What impacts male fertility? Everything you need to know about the male reproductive system
One of the most common misconceptions about infertility amongst couples trying to conceive is that the issue arises due to problems in the female reproductive system. However, the reality is not that simple. Male fertility account for About 20% of infertility cases that arises solely due to issues with the male reproductive system. Furthermore, the malefactor plays a partial role (informative) in 30-40% of infertility cases.
Suppose we put the numbers in some context here, for every ten couples that visit a fertility specialist. In that case, 5-6 couples receive a diagnosis that indicates issues with sperm quality or other problems with the male reproductive system.
The sections below will learn different aspects of the male reproductive system that can cause fertility issues. We will also discuss some factors that make the sperm healthy, including environmental factors and lifestyle.
Male reproductive system 101
Let’s begin our discussion by refreshing our knowledge about the male anatomy. The human male system consists of the following major parts-
- The penis
- The testes
Apart from these major parts, other parts of the male reproductive system, such as vas deferent, seminal vesicles, and the bulbourethral glands, play a minor but crucial role. If all the male reproductive system parts are working properly, the sperm production is optimal, and the sperm can reach the eggs for fertilization.
- The penis and the scrotum are the parts of the male reproductive system located outside the body. The scrotum is a bag-like structure that holds testicles. Two testicles play a crucial role in the production (spermatogenesis) and nourishment of the sperm. The testicles also play a vital role in the body’s endocrine system by producing the male sex hormone or Testosterone.
- Each testis is connected to a long tube-like structure called the epididymis that holds the sperm temporarily and helps them to mature before they are ejaculated into the female reproductive tract. Attached to the epididymis of each testis is another tube-like structure called the vas deferens, and these tubes help to transport the sperm from the epididymis to the penis. Along the way, the ejaculate picks up secretions of three reproductive glands- the seminal vesicles, the prostate, and the bulbourethral glands.
- The seminal vesicles produce an alkaline fluid called the seminal fluid that contributes about 60% of the total volume of the semen. The seminal fluid helps the sperm cells to swim and also helps to neutralize the acidic environment of the vagina, making it more hospitable for sperms.
The sperm & male fertility
The sperm cells look almost like tadpoles under a microscope, but they are quite complex involving many parts that play a significant role right up to the fertilization. In general, a sperm cell can be divided into the following three segments-
- The head is the most vital part of the sperm as it contains the nucleus, which holds all the genetic information, and it is the only part of the sperm cell that penetrates the egg.
- The middle piece, or a.k.a the body: Contains many vital organelles of the sperm cells called the mitochondria. Without going into a lot of science, you can correctly assume that mitochondria play an important role in producing energy that sperm utilizes to swim.
- The tail is the last part of the sperm that helps the sperm swim by performing a swirling motion.
One of the most important hormones in the male reproductive system is Testosterone, and it helps the production of sperm by a process called spermatogenesis. Other hormones also play an important role in maintaining the health of the sperm, including Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH).
What factors play a role in maintaining the health of the sperm?
Healthy sperm cells meet certain quality standards during the sperm test. The parameters that are tested during a standard sperm test are the ones that enable the sperm cells to reach and fertilize the egg. Some of the parameters measured include-
- Concentration: The number of sperm cells present in 1 millilitre of the semen or ejaculate
- Volume: The volume of semen that is ejaculated
- Motility: The ability of the sperm to swim or move through the fluids
- Morphology: It refers to the external appearance of the sperm cells. If the sperm cell has normal morphology, it will have all the parts, including the head, middle piece, and tail. If the sperm cell is developed abnormally, it might have an unusually long body or multiple tails. Such sperm cells are not ideal for fertilization.
Male infertility stems from the following causes-
- Problems on sperm production (spermatogenesis)
- Problems in the way the sperm are delivered through the reproductive organs
- Problems with sexual function (for example, erectile dysfunction)
According to medical professionals, the most common cause for male factor infertility is issues regarding sperm production, such as low sperm count or motility issues.
What are some environmental factors that can affect male fertility?
It takes about three months for the sperm to form and mature in the testes. Consequently, your lifestyle choices can have a major impact on both the amount and the quality of sperm you produce. Some of the environmental factors that can affect sperm production include-
- Smoking and drinking: Smoking tobacco and drinking alcohol (14+ drinks per week) can seriously negatively impact both the sperm count and the motility of the sperm. Although there is no clarity on the effects of cannabis on the various aspects of sperm health, healthcare professionals do warn against the use of cannabis as there can be a potential risk.
- Nutrition: Some studies do suggest that certain foods can lower your sperm count. Soy, processed meat, trans fat, and food rich in high dairy fat have been found to reduce the number of sperm your body can produce. The reason for this is attributed, at least in part, to a high amount of estrogen present in these processed foods. Consuming large proportions of these foods can create an imbalance between the androgen and estrogen in your body, resulting in sperm production and motility issues.
Consuming a high amount of trans fats can also increase the production of endogenous estrogens in the body. According to medical professionals, some people might have an inflammatory response to red meat, potentially decreasing the sperm count.
- Stress: Another very common factor responsible for low sperm count is stress. Several studies linking mental stress and sperm quality have been conducted in the last decade or so have found a correlation between stress and the quality of sperm. Stress can also negatively impact a man’s ability to maintain an erection, creating problems if you are trying to conceive.
- Exposure to heat: There is a reason why the testes are held outside the body in the scrotum. The spermatogenesis (synthesis of sperm cells in the testis) requires a lower temperature than your body’s core temperature. If you use hot tubs or saunas frequently, sperm production can take a hit, and your erm count might fall significantly. Wearing tight underwear can also reduce the number of sperms you can produce. The heat from cell phones and laptops is also not good for sperm count.
