Male infertility – Causes & Treatment Options

Causes of Male Infertility

Male infertility is a result of absent sperms, low sperms, weak sperms or abnormal sperms which can be caused by a variety of factors, including:

1. Medical Causes

• Varicocele: Swelling of veins in the scrotum, leading to increased testicular temperature and low nutrition causing weak sperms with low count.
• Hormonal Imbalances: Conditions like low testosterone levels or imbalances in FSH, LH, and prolactin can affect sperm production.
• Medication & Supplements: Taking supplements in gym for body building is now a day a major reason. Hormonal medication, Hair loss treatment, cancer chemotherapy and unverified herbal remedies can interfere with sperm quality and quantity.
• Infections: Sexually transmitted infections (STIs), tuberculosis, mumps, or prostatitis can block fine tubes carrying sperms.
• Genetic Disorders: Conditions like Klinefelter syndrome, Y chromosome microdeletions, or cystic fibrosis can lead to infertility.
• Ejaculatory Disorders: Unable to ejaculate due to Diabetes or spinal cord problems.
• Undescended Testicles (Cryptorchidism): A condition where one or both testicles fail to descend properly at birth, affecting sperm production.
• Obstruction in Reproductive Tract: Blockages in fine tubes carrying sperms can prevent sperm from being released in semen.
• Testicular Cancer or Injury: Damage to the testicles due to trauma, surgery, or chemotherapy can impair sperm production.

2. Environmental & Occupational Factors

• Exposure to Pollution: Air pollution, pesticides, and industrial chemicals can negatively impact sperm health.
• Radiation & Heat Exposure: Frequent use of saunas, hot tubs, or working in high-temperature environments can reduce sperm count.
• Heavy Metal Exposure: Lead, mercury, and other toxic metals can impair fertility.
• Electromagnetic Radiation: Prolonged exposure to mobile phones, laptops on the lap, and other electronic devices may affect sperm quality.

3. Lifestyle Factors

• Smoking & Tobacco Use: Reduces sperm count and motility, and increases DNA damage.
• Alcohol & Drug Abuse
• Obesity: Leads to hormonal imbalances
• Poor Diet: Deficiencies in vitamins like zinc, selenium, and folic acid can impact fertility.
• Stress & Mental Health Issues
• Lack of Exercise or Over-exercising: Both extremes can affect hormone levels and sperm health.

4. Socioeconomic & Cultural Factors in India

• Late Marriages & Delayed Childbearing: Fertility declines with age, even in men.
• Unawareness & Social Stigma: Many men avoid seeking medical help due to cultural taboos.
• Use of Traditional Remedies: Unverified herbal treatments may sometimes cause harm rather than improve fertility.

5. Sexual Health Issues

• Erectile Dysfunction (ED), Premature Ejaculation & Low Libido

Why is there a rising trend of male infertility

The rising trend of male infertility in India is driven by multiple factors, including:

1. Lifestyle Changes

• Poor Diet & Nutritional Deficiencies: Now a day diets, especially urban regions, are increasingly high in processed foods, refined sugars, and unhealthy fats, leading to obesity and deficiencies in zinc, folic acid, and antioxidants, which are essential for sperm production.
• Lack of Physical Activity: Sedentary lifestyles contribute to obesity, which in turn causes hormonal imbalances and low testosterone levels, affecting sperm health.
• Smoking, Alcohol, & Drug Use: Increased tobacco and alcohol consumption among Indian men significantly reduces sperm count, motility, and quality.

2. Increased Stress & Mental Health Issues

• Work-Related Stress: The competitive job market, long working hours, and work pressure contribute to chronic stress, leading to hormonal imbalances that negatively impact fertility.
• Anxiety & Depression: Mental health issues, often overlooked in India, can lead to decreased libido, erectile dysfunction, and lower sperm production.
• DINS (Double Income, No Sex): Both husband and wife are busy in job and not getting time for sex during fertile period.

3. Environmental Pollution & Toxins

• Air Pollution
• Pesticides & Chemical Exposure
• Plastic & Microplastic Contamination

4. Rising Cases of Varicocele & Hormonal Disorders

• Varicocele: over exercising without proper scrotal support can lead to swollen testicular veins.
• Low Testosterone & Hormonal Imbalances: Sedentary life style, supplements for body building including testosterone supplements leads to poor sperm quality.

5. Late Marriages & Delayed Parenthood

• Changing Social Norms: More Indian men are getting married in their late 30s or 40s due to career priorities, financial stability concerns, or lifestyle choices.
• Age-Related Fertility Decline: Male fertility also declines with age, leading to a rise in DNA fragmentation in sperm, reducing conception rates and increasing the risk of birth defects.

6. Increased Cases of Infections & STDs

• Untreated Infections: Sexually transmitted infections (STIs) like chlamydia and gonorrhea, as well as tuberculosis, which remains prevalent in India, can cause reproductive tract damage and blockages.

7. Rising Use of Electronic Devices & Radiation Exposure

• Mobile Phones & Laptops: Studies suggest that prolonged exposure to electromagnetic radiation from mobile phones, Wi-Fi routers, and laptops may reduce sperm motility and count.
• Occupational Radiation Exposure: IT professionals, factory workers, and medical professionals exposed to radiation and chemicals may experience declining fertility rates.

