Male Infertility Tips

Impotence

Impotence, or the lack of ability to attain or sustain an erection for penetration during intercourse, is one of the primary causes of male infertility. This is also called "erectile dysfunction (ED)."

There are different medical conditions that can contribute to ED, including hormonal imbalances, history of trauma to the pelvis, medication side effects, psychological factors, structural problems, and complications of certain chronic diseases. Your ED may be caused by one or more of these conditions.

1. Hormonal imbalances can effect erection and ejaculation, and include: low testosterone levels, and pituitary or thyroid malfunction.

2. Traumatic causes can include: straddle injuries, penile amputation, pelvic fractures, or puncture wounds to the penis, bladder or testes.

3. Medication Side Effects from medications such as: high blood pressure medication (Lisinopril), anti-depressants (Trazadone), anti-histamines (Benedryl), narcotic pain medication (morphine), diuretics (Lasix) or muscle relaxants (Flexeril).

4. Psychological factors which can contribute to ED include: stress, anxiety, depression, guilt, low self-esteem and indifference.

5. Structural problems, which can include: diseases or injuries to the blood vessels in the pelvis and penis, muscle malformation or damage, or congenital nerve structure anomalies.

6. Complications of diseases, like diabetes, Multiple Sclerosis, Parkinson's Disease, Muscular Dystrophy, Kidney Disease, Hypertension and Stroke.

Since many of these contributors to impotence and male infertility are treatable, it is important that you talk with your healthcare provider about the best treatment for your erectile dysfunction.

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Causes of Male Infertility

Male infertility is more than a problem attaining or maintaining an erection, although sexual dysfunction is one contributing cause to infertility.

There are many medical conditions which can contribute to male infertility. The five (5) main categories include:

1. Sexual dysfunction - inability to attain or maintain an erection for penetration, or ejaculatory dysfunction

2. Disorders of sperm motility - sperm maturation defects, congenital defects in the sperm (lack of or malformed sperm tail) or immotile cilia in which the mechanism for moving the sperm in defective

3. Disorders of sperm transport - congenital defects of the male organs, acquired defects (infections with scarring) or nerve damage in the pelvic area from prior surgery or injury

4. Hormonal problems - lack of appropriate pituitary hormones, hemachromatosis (iron deposits in the testes and pituitary gland)

5. Testicular problems - missing testes, underdeveloped testes, testicular trauma or genetic low sperm production

In order for your physician to determine what may be contributing to challenges with conception, you will need to undergo a thorough examination, including history and physical. Many types of male infertility can be treated, and with the help of a qualified medical practitioner, you increase your chances of successfully conceiving a child.

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Stress and Male Infertility

We have all heard of the term "stress," but what is "stress" and how does it impact male fertility?

When we experience "stress," - a known or perceived threat which activates self-defense responses - our bodies produce stress chemicals such as cortisol, prolactin and adrenaline. During periods of increased stress, blood flow decreases to our core organs and increases to our limbs. Our breathing and heart rate increase, our vision becomes more acute and we tense up for the impending event, which is creating these symptoms. Some of these responses are mediated by the hypothalamus and pituitary.

In addition to these normal body responses to stress, we see negative effects including: sleep disturbance, gastrointestinal problems, and impaired sexual function. Since both the pituitary and the hypothalamus have a role in reproductive hormones, it makes sense that stress would then impact fertility.

Add to these factors, fear of failure, performance anxiety and feelings of inadequacy associated with past infertility, and the impact of stress is significant, both physically and psychologically.

With this information, is seems logical that stress-reduction exercises and stress management education could aid in reducing stress-complicated infertility.

Breathing exercises, visualization, massage and other self-help techniques can aid in reducing the production of stress hormones, which negatively impact both your psychological and your physical health, and which can worsen or contribute to male infertility.

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Sperm Motility as a Cause of Male Infertility

There are many causes of male infertility, including sperm-related conditions. The three primary sperm-motility causes of male infertility, include:

1. lack of, or misshaped, sperm tail
2. sperm maturation defects
3. immotile cilia

Congenital abnormalities in the sperm can result in failure of the sperm tail to develop properly. Sperm with missing or misshaped tails are unable to effectively propel themselves after ejaculation.

Sperm with maturation defects do not grow and mature at a normal rate, which impacts their ability to perform normal sperm functions.

When immotile cilia is the problem, the small hair-like structures that aid in propelling the sperm to its destination, are not working properly, impairing the sperm's ability to "swim." Defects in the sperm themselves can also impair the function of the cilia.

