What are the causes of male infertility?

If a woman cannot get pregnant, it is not only due to her physical condition, it may also be caused by male infertility. There are many reasons for male infertility, which may be caused by endocrine diseases, blockage of fallopian tubes, and sometimes even infection that is not noticed or not taken seriously may cause infertility in the future.

Pathological etiology

Common causes of male infertility include:

1. Chromosomal abnormalities Common ones include male pseudohermaphroditism, Klinefelter syndrome and XYY syndrome. Chromosomal abnormalities such as 46XY/47XXY can cause testicular spermatogenesis disorders.

2. Endocrine diseases: Hypothalamic dysfunction, such as Kallmann syndrome, is mainly caused by gonadotropin-releasing hormone deficiency; pituitary dysfunction, such as selective luteinizing hormone (LH) deficiency and follicular gonadotropin (FSH) deficiency, hyperprolactinemia, etc. Adrenal hyperplasia can inhibit the pituitary secretion of FSH and LH, leading to infertility.

3. Reproductive tract infections such as prostatitis, epididymitis, orchitis, and urethritis. Severe cases may affect male fertility.

4. Obstruction of the vas deferens Both congenital and acquired obstructions can affect the transport of sperm and cause infertility.

5. Abnormal testicular spermatogenesis. Cryptorchidism, microtestis, atestis, viral orchitis, varicocele, toxins, magnetic fields, high fever and trauma and other physical and chemical factors can all cause testicular spermatogenesis disorders.

6. Abnormal sperm structure and seminal plasma can affect sperm motility, capacitation and acrosome reaction.

7. Immune infertility Anti-sperm antibodies produced by men themselves and anti-sperm antibodies produced by women can affect sperm motility and its ability to penetrate eggs.

8. Male sexual dysfunction Erectile dysfunction, premature ejaculation, anejaculation and retrograde ejaculation can all cause male infertility.

9. Drug factors: Common ones include cimetidine, sulfasalazine, triptolide, spironolactone, nitrofurantoin, niridazole, colchicine, various hormone drugs and cancer chemotherapy drugs such as certain alkyl compounds, which can often cause temporary or permanent damage to sperm production.

10. Surgical factors such as urethral valve surgery, bladder neck incision for urethral obstruction, retroperitoneal lymph node dissection or larger retroperitoneal surgery may cause retrograde ejaculation or ejaculation disorders, leading to infertility.

11. Bad living habits and work factors: wearing tight pants for a long time, smoking and drinking, contact with toxic substances, frequent hot water baths, improper or excessive sexual intercourse, frequent long-distance and excessively strenuous cycling, and radiation damage, etc.

12. Others Ciliary stasis syndrome is characterized by the patient suffering from chronic respiratory diseases in childhood. In adulthood, the cilium at the tail of the sperm is abnormal and the sperm's ability to swim forward is weak.

Symptoms and signs

1. Medical history: Inquire about occupation, past medical history, lifestyle and eating habits, smoking and drinking history, marital history, sexual life (frequency, posture, erection and ejaculation, whether or not there is orgasm), whether semen has been tested, and the woman’s health and marital history.

2. Physical examination: Check the general condition and pay attention to any special body shape and systemic diseases. Check the external genitalia and pay attention to the degree of penis development, external urethral opening, testicular size, the relationship between the epididymis and testicles, and whether there are lesions in the spermatic cord (such as varicocele, lesions in the vas deferens, etc.). Pay attention to the prostate and seminal vesicles during rectal examination, perform prostate massage, and perform smear examination.

Preventive care

A considerable part of male infertility can be solved through population or individual prevention, which requires that all people, especially those susceptible to the disease, receive universal education on sexual and reproductive knowledge.

1. Eliminate inbreeding, especially those where one or both parties are known to have congenital or genetic defects. This can not only reduce infertility, but also improve the quality of the newborn population.

2. Eliminate the influence of physical and chemical factors. Avoid contact with ionizing and non-ionizing radiation, eliminate the warm state of the testicular area, avoid changes in testicular morphology, metabolism and biochemistry, maintain a normal microenvironment, reduce reproductive immune response, etc.; minimize contact with metal elements such as cadmium, lead, zinc, silver, cobalt and chemicals such as cottonpol and diloxol, and take as little or no chemotherapy, antihypertensive drugs, hormones, sedatives and anesthetics as possible; long-term excessive drinking and smoking can cause impotence, abnormal ejaculation function, and even abnormal sperm quality, leading to infertility or teratogenic pregnancy. Every patient should be made aware that malnutrition will lead to a deficiency of protein, vitamins and trace elements, which will affect the production and function of sperm, causing abnormalities in sperm quantity and quality, and will also cause male infertility.

3. Pay attention to personal hygiene and prevent male reproductive system infection. This is an important aspect of preventing male infertility, especially sexually transmitted diseases. Once infected, not only will the sperm duct be obstructed, but in severe cases, it will cause gonadal dysfunction. On the other hand, family disputes and emotional discord caused by this factor will psychologically affect sexual function.

4. Treatment of varicose veins Varicose veins are another treatable aspect of male infertility. When a man feels a sense of drooping or earthworm-like bulges on the left or both sides of the scrotum, he should see a doctor immediately and receive surgery immediately to prevent long-term varicose veins from leading to testicular insufficiency. Other urinary system abnormalities such as hematospermia and testicular enlargement should be treated as soon as possible to avoid aggravation of the condition due to negligence, resulting in infertility or even more serious consequences.

5. Treatment of sexual psychological abnormalities Sexual psychological abnormalities can lead to sexual dysfunction, and sexual dysfunction can cause male infertility. Therefore, patients should undergo necessary examinations and appropriate treatment as soon as possible.