Infertility in Men

Misconception, Possible Causes and Treatment.

Infertility in Men

Traditionally, infertility has been thought of as a woman’s problem. When there is a delay in child reproduction, the woman gets questioned. Series of questions, lots of opinions, and solutions are proffered to the woman on ways to get pregnant because everyone assumes she’s the one with the issues. No one stops to ponder and ask, what if the man has issues?

Shocking but true, the male-factor contributes to infertility around half the time, and about one-third of the time, it is the main cause of infertility. Male infertility in Nigeria accounts for up to 50% of all infertility cases.

During ejaculation, about 150 million sperm are released, which sounds like a lot.  A lot of sperm to fertilize at least one egg right? But an egg can only be fertilized if it comes in contact with the sperm. So sometimes, making sperm is not the problem. The problem is getting the sperm where it needs to go.

So, the quality of sperm is vital in reproduction, and the quality is dependent on semen.

Semen is a greyish white body fluid that is secreted from the male reproductive tract, that contains sperm cells, which are capable of fertilizing the female’s eggs.

The use of sperm and semen interchangeable does not mean they are the same. Let me explain further:

Sperm is part of semen, but semen is not a part of sperm.

Sperm are tadpole-shaped, microscopic cells that are part of semen. The job of sperm is to fertilize an egg.

When a man ejaculates or cum, the whitish fluid that comes out of the penis is called Semen. Semen is a combination of mature sperm and fluids, that contains fructose and other enzymes that help the sperm to survive to facilitate successful fertilization.

The purpose of semen is to help the sperm get to the egg, so the egg gets fertilized. So without the help of semen, the sperm will keep swimming in circles.

So both are important, they need each other for reproduction.

You see, semen and sperm are not the same thing. So, now you know right?


Causes of Infertility

Making mature and healthy sperm depends on many things. These are the main causes of male infertility:

Retrograde Ejaculation

This when the semen goes backward in the body. Retrograde ejaculation happens when the nerve and muscles closes during orgasm causing the semen to go to the bladder instead of the penis.  Various health conditions can cause retrograde ejaculation, such as diabetes, spinal injuries, surgery of the bladder.

Some men with spinal cord injuries or certain health issues cannot ejaculate semen, even though they still produce sperm.


It is the most common reversible cause of male infertility. Varicocele is the swelling of the veins that drain the testicle. The exact reason that varicocele causes infertility is unknown.

Immunologic Infertility

The body mechanism produces antibodies to keep itself from being attacked by invaders. Sometimes, the body makes antibodies that attack the sperm. This prevents sperm from moving and working normally.

Sexually Transmitted Disease

Sexually transmitted infections (STIs) are common problems that are associated with male infertility. Studies have shown that there is an association between male infertility and previous exposure to sexually transmitted diseases. For men who have repeated episodes of STIs, penile discharge, painful micturition, genital ulcers, and testicular pain were more likely to be infertile.

Sperm Disorder

The factors that contribute to the overall sperm quality include sperm motility, speed, density, morphology (shape and size), and liquefaction.  When there is a problem in the quality of sperm produced, it affects fertility. In some cases, sperm is produced in low quantity (oligospermia), or not produced at all (azoospermia).


Medication used in the treatment of cancer, depression, high blood pressure, testosterone replacement therapy. Certain antifungal medications, some ulcer drugs, and certain other medications can impair sperm production and decrease male fertility.


Environmental Impact and Lifestyle

Environment and lifestyle play a vital role in fertility. Though the human body defense mechanisms can protect itself from harmful substances, some environment, and occupational hazards are capable of impacting one’s health negatively.

  • Toxic Metals

Toxic metals such as lead, mercury, cadmium, arsenic, and aluminum have been reported to impact negatively on male infertility.

Mercury is commonly found in thermometers, batteries, and industrial emissions. Its concentration is increased in the food chain leading to bioaccumulation that can negatively affect reproductive health. Mercury is capable of altering spermatogenesis and disrupting fetal development.

Lead that is present in batteries, pipes, metals, paints, ceramic can interrupt the hypothalamic-pituitary axis and hence alters hormone levels.

  • Body Weight

Bodyweight has an impact on reproductive health and is often associated with eating habits and levels of activity.

It has been observed that the semen quality of an obese man is three times lower than men of normal BMI.

Being underweight also affects fertility. Men who are underweight, tend to have lower sperm concentration compared to men with normal BMI.

  • Smoking, Alcohol and Illicit Drugs

On the pack of a cigarette, it says “Smokers are liable to die young.” Aside, the fear of death, smoking tends to reduce mitochondrial activity in spermatozoa and decreased fertilizing capacity.

Illicit drugs such as marijuana and cocaine have negative effects on fertility. Cocaine, marijuana both acts both centrally and peripherally to cause abnormal reproductive function. Cocaine has been proved to affect fertility because of its ability to increase serum prolactin and decrease testosterone. The long term use of drugs may lead to sexual stimulation, difficulty in achieving and maintaining an erection.

Sitting for long periods, wearing tight clothing, or working on a laptop for long stretches may increase the temperature in the scrotum and may reduce sperm production.


Risk Factors
Some factors linked to male infertility include:

  • Having certain past or present infections
  • History of undescended testicles
  • Certain medical conditions, including tumors and chronic illnesses such as cancer, sickle cells.
  • Overheating the testicles.


Causes of male fertility can be hard to diagnose. Diagnosis can start from a full history and physical examination. Routine lab test (semen analysis), ultrasound (Transrectal ultrasound), testicular biopsy, hormonal profile.


Treatment for male infertility depends on the cause of infertility. Non-surgical therapy, surgical therapy,

It is important to note that infertility is not you or your partner’s fault. Techniques such as intrauterine insemination, in vitro fertilization, sperm extraction techniques, and micro assisted fertilization are now available.






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November 4, 2020 5:43 pm

Ok, so this highly informative, however, I’ll like to know how I can possibly get my sperm examined before I start the business of baby production. Do I just go to any medical lab?? or do we have designated centres for this,
Furthermore, don’t you think fertility test should a requirement before getting married ?

November 5, 2020 6:52 pm

Thanks so much… So many women have suffered because of lack of knowledge and ‘the male ego’. I do believe fertility test should be a requirement before marriage.

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