reason could be genetic.

Damaged/Scarred Ovaries:

Even in physical damage to the ovaries may result in failed ovulation. e.g. sygical removal of ovarian cysts may be one of the cause of the ovary to be damaged. In case of any Infection the same effect can happen.

Follicle Problems:

In this case the egg remains inside the ovary and ovulation does not occur properly.

Causes of Poorly Functioning Fallopian Tubes

This problem could be mild or completely damaged fallopian tube. Surgery or laser treatment has not given good results in terms of reveral of damaged fallopian tubes and success rates after this treatment is low. These are the few causes of tubal damage:

Infection:

Sexually transmitted bacterial or virus infection caused by both bacteria and viruses and usually transmitted sexually, these infections may cause inflammation resulting in damage to tube. A specific example is Hydrosalpnix, a condition in which the fallopian tube is occluded at both endpoint and fluid collects inside the tube. these infections remain subclincal without any warning symptoms.

Ectopic Pregnancy:

In this case pregnancy occurs in the tube only and even in cased of successfully overcome  may cause tube damage and reach to a life-threatening condition.

Previous Surgeries:

One of the cause of tubal disease and scarring is abdominal or Pelvic surgery, which can result in adhesions means that tubes are altered in such a way that travelling of eggs through them is not possible.

Abdominal Diseases:

Diseases like appendicitis and colitis may cause inflammation of the abdomien which can definately affect the fallopian tubes and lead to blockage or scarring.

Congenital Defects:

Genetically women can be born with tubal problems which is commonly also associated with uterus problems.

Endometriosis:

Endometriosis had affected 5,000,000 women in USA only.  A lot of patients with endometriosis are infertile.  This can reduce 1/3 charges of pregnancy on monthly basis. Excessive growth of the lining of the uterus is called as endometrial hyperplasia.  This Growth can occurs in the abdomen, fallopian tubes, ovaries, the pelvic peritoneum and in uterus. Symptoms which are generally associated with this disease is painful, heavy  and long menstrual periods, rectal bleeding, urgent urine and premenstrual spots.  Pregnancy rates hardly improves by minimal endometriosis treatment. Endometriosis is also known to effect the quality of eggs.

Unexplained infertility:

Due to complex nature of reproduction system sometime no reason is found for infertility, so called as unexplained infertility. May be some minor factor or combination of minor factor can cause infertility. But in this category there are higher chances of pregnancy at any time.