Male Infertility Causes & Diagnosis
Causes of male infertility
Causes of infertility in men can be explained by deficiencies in ejaculate volume, sperm concentration (e.g. too few – oligospermia - or no sperm – azoospermia - in ejaculate), sperm motility or sperm morphology (shape of the sperm).
Some specific causes are:
- Hypothalamic disease can include deficiency in GnRH, LH or FSH
- Pituitary disease e.g. tumours, thyroid problems
- Chromosomal abnormalities e.g. Klinefelter’s syndrome
- Trauma to the testicles
- Defective androgen synthesis or action
- Cryptorchism (undescended testis)
- Systemic disease (renal failure, hepatic disease, sickle cell disease)
- Difficulties with intercourse e.g. ejaculatory failure, impotence
Sometimes a cause for male infertility cannot be found.
Diagnosis of Male Infertility
Your consultant will first take your medical history and conduct a careful physical examination. The history will include noting details of: any childhood illnesses; previous surgery; exposure to occupational and environmental toxins, excessive heat, chemicals or radiation; alcohol, drug and medication use; and any medical conditions related to the reproductive system. The physical examination will include a careful examination of the scrotal contents.
The most useful tool in testing for male infertility is the semen analysis. The ‘normal’ values for different measurements of sperm quality have been worked out by testing large groups of healthy fertile volunteers. When a semen analysis is done, the results are compared with the normal range of values and any abnormalities will suggest a male problem. The tests carried out on a semen sample will look for abnormalities in sperm number (the sperm count), sperm movement and sperm shape.
Blood tests to assess the levels of hormones relevant to sperm production are also used to exclude hormonal factors and/or abnormalities.