Causes of male infertility

Αιτίες ανδρικής υπογονιμότητας

Causes of male infertility

The traditional perception that the causes of a couple’s failure to conceive were attributed to women exclusively, has led to a huge delay in investigating of men’s fertilization potential, as it started only 15-20 years ago.

Nowadys, even though knowledge on the causes relating to male infertility has sufficiently advanced, it is still not possible to clearly identify them. In a high percentage of cases, around 40%, the causes to the problem remain unclear. We thus refer to cases of “idiopathic infertility” or “unexplained infertility”.

Thorough analysis of the medical history, combined with complete clinical and laboratory examination, has led to the identification of general categories of factors causing male infertility, mainly related to a variety of conditions.

Approximately 2/3 of infertile men are unable to produce sufficient number of and/or functionally qualitative spermatozoa. Several factors may affect the process, such as:

Genetic factors
Chromosomal or genetic abnormalities
Clinical factors
Cryptorchidism
Varicocele
Testicular torsion
Inflammation
Parotitis
Medical factors
Medicines
Radiation
Environmental factors
High temperature
Chemical substances
Radiation
Unidentified factors

About 3 in 20 infertile men experience an inability to transport sperm from the testicles to the exit of the genital tract due to a obstruction, which may be related to:

  • Inflammation
  • Prostate problems
  • Absence of vas deferens
  • Severance of vas deferens (vasectomy)

The presence of anti-sperm antibodies reduces sperm motility as well as their ability to bind to the egg. This phenomenon occurs in around 1 out of 16 infertile men and may relate to:

  • Severance of vas deferens (vasectomy)
  • Injury or inflammation of the epididymis
  • Unidentified aetiology

The phenomenon of male infertility arises, less frequently, as a side effect of a condition associated with sexual dysfunction. This case concerns 1 out of 100 infertile men and relates to:

  • Retrograde or premature ejaculation
  • Failure of ejaculation
  • Non-systematic intercourse
  • Injury of the spinal cord
  • Prostate surgery
  • Nervous system damage
  • Intake of special medication (antidepressant, antihypertensive)

It is a rather rare case of male infertility, affecting around 1 in 100 infertile men. It is caused by an abnormality in the function of the hypothalamus-hypophysis-testicles axis, resulting in abnormal secretion of the hormones that regulate spermatogenesis. Therefore, the spermatozoa production process is disrupted. It mainly relates to:

  • Neoplasia of the hypophysis
  • Congenital deficiency of LH and FSH hormones
  • Use of anabolic steroids

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