- Exposure to toxins: Exposure to toxins such as BPA (A chemical found in plastics) heavy metals such as lead and mercury can reduce sperm count.
What does age have to do with male fertility?
As it is difficult for women to get pregnant as they age, males also see a decline in sperm quality and fertility. However, this decreases slower and probably has less clinical significance in males.
A study comparing sperm in two groups of men (30 and 50 years old) found that sperm quality (including sperm motility morphology) is lower in older men than younger men. However, sperm parameters can’t accurately predict male fertility. It is unlikely that male fertility declines beyond the 40s-50s, and this is in contrast to females, where fertility reduces greatly with age.
Are there any health conditions that are not directly related to sperm that can impact male fertility?
Many disorders can be linked to male factor infertility, which we don’t usually think of in sperm or pregnancy.
- Diabetes or spinal cord injuries may cause problems in ejaculation. In some cases, the semen returns to the urinary bladder rather than out the tip of the penis.
- Cystic fibrosis patients are often born without vas deferens, and this means that sperm cannot leave the testes by itself.
- Chromosome defects related to genetic disorders such as Kallmann’s and Klinefelter syndromes can lead to abnormal development of male reproductive organs, affecting sperm production.
- Malignant tumours and cancers of the pituitary can cause spermatogenesis to be disrupted if they affect the part of the pituitary that makes LH and FSH.
- Side effects of chemotherapy and cancer medication, anabolic steroids, and testosterone replacement therapy can cause lower sperm quality and infertility.
Are there any health conditions that are directly related to sperm or the male reproductive system?
A decrease in the number of sperm is associated with some disorders, including the following-
- Azoospermia – Semen that does not contain sperm (there is any sperm count in such males)
- Oligospermia- Low sperm count (less than 20,000,000/mL). If the count is less than 5 million/mL, the condition is categorized as severe oligospermia.
- Asthenozoospermia -The motility of the sperm is severely hampered, and the sperm cannot swim.
- Teratospermia: In this condition, the sperm cells show an abnormal morphology.
Male factor infertility can be caused by other factors, including malignancies (cancers), infections, and hormonal imbalances, to name a few.
- Obstructive vas deferens can be caused by surgical scarring, cancers of the reproductive organs, injury, or other infections. This can make it difficult or even impossible to ejaculate.
- Infertility can be caused by untreated STIs such as HIV or gonorrhea.
- Varicocele is a swelling of the veins draining the testicles. This can cause male infertility as well as decreased sperm quality and temperature regulation problems in the testicles.
- Low levels of Testosterone, androgens, and high estrogen levels can cause sperm loss.
- Undescended testes, a medical condition in which the testes do not descend into the scrotum at birth, can also cause azoospermia. If the testes remain in the abdomen, the higher temperature makes it virtually impossible for the testes to produce sperm. This condition can be surgically cured by a procedure called orchiopexy.
- Infections such as mumps and orchitis may affect sperm motility, decrease sperm counts, and cause azoospermia. This can lead to infertility later on in life.
Can you “boost” male fertility?
It is possible to boost your fertility using different approaches, including medication, surgery, and assisted reproductive technology. Boost male fertility in Australia with conceive plus vitamins. Consult with your healthcare provider to pick the options that suit your needs and condition the best.
How is male infertility diagnosed?
The first thing to diagnose male infertility is to get your sperm tested. This type of testing can be done either in a doctor’s office, an andrology lab, or at home using special kits.
Your sperm will be analyzed to see if there is an issue with the number, morphology, or motility that might prevent them from reaching the egg and fertilizing it. Additional testing, such as bloodwork or sperm analysis, may help confirm that you are experiencing fertility problems. Here are some possible categories of infertility:
- Infertility is caused by primary testicular defects that affect the development or production of sperm. It occurs in 65 to 80% of male cases.
- Idiopathic male fertility: In this condition, the sperm analysis comes back as being ‘Normal,’ but the sperm are still unable to fertilize an egg for some reason. This is the case in 30% of male infertility cases.
- Sperm Transport Disorders: A large chunk of fertility issues in men arise from problems with sperm motility. If the sperm cannot move normally, they might not be able to reach the egg and fertilize it.
- Hormonal and systemic disorders: Hormonal disorders can cause male infertility, accounting for about 2-5% of all infertility cases. These disorders usually impact your levels of gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and Testosterone (T).
Once there is a diagnosis of a fertility disorder, you will be guided to appropriate treatments by your fertility expert.
Medical treatments for male infertility
Men with fertility issues can be treated with medications to stimulate spermatogenesis. Commonly prescribed treatments for increasing testosterone levels and motile fertility may include gonadotropin therapy, clomiphene citrate, and anastrozole.
- For men with infertility caused by a varicocele or vas deferens obstruction, surgical procedures might be the only way out.
- Assisted reproductive technology (ART) can help men with low sperm motility. If male infertility persists, a sperm donor may be used to inseminate a partner using ART or IUI.
- Dietary supplements, folate, and zinc supplements are generally recommended to improve male fertility, but their utility is still under investigation. Although these supplements certainly don’t cause any harm, they might not have a huge impact on your fertility.
- There is some evidence that eating walnuts and having a Mediterranean diet can help boost male fertility. A diet rich in antioxidants that is rich in fresh fruits and vegetables can help male infertility. Avoiding smoking, drinking alcohol, and reducing processed and red meat can also improve sperm counts in men with fertility issues.
- A high body fat percentage can create an imbalance between estrogen and testosterone levels, leading to fertility issues. Exercising regularly and keeping your body fat low can also boost your sperm count.
Reproductive health is very important whether you are trying to become a parent or not. Eating a healthy, balanced diet and having a healthy lifestyle can boost your sperm count. If you suspect that you might have male fertility issues, do not hesitate to consult with your fertility expert.