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Testicular Causes of Male Infertility

Male infertility is a complex and challenging problem to overcome, since there are many contributing causes. Problems with the testicles can contribute to male infertility, with the main testicular causes of male infertility including:

1. Genetic disorders
2. Internal disorders
3. External conditions

• Kleinfelter's Syndrome - an extra "X" chromosome results in small testes with low sperm volume.
• XX Disorders - causes structural problems within the penis and variable sperm production.
• Noonan's Syndrome - low sperm production and abnormal testes, with testicle damage later in life
• Enzymatic production defects, including defective testosterone production and androgen resistance

• Lack of testes or anorchia (pronounced "an-or-key-uh")
• Absence of sperm germinal cells - cells which mature into functional sperm
• Blocked ducts leading from the testes to the penis
• Systemic diseases such as kidney failure, liver failure and sickle cell disease
• Scrotal cysts or fluid pouches, called varicoceles (pronounced "var-ick-oh-seals")
• Overheating of testicles due to backflow of blood into the scrotum

• Radiation for cancer treatment
• Testicular trauma, such as that caused by straddle injuries
• Acquired infections such as mumps and sexually transmitted diseases
• Injuries associated with surgery in the groin, bowel, or pelvis

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Treatment for Male Infertility

As with the causes of male infertility, there are also many different treatments to manage this emotionally and physically challenging condition. Some treatment options include:

• Surgical intervention
• Hormone treatment
• Assistive Reproductive Techniques

Hormonal interventions could be utilized for imbalances in testosterone, or the hormones involved in sperm production, or can be used to treat underlying medical problems contributing to infertility, such as low thyroid, or pituitary disease.

Assistive reproductive technology, such as artificial insemination, can be used when male infertility cannot be remedied by other methods. This can include cases where penile trauma prevents intercourse, or with structural problems that cannot be repaired in such a way as to promote conception.

There are numerous options for treating male infertility. Talk to your Infertility Specialist to see which treatment option is the best for you.

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Hemachromatosis and Male Infertility

There are a wide range of contributors to male infertility, including genetic, structural, hormonal, and functional problems. One such cause of infertility in men, is Hemachromatosis.

Hemachromatosis (pronounced "he-muh-crow-muh-toe-sis) is a condition where iron, normally carried within the bloodstream, is deposited in body organs, including the reproductive organs. The body does not appropriately process iron which, once in the organs, causes tissue damage. Iron can accumulate in the testes, effectively impairing the body's ability to produce healthy sperm. In essence, the sperm get heavy metal poisoning.

The cause of hemochromatosis is genetic - it is very common in Northern European peoples, with as many as one in every 10 persons of Northern European descent carrying the defective gene.

Treatment primarily consists of removal of blood (blood letting) to reduce the total iron levels, in addition to treating the subsequent organ damage, limiting alcohol intake and increasing your intake of foods that prohibit iron production.

Testing for hemachromatosis would be conducted by your Fertility Specialist in the course of your evaluation for male infertility, if you are of Northern European descent.

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Sperm Transport Problems as a Cause of Male Infertility

Many different factors influence male fertility and infertility, including sperm transport. When sperm are not effectively transported to the uterus, fertilization cannot occur.

There are three main causes of sperm transport problems:

1. Congenital disorders
2. Acquired disorders
3. Functional obstruction

Acquired disorders that impact sperm transport can include: scarring of the ducts due to bacterial infections, such as sexually transmitted diseases, or accidental severing of transport ducts during hernia repair or other surgery.

Functional disorders that impede sperm transport, in male infertility, can include: nerve damage to the reproductive organs from trauma, surgery or spinal cord injury. Medications, such as high blood pressure medicine, tranquilizers and anti-depressants, can also effect the nervous system and result in functional problems.

Since there are do many different conditions which can cause male infertility, determining the contributing causes, including the presence of sperm transport problems, requires assertive testing and intervention, in order to get the best outcome. Talk to your Infertility Specialist, who can help you problem-solve your fertility concerns.

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The Role of Hormones in Male Infertility

As with women, hormones play a significant role in reproduction for men. Hormonal abnormalities can significantly effect a man's ability to produce sperm, achieve an erection and produce children. The primary hormones involved in male fertility are:

• Gonadotropin Releasing Hormone
• Luteinizing Hormone
• Follicle-stimulation Hormone
• Testosterone

LH and FSH have primary functions in male fertility in binding with specific sperm germ cells (immature sperm cells) within the testes, to prompt sperm production. LH mediates testosterone production FSH assists Sertoli cells located in the testes, to nourish growing sperm cells.

Testosterone is metabolized into androgen and estrogen, which moderate LH production, aiding in controlling sperm production, maturation at puberty, and regulation of GnRH.

These hormones work together in a careful balance to control sperm production. Any disturbances in these hormone levels, such as might be caused by pituitary or hypothalamus disease, chemical or medication influence, or thyroid dysfunction can adversely affect a man's ability to produce and maintain sperm, and therefore, be able to conceive.

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