Infertility or sterility is the inability to conceive after about one year of unprotected sex. Both partners contribute equally, for creation of a baby. But in majority of cases in failure to conceive, it is the woman who is blamed though fault may lie with the man.

Birth defects in the development of reproductive organs in the man can impair production of sperms. Conditions like poor development of testes or undescended testes, i.e. where testes do not enter their proper place in process of development are associated with failure to produce sperms. The penis is shaped such in some men, that they ejaculate posteriorly, thus failing to deposit the semen in the vagina. These defects are usually identified much later in life, when the man is examined for some other problem or while being investigated for infertility.

Problems or infections of the penis or scrotum are also known causes for infertility. Infections in boyhood like mumps, measles, e.t.c. can often cause inflammation of the testes which passes unnoticed in young children. As the boy becomes an adult, this can be the cause for infertility.

Hormonal disorders in men as in women, like disorders of pituitary, thyroid or adrenal glands, can cause sterility.

There are several risk factors which reduce sperm production and cause infertility in men. Warmth locally 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 sperm production.

Keeping a laptop computer for long time on the lap is also known to reduce fertility of a man. 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, effectively brings down the sperm count to very low levels. It may also reduce desire for sex in a normal person, thus reducing the possibility of conception. Therefore, any healthy man who desires a baby should restrict his sexual activity and also be disciplined in this matter, because sexually transmitted diseases can also result in sterility due to inflammation o the testes or vas deferens.

Any trauma to testes or tubes which transport sperms can impair sperm production or transportation. Mental stress is also known to produce spasms of the tubes thus blocking the passage of sperms.

Alcohol causes sexual impotence and also inflammation of the testes, thus causing sterility by multiple causes. Similarly tobacco use in any form is also known to diminish sexual function and sterility in men.

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 is not healthy. One desiring to produce 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. Mental relaxation is also very important to increase one’s libido and also augment chances of reproduction.

It should be understood very well that a man is also a human being like a woman and can have some problem which prevents conception.

Dr Rachna Pande, Specialist, internal medicine