Nearly 1 out every 6 couples is infertile even after a year of unprotected intercourse. The sheer numbers of couples struggling to conceive without medical intervention is on the rise and surprisingly every third of them is down to male infertility.
Even though the popular wisdom may suggests and is quick to castigate women when it comes to infertility issues, in 40-50 % of cases it comes down to the male. Either directly or indirectly, it may be linked to what is called as male factor infertility. It can be due to a congenital problem with the testes, environmental, due to a cancerous growth or related to hormonal imbalance.
The condition of infertility itself may be due to a no sperm count (azoospermia), low sperm count (oligospermia), or decreased sperm motility (asthenospermia) or other structural abnormalities that impede the delivery of sperm.
Medically, low sperm count is fewer than 15 million sperm per milliliter of semen or fewer than 39 million per ejaculate but it is not just the quantity but quality of sperm that also needs to be factored in. If the sperm is not moving (motility) or functioning normally, it might never get to the egg or penetrate it successfully.
The symptoms, apart from the obvious inability to conceive, are not very clear and distinguishable. There can be an underlying issue (like mentioned above) but for most men it comes to issues with sexual performance and function like premature or weak ejaculation, reduced libido and desire and inability to maintain erection i.e. erectile dysfunction. Some of the other physical telltale signs (even though rare) include respiratory discomfort, swollen testicles, no or reduced facial or body hair, gynecomastia (abnormal breast growth).
Other medical conditions that can play a part are varicocele (swelling of the veins that drain the testicle), epididymitis (inflammation of the epididymis), orchitis (inflammation of the testicles) etc. Reproductive tract infections can also interfere with sperm production or sperm health including gonorrhea or HIV.
Environmental causes like exposure to toxic chemicals like organic solvents, pesticides or radiation like X-Rays can also impede sperm function. Exposure to heat due to elevated temperatures also interferes with sperm production and function. Exposure and intake of anabolic steroids can result in decreased sperm production. Similarly, intake of recreational drugs like marijuana, cocaine etc., alcohol can sexual problems and can lower testosterone levels.
One thing that is often overlooked is the psychological component when it comes to problems with sexual intercourse. Psychological or relationship problems can impair not just sperm production but also decrease sexual desire. Emotional stress and chronic depression can cause sexual dysfunction as well.
There can also be physical trauma like spinal injuries, undescended testicles, tubular defects in the transportation of sperm etc leads to permanent testicular damage or ejaculatory malfunction. Lifestyle disorders like diabetes, obesity etc also impede the process of sperm production and motility.
Usually a time period of 1 year of unprotected intercourse is advised before any alarm bells are needed to be rung. So in case one has gone through the advised length of span, a visit to the doctor becomes imperative.