The reasons for infertility in men are numerous; the primary causes of male infertility entail problems with spermatozoa production or delivery that may result from certain types of hormonal dysfunction, whereas trauma or anatomical defects in the reproductive system and other illnesses can all lead to infertility. Recent research has shown that approximately one in four men over age 30 have low levels of testosterone.2 Some additional causes of male infertility include:
Cryptorchidism—a failure of one or both testes to descend that can impair sper-matogenesis
Cystic fibrosis—a condition associated with both an absence and=or blockage of the vas deferens
Ductal obstruction—an anatomical problem that may be caused by repeated infections, inflammations, or a developmental defect
Hemochromatosis—a metabolic disorder that causes iron deposition in the testes
Hormone dysfunction—a condition caused by dysregulation in the hypothalamic-pituitary-gonadal axis (See Chapter 2 on andropause)
Drugs and other substances—pharmaceuticals used to treat hypertension, arthritis, and digestive diseases; agents for chemotherapy; and recreational drugs (such as marijuana) that are associated with sperm-production problems and infertility as is alcohol use
Retrograde ejaculation—an anatomical defect that involves the muscles and nerves of the bladder neck
Sexually transmitted infections—diseases that may cause obstructions, infections, and scarring
Sickle-cell anemia—a condition that can cause hypogonadism
Systemic diseases—such as high fevers, infections, kidney diseases, or metabolic disorders that can impair spermatogenesis
Testicular cancer—a condition that may cause obstructions or dysfunctions or problems related to chemotherapy used to treat the disease
Testicular trauma—an event that causes damage to testes, impairing their ability to function
Varicocele—a condition that can alter testicular temperature affecting spermatogenesis
Spermatogenesis occurs in cycles composed of six stages; each one takes approximately 16 days to complete, and it takes 3 months to produce mature sperm. Development of sperm is ultimately controlled by the endocrine system via the hypothalamic-pituitary-gonadal axis. Because sperm production occurs over a relatively long period of time, an illness that occurs within that time period can affect sperm production; therefore, it is important to consider recent health history when exploring causes of infertility.
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