I am sure you are amazed at this title – male infertility. Some cultures do not permit us to talk about males being infertile. When a couple get married and there is no child, the woman is blamed. She is called sort of names by the in-laws, the community sees her as barren. Religious centres would organise prayer sessions for the woman. Everyone believes the woman is the problem.

The woman also seems confused.  She goes about from one hospital to the other running investigations and taking medications. Her mental health becomes affected.  She develops a low mood; this may culminate into frank depression.

Unfortunately, the man is spared. Most people are not aware or they ignore the fact that men could be infertile.

Yes, a man could be the source of infertility in a home. 

This article will describe the reproductive system of a man, possible causes of infertility and possible preventive measures and recommendations. 

Male reproductive system

The major part of the male reproductive system lies outside the body. This includes the penis and scrotum. The scrotum houses the testes which function in producing the male sex hormone and sperm. Hormones from the brain initiate this process. It sends some signals to the testes to produce its own sex hormones which in turn stimulates the production of sperm. 

Sperm is then transported or stored in the epididymis. During sexual intercourse,  sperm travel through the vas deferens. The seminal vesicles, prostate gland and bulbourethral gland  produce semen in which sperm swim and get its nutrients. This sperm + semen combination moves up through a route called urethra and comes out through the urethra meatus (an opening at the tip of the penis) during intercourse. 

What then could be the cause of infertility in a man?

Anything that causes disruption in the above structure can lead to infertility in a man. Let’s start from the testes. The scrotum of some men are empty, they do not have testes. If there is no testes, then the man will not be fertile as it is the testes that produces the sex hormones and the sperm. Please note that the testes are paired. If a man has 1 testes, he can father a child as 1 testes can perform more than half of the expected function of 2 testes.

Why then will a man not have testes? This could be a problem that started during childhood. Some children had undescended testes after they were born. This means the testes did not enter into the scrotum before or after birth. It finished its journey either in the tommy where its formed  or along its route into the scrotum. Some may have 1 undescended testes and some 2. 

An individual with 1 testes must guard the other. The testes is fragile. Any injury to the testes can make it atrophy, losing its structure and function. If an individual is hit on the scrotum, it can injure the testes. The testes can also twist around the cord suspending it in the scrotum leading to shortage of its blood supply. It can die and become atretic. 

As said earlier, the sperm gets its nourishment from the semen. If one of the structures producing semen is affected, it can reduce the quality and quantity of sperm that made it to the end of the journey (ejaculation) as some sperm might die or lose their structure along the line.

Furthermore, infection of the testes or any other abnormality in the testes can affect the number and quality of sperm produced. Kindly note that a minimum number of sperm is required to be in the semen during ejaculation to increase the chances of fertility.

Any blockage along the route of sperm and semen can also cause infertility. This could be a partial or total blockage and its usually caused by infection or the use and previous insertion of an instrument like catheter into this route. 

It is important to note that other factors can contribute to infertility in men. This includes the presence of other diseases like diabetes, thyroid disease, chromosomal abnormalities. Some drugs have also been implicated in infertility. Examples are drugs used in treating hypertension, depression and cancer. Any abnormality in the brain can also affect the production of sperm. Smoking, alcoholism, and old age can also contribute to infertility in men. 

How can you reduce your risk of becoming infertile?

• Guard your testes / scrotum. Prevent any injury to this site. The scrotum is suspended at its location to maintain the temperature of the testes  as the normal body temperature might be harmful to it.  Therefore  wearing of tight underwear can bring the scrotum close to the body thereby gradually damaging it.
• Avoid infection especially sexually transmitted infections. Do not have multiple sexual partners. If you have an infection anywhere in your reproductive system, ensure you get treated as soon as you can.
• If you develop a sudden pain in your scrotum, visit the hospital immediately. It’s an emergency. The testes can still be spared via immediate action.
• Eat a balanced diet.  Avoid radiation to your testes. Ask your doctor about the side effects of your medications.

What should you do as a couple if you cannot have a child?

As a man, do not leave all the running around for the woman. Encourage her and ensure you go for your investigations as requested. These tests will be targeted towards knowing the cause of your infertility. Once this is diagnosed , you will be treated or directed to the appropriate specialist.