CAUSES OF MALE SUB FERTILITY

(1)It is not always possible to find exact causes in men to have lower sperm count and other parameters, as it is females. It is because of the fact that the organs are not easily visualized in men as it is deep seated, where as the uterus, tubes and ovaries can be fully visualized on laparoscopy to find the exact cause.

Causes:-

  1. 1. Infections
  2. 2. Hormone problems
  3. 3. Genetic ( by birth)
  4. 4. Anatomical (structural problems like block)
  1. Infections:-

Childhood mumps is a common cause seen locally in Kerala/India.
Infections due to diabetes can also cause prostatitis (leading to failure to liquify) or block causing absent sperms on S.A. Sexually transmitted diseases like Chlamydia, syphilis, AIDS etc: are often silent causing similar problems. TB can also cause block and is easily overlooked. Appropriate antibiotics will help in controlling infection.

  1. Hormone problems:-

Inadequate hormones like reduced LH, FSH will reduce or stop
sperm production. Thyroid and prolactin levels should also be checked.
These are easily treatable, and levels

MUST

be checked.

  1. Genetic (chromosome):-

Azoospermia (absent sperms)can be due to defective chromosome like as in klinefelter's syndrome(tall men with slightly subnormal I.Q)

  1. Anatomical

Undescended testis in babies, where testis is inside Abdomen, should be corrected immediately, or else it will result in male sub fertility later in their life. Hypospadiasis can have problems due to the abnormal position of urethral meatus, IUI can be done successfully. Congenital absence of vas (the tube carrying sperm) can result in Azoospermia, PESA/TESA & ICSI can be done to achieve pregnancy. Varicocele is a condition where veins are dilated, surgical correction by Varicocelectomy can be done.

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