- May 9, 2018
- Posted by: Dr. Nnamdi Elenwoke
- Category: Uncategorized
What you need to know
In PART I we defined Infertility as failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse (World Health Organization, WHO). The average infertility in Africa is aproximately 10.1 percent (32% in some countries). Most of the causes are preventable or treatable.
In many societies like Nigeria, the populace admits that it is a female issue and male infertility is a taboo plus insult to male dignity. In fact one of the most important causes of divorce in Nigeria is Infertility. Marriage without children is generally considered as a failure. But research has shown that it equally affects men too. In fact around 40% of Infertility is caused by men. This is a major family and society problem.
Causes of Male Infertility
The most common causes of Infertility in men are related to Quality and Quantity of Sperms. Other causes of Infertility in men are problems in the male’s sexual organs as seen below…
- Varicocele: enlarged varicose veins in the scrotum can affect sperm production, quality, and transport.
- Semen disorders: Azoospermia, Oligospermia, Poor sperm motility or morphology
- Developmental disorders like Congenital absence of the vas deferens
- Ejaculatory duct obstruction (EDO) due to injury, infection or congenital which has been present since birth.
- Previous surgery: vasectomy
- Premature ejaculation: If a man consistently ejaculates before vaginal penetration (which can be caused by prostate health issues, mental health issues, and certain medications) the chances of a sperm meeting an egg are very low.
- Erectile dysfunction: Consistent trouble achieving or maintaining an erection can be caused by systemic disease including Diabetes mellitus.
- Unknown causes can be more than 20 percent.
See more causes here.
Most problems of infertility in men is a product of low sperm quantity or quality. This is seen in more than 90percent of the cases
Risk factors linked to male infertility
- Unhealthy lifestyle
- Using alcohol
- History of infections like sexually transmitted diseases
- Exposure to radiation/toxins/medications
- Anatomical problems including male sexual organs trauma, surgery or genetic problems.
- Diseases like Tumours, Diabetes mellitus, Sickle cell etc.
Visiting a doctor
In an infertile couple the man should be very much involved as his female partner. A medical history and physical examination are standard evaluations in these men. This includes semen analysis. Other tests may include scrotal ultrasound, genetic or hormone testing or testicular biopsy.
According to WHO criteria, andrological investigations are indicated if semen analysis is abnormal in at least two tests to define a diagnosis. Semen analysis must follow the guidelines of the WHO Laboratory Manual for the Examination and Processing of Human Semen. The WHO laboratory manual proposes reference values based on fertility, hence, these reference values do not allow to classify a man as being infertile.
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The good news is that most causes of Infertilty can be avoided or treated and with advance of medicine most woman can have a child. Infertility can be treated with medicine, surgery, artificial insemination or assisted reproductive technology or a combination of both. In rare case that problems cannot be treated, your doctor may advice you to consider adoption or using a donor.
You can read Infertility In Women here.