Cause of Male Infertility
Male infertility can be caused in men by factors such as hormone disorders, illness, reproductive anatomy trauma and obstruction, and sexual dysfunction. These factors can temporarily or permanently affect sperm and prevent conception. Some disorders become more difficult to treat the longer they persist without infertility treatment.
Male Infertility Causes and Risk Factors
- Cryptorchidism
- Cystic fibrosis
- Drugs
- Ductal obstruction
- Hemochromatosis
- Hormone dysfunction
- Prostatitis
- Retrograde Ejaculation
- Sexually transmitted diseases (SDT)
- Sickle cell anemia
- Spinal Cord Injury (SCI)
- Systemic disease
- Testicular cancer
- Testicular trauma
- Varicocele
- Summary
Cryptorchidism which is the failure of testes to descend; can impair spermatogenesis (the creation of sperm).
Cystic fibrosis may cause absence of the seminal tract such as the epididymis, vas deferens, or seminal vesicles.
Drugs - Certain drugs used to treat hypertension, arthritis, and digestive disease, as well as chemotherapy drugs are associated with sperm production problems and infertility.
Ductal obstruction is most often caused by vascectomy, but may also be casues by repeated infection, inflammation, or developmental defect can prohibit sperm transport.
Obstruction in any of the named structures may prevent sperm from passing through:
Hemochromatosis which is a metabolic disorder; causes iron deposition in the testes.
Hormone dysfunction is caused by disorder in the hypothalamic-pituitary-gonadal axis.
Prostatitis - Inflammatory infections of the prostate (prostatitis), epididymis (epididymitis), and testicles (orchitis), can cause irreversible infertility if they occur before puberty.
Retrograde ejaculation occurs when impairment of the muscles or nerves of the bladder neck prohibit it from closing during ejaculation, allowing semen to flow backwards into the bladder. It may result from bladder surgery, a developmental defect in the urethra or bladder, or disease that affects the nervous system, including diabetes. Diminished or "dry" ejaculation and cloudy urine after ejaculation may be signs of this condition.
Sexually transmitted diseases - STDs; can cause obstruction, infection, and scarring.
Sickle cell anemia can cause hypogonadism.
Spinal Cord Injury (SCI) - There are approximately 10,000 new spinal cord injuries every year in the U.S. The majority of these injuries occur in healthy men of reproductive age (30 year old average), producing sexual and reproductive difficulties. The majority of couples stay together following SCI and resume sex and start families together.
Many factors may predispose spinal cord injured men to infertility. Ejaculatory dysfunction, abnormalities of sperm production, chronic infections and blockage of sperm within the male reproductive tract are all potential factors.
Management of male infertility due to spinal cord injury includes a number of different methods to obtain sperm. These are often combined with various forms of assisted reproductive techniques. Sperm can often be obtained through vibratory stimulation to the head and shaft of the penis if the level of injury is T-12 or above. Rectal probe Electroejaculation (EEJ) or sperm harvesting along the ejaculatory path from the vas deferens, epididymis, and directly from the testis.
Systemic disease - Systemic disease fever, infection, kidney disease, metabolic disorder; can impair spermatogenesis.
Testicular cancer - Can limit or destroy the ability for spermatogenesis.
Testicular trauma, resulting from injury, surgery, or infection can trigger an immune response in the testes that may damage sperm. Though their effects are not fully understood, antibodies can impair a sperm cell's ability to swim through cervical mucus or to penetrate a female egg.
Varicocele - In order to understand what a varicocele is, one must be aware of some basic anatomy and physiology. The testicles are the paired male genital organs that contain not only sperm but also cells that produce and nourish the sperm. These organs are located in a sac called the scrotum. The epididymis is a small, tubular structure attached to the testicle. It is a reservoir where the sperm mature and are stored. The vas deferens connects the epididymis to the prostate gland and is the tube through which sperm travel during ejaculation. The vas deferens is not situated by itself but is a part of a larger tissue bundle called the spermatic cord. The spermatic cord contains many blood vessels as well as the vas deferens, nerves, and lymphatic channels. The vein of the spermatic cord are known as the pampiniform plexus. These veins drain blood from the testes, epididymis and vas deferens, eventually becoming the spermatic veins that drain into the main circulation at the level of the kidneys. The pampiniform plexus of veins may at some time become tortuous and dilated much like a varicose vein of the leg. In fact, a scrotal varicocele is simply a varicose enlargement of the pampiniform plexus around the testicle. Dr. Bastuba offers varicocele treatment in his center.
Summary
Dr. Bastuba performs all of these therapies, as well as sperm cryopreservation, and works directly with female fertility specialists for successful treatment. Besides being a male fertility issue, spinal cord injuries could also cause some form of male sexual dysfunction. Dr. Bastuba's training, experience, and interest in both of these areas make him uniquely qualified to effectively treat their symptoms and to assist couples in achieving conception.
Male Fertility Specialists
6699 Alvarado Road, Suite 2207
San Diego, CA 92120
(619) 286-3520
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