The problem of infertility has very much been blamed to women in our old tradition society, but men too can become infertile. Infertility is the failure of a couple to become pregnant after one year of regular, unprotected intercourse. About a half of infertility problems are due to female infertility, and another half are due to male infertility. However, the cause of infertility in both sexes still give scientists headache. More than 90% of male infertility cases are due to low sperm counts, poor sperm quality, or both. The remaining cases of male infertility can be caused by a number of factors including anatomical problems, hormonal imbalances, and genetic defects. Sperm abnormalities can be caused by a range of factors, including congenital birth defects, disease, chemical exposure, and lifestyle habits. Sperm abnormalities are categorized by whether they affect sperm count, sperm movement, and sperm shape. Low sperm count (Oligospermia); a sperm count of less than 20 million/mL is considered low sperm. Azoospermia refers to the complete absence of sperm cells in the ejaculate, and accounts for 10 - 15% of cases of male infertility. Partial obstruction anywhere in the long passages through which sperm pass can reduce sperm counts. Sperm count varies widely over time, and temporary low counts are common. Therefore, a single test that reports a low count may not be enough to confirm the problem. Poor sperm mortility (asthenospermie); Sperm motility is the sperm’s ability to move. If movement is slow, not in a straight line, or both, the sperm have difficulty invading the cervical mucous or penetrating the hard outer shell of the egg. Other causes include retrograde ejaculation. Retrograde ejaculation occurs when the muscles of the bladder wall do not function properly during orgasm and sperm are forced backward into the bladder instead of forward out of the urethra. Sperm quality is often impaired in this case. It is important to notice that retrograde ejaculation can be the consequence of several conditions such as Surgery to the lower part of the bladder or prostate, diseases such as diabetes and multiple sclerosis, spinal cord injury or surgery, Medications such as tranquilizers, certain antipsychotics, or blood pressure medications also may cause temporary retrograde ejaculation and age. There are also some defects that are congenital that is to say defects that a child is born with. Any structural abnormalities that damage or block the testes, tubes, and other reproductive structures can have a profound effect on fertility. For example, Cryptorchidism is a condition usually seen in newborn infants in which the testicles fail to descend from the abdomen into the scrotum. Cryptorchidism is associated with mild to severe impairment of sperm production. Risk factorsA varicocele is an abnormally enlarged and twisted (varicose) vein in the spermatic cord that connects to the testicle. They can raise testicular temperature, which may have effects on sperm production, movement, and shape. Age; age related sperm changes in men are not abrupt, but are a gradual process. Aging can adversely affect sperm counts and sperm motility (the sperm’s ability to swim quickly and move in a straight line). The genetic quality of sperm declines as a man ages. Sexually transmitted diseases such as chylamidia and gonorrhea infections are most often associated with male infertility. Such infections can cause scarring and block sperm passage. Human papilloma viruses, the cause of genital warts, may also impair sperm function. Nearly any major physical or mental stress can temporarily reduce sperm count. Some common conditions that lower sperm count, temporarily in nearly all cases, include emotional stress, overheating such as from high fevers, saunas, and hot tubs, may temporarily lower sperm count. TreatmentTreatment for infertility should first address any underlying medical condition that may be contributing to fertility problems. Drug therapy may be used to treat hypogonadism and other hormonally related conditions. Surgery is used to repair varicoceles and correct any obstructions in the reproductive tract. If fertility issues remain unresolved, intrauterine insemination also called artificial insemination and assisted reproductive technologies such as in vitro fertilization should be considered. Intracytoplasmic sperm injection is commonly used in combination with in vitro fertilization in cases of male factor infertility. Ends
