ALTERNATIVE APPROACH TO THE TREATMENT OF MALE INFERTILITY I

A normal sperm count (i.e fertility) is often a reflection of a man’s general health. Fathering a healthy child means that the man’s sperm must also be healthy.

- the semen must be present in sufficient volume and must not clump together.
- The sperm density (i.e the number) must be adequate and they must be relatively normal in size, shape and must be actively motile in order to overcome the laborious task of reaching the fallopian tubes and the fertilizable egg.
- Above all the sperm cells must not be inhibited by sperm antibodies that may be present in the woman. Male infertility results when, the man’s testicles:
- Lacks the power to produce sperm e.g. azoospermia or
- When the production of sperm is grossly inadequate or
- When they lack the swimming power and lazy to overcome the woman’s cervical mucus or reaching their final destination or when the majority of the sperms have abnormal shape.

A man is also considered to be infertile when despite normal sperm analysis, he has the problem of delivering the sperm into the vagina e.g in cases of impotence, premature ejaculation, especially when ejaculation comes quickly prior to inserting the penis fully into the vagina or when the semen is ejaculated into the urinary bladder rather than through the tube where the semen normally travels. Furthermore, the sperm analysis could be normal, but the correct timing of the woman’s ovulation may be missed.

Apart from those caused by male infertility, which are non-physical or what are technically referred to as “unexplained factors,” several medical causes of male infertility have been identified and these include:
i. Infections/diseases/drugs: Sexually transmitted diseases like gonorrhea, Chlamydia or syphilis when poorly treated can damage or block the spermatic ducts especially when they result in chronic active prostatitis (inflammation of the prostrate gland) tuberculosis infection can also cause scarring and blockage to the spermatic ducts and these often result in azoospermia if there is complete blockage or low sperm count if the spermatic duct is partially blocked or damaged.
The infections can further cause the testicles to shrink in size (atrophy).

Other types of infection that can affect sperm production are: urinary tract infection, mumps in adulthood, typhoid, small pox, etc.

Sometimes systemic diseases, severe illness, fever, spinal cord injury, genital injury, undescended testicles, twisting of the testes inside the scrotum, impotence, kidney failures, etc are some of the diseases that can affect sperm production and fertility.

Drugs, e.g those used in the treatment of hypertension, cancers and depression. Also, those used in muscle building (anabolic drugs) may not only cause infertility, but are equally known to cause the testicles, twisting, to shrink. There are numerous drugs that have been listed in some medical books that can interfere with sperm production. E.g. cocaine and marijuana abuse. It a well known fact that
-excessive indulgence in alcohol results in a transient erectile dysfunction and reduces the activity of the male sex hormone (testosterone) and may therefore lead to low sperm count.
-cigarette smoking not only depresses sperm production, but drastically reduces the ability of the sperm to swim actively and gives rise to abnormal forms.
-alcoholism equally leads to malnutrition which is a factor for male infertility.

ii. Constant exposure to environmental toxins: the testicles can be damaged by toxic chemicals, heavy metals, radiations, insecticides, etc.

iii. Excessive heat on the scrotum: all the factors that produces heat in the testicles, or those that cause a rise in temperature in the scrotal area or overheating the testicles can dramatically reduce or even stop the production of sperm. A varicose vein is the vein that allows blood to pool in the scrotum. But when the veins dilate and bulge or swell blood pools around the testicles and produce heat that may interfere with sperm production, resulting in the destruction of the sperm and such condition is known as Variococele. Studies have shown that 40% cases of male infertility is the result of variococele. The condition is often described as a feeling like “Bag of worms” in the scrotum, especially when the condition is prominent.

Other conditions that “cook” or “over heat” the testicles include: excessive hot baths, saunas, sitting and driving, over heated cars, long distance driving, wearing close fitting or tight underpants, etc.

iv. Hormonal disturbances: Testosterone becomes very low in the blood. Being the male hormone that matures the testicles under the influence of the brain and the pituitary, a deficiency affects the production and maturing of sperm. The testicles may also fail to function due to hormonal imbalance.

Sometimes some do experience high blood level of prolactin and this often leads to inadequate sperm production and also impotence.
v. Chronic stress is known to affect all aspects of human health; the immune system, the endocrine glands and sperm production.
vi. Other factors that have been associated with low sperm count in men are:
-excessive body weight or sudden and drastic weight loss.
-frequent recurrent fever
-strenous exercise
-nutritional deficiencies e.g when Vitamin C is low in the body, the semen clumps and gives rise to poor sperm motility, low zinc diet is also a factor.
-men whose mothers were exposed to the drug called des (die thylstiberstrol) when they were pregnant have been found to develop sperm producing defects that could be due to abnormal testicles.