Infertility is inability to conceive after about one year of unprotected intercourse. Sterility is a big bane in many traditional societies and blame is universally put on the woman. But in one-third cases, fault lies with the man, after all it takes 2 to make a baby.

Defects in males may exist for an entire lifetime and may impair production of sperms. Conditions like poor development of testes or undescended testes are all associated with failure to produce sperms. Some men have the penis shaped such that they ejaculate posteriorly, thus failing to deposit the sperm in the vagina. These defects are usually identified much later in life, when the man is examined for some other problem or rarely, where the person accepts to be investigated for infertility. Problems associated with structure orientation of reproductive parts are also known causes for infertility.

Infections in boyhood like mumps, measles can cause inflammation of the testes which passes unnoticed during childhood. As the boy becomes an adult, this may become a cause for infertility. Hormonal disorders in both men as in women cause sterility. There are many risk factors which reduce sperm production and cause infertility in men. Warmth reduces production of sperms in an individual. Therefore wearing very tight trousers or nylon underpants can reduce the sperm count, rendering a man sterile. Sitting for long hours as in case of desk workers also increases heat over the testicles and impairs their function of sperm production. Putting a laptop on the lap for a long time also reduces sperm production for the same reason. Obesity is also known to cause infertility by reducing sperm production. This happens because excess fat in the body tissues, locally raises temperature over the testes. Multiple ejaculations caused due to excess sexual activity, can reduce sperm count. In other instances, the total sperm count may be inadequate around time of ovulation in a woman. It also reduces desire for sex, thus reducing the possibility of conception. Therefore when a couple plans a baby, sexual activity should be possibly restricted to around time of ovulation.

Alcohol causes sexual impotence and also inflammation of the testes, thus impairing fertility. Similarly tobacco use in any form is also known to diminish sexual function and sterility in men. Transportation of sperms is difficult if the tubes are blocked. Infections of the tubes or any trauma can also block the tubes. Mental stress is also known to produce spasms of the tubes thus blocking the passage of sperms.

Sexually transmitted diseases are known to cause inflammation of the tubes or testes or other genital parts, and result in sterility. Tuberculosis of the vas deferens or the male tubes or testes also results in sterility. Therefore if a couple decides to create a baby and fail to do so in one year, both the husband and wife need to be investigated. A sperm analysis is essential for the man, apart from a routine clinical examination. To get good results, the sample for sperm analysis should be given after about a week or 10 days of abstinence from sex and alcohol, otherwise false low counts may be obtained.

Wearing tight trousers should be avoided. Ideally underpants should always be of cotton as nylon does not allow skin to breathe and is not healthy. One desiring of having a baby should give up alcohol and tobacco. Any itching or discharge from the genital parts should be treated timely as these indicate a sexually transmitted disease and can lead to permanent sterility. Similarly hydrocoele (swelling of scrotum) is treated by a minor surgery and when treated can help in improving fertility. Mental relaxation is also very important to increase one’s libido and also augment chances of reproduction.Therefore it should be understood very well that a man can also be responsible for infertility.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital

E-mail rachna212002@yahoo.co.uk