8. Social Stigma & Lack of Awareness

• Reluctance to Seek Help: In India, infertility is often perceived as a female-only issue, leading to delayed diagnosis and treatment for men.
• Reliance on Unscientific Remedies: Many couples resort to traditional herbs, faith healers, or unproven home remedies instead of seeking medical intervention.

Treatment Options:

The treatment of male infertility depends on the underlying cause. It can involve: 

1. Lifestyle & Natural Remedies

• Healthy Diet
• Regular Exercise
• Quit Smoking & Alcohol
• Manage Stress: Yoga, meditation, and adequate sleep
• Avoid Heat & Radiation Exposure: Reduce laptop use on the lap, prolonged mobile phone exposure, and hot baths.

2. Medications & Hormonal Therapy

•  Hormonal Therapy
• HCG & FSH Injections: Stimulates sperm production in men with hormonal deficiencies.
• Clomiphene Citrate (Clomid): Used to boost testosterone and sperm count.
• Antibiotics & Anti-Inflammatory Medications : for infections that can block sperm flow.
• Antioxidants & Supplements
• Coenzyme Q10, L-carnitine, Zinc, Selenium, and Folic Acid improve sperm count, motility, and quality.

3. Surgical Treatments

If male infertility is caused by structural problems, blockages, or varicocele, surgery may be required.

• Varicocele Repair (Varicocelectomy)-
• Many methods are available but microsurgical corrections are best now.
• Surgical Sperm Retrieval (SSR)
  For men with low sperm count or no sperm in semen (azoospermia), sperm can be surgically extracted for assisted reproduction. Methods include:
• TESA (Testicular Sperm Aspiration)
• TESE (Testicular Sperm Extraction)
• MESA (Microsurgical Epididymal Sperm Aspiration)

• PESA (Percutaneous Epididymal Sperm Aspiration)

   

• Ejaculatory Duct Obstruction Surgery

4. Assisted Reproductive Techniques (ART)

When natural conception is difficult, assisted reproductive methods can help couples conceive.

• Intrauterine Insemination (IUI)
• A concentrated sample of sperm is placed directly into the uterus to increase pregnancy chances.

• Used for mild sperm abnormalities.

   

• In Vitro Fertilization (IVF)
• Sperm is combined with an egg in a lab, and the fertilized embryo is implanted into the woman’s uterus.

• Used when sperm count is low or motility is poor.

   

• Intracytoplasmic Sperm Injection (ICSI)
• A single healthy sperm is directly injected into an egg to aid fertilization.

• Recommended for severe male infertility (low count, motility issues, or sperm abnormalities).

   

• Donor Sperm
• Used when sperm production is completely absent or genetic disorders are a concern.

Boosting male fertility naturally

Boosting male fertility naturally involves: 

1. Eat a Fertility-Boosting Diet 

Key Nutrients & Foods to Include:

✅ Zinc-rich foods (boost sperm production & testosterone)

• Pumpkin seeds, lentils, chickpeas, nuts, meat, eggs

✅ Antioxidants (protect sperm from damage)

• Vitamin C: Oranges, strawberries, bell peppers
• Vitamin E: Almonds, sunflower seeds, spinach
• Selenium: Brazil nuts, fish, eggs

✅ Omega-3 Fatty Acids (improves sperm motility)

• Walnuts, flaxseeds, chia seeds, fatty fish

✅ Folic Acid (supports sperm health)

• Leafy greens, beans, fortified cereals

✅ Lycopene (improves sperm count & motility)

• Tomatoes, watermelon, papaya

✅ Coenzyme Q10 (enhances sperm function)

• Fish, nuts, meat

✅ L-Carnitine (helps sperm movement)

• Dairy, red meat, avocado

2. Maintain a Healthy Weight 🏋️‍♂️

• Obesity lowers testosterone and sperm production.
• Exercise regularly (but avoid excessive high-intensity workouts and body building supplements).
• Focus on cardio + strength training for hormonal balance.

3. Reduce Stress & Improve Mental Health 😌

• Practice meditation, yoga, deep breathing, or mindfulness.
• Get enough sleep (7–8 hours per night) to regulate hormones.

4. Quit Smoking & Reduce Alcohol & Limit caffeine 

5. Avoid Excess Heat Exposure 🌡️🔥

• Avoid hot baths, saunas, and tight underwear
• Keep laptops & mobile phones away from the lap.

6. Stay Hydrated & Avoid Toxins 🚰

• Drink at least 2-3 liters of water daily
• Avoid pesticides, plastic containers (BPA), and pollution exposure
• Use glass or steel bottles instead of plastic.

8. Regular Sex 

• Frequent sex (2-3 times a week) improves sperm quality.
• Avoid prolonged abstinence, which can lower sperm quality.

9. Health Check-Ups by Andrologist (Urologist)🏥

• Check for hormonal imbalances, STIs, varicocele, and infections.
• Get a semen analysis if trying to conceive for more than a year.