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Page 6 of 16 Other Causes Of Infertility
The same conditions that cause retrograde ejaculation (e.g.., diabetes, multiple sclerosis, bladder neck or prostate surgery, and spinal cord injury) may also be responsible for failure to ejaculate. Chronic prostatitis (inflammation of the prostrate gland) can also cause sperm motility problems. Abnormalities of the thyroid or adrenal glands may have an indirect effect on fertility. Other medical conditions that can affect male fertility include any severe injury or major surgery, heart attack, liver failure, chronic anemia, kidney failure, obesity, or starvation.
Drugs and Medications
The effects of medications on sperm quality and count have not been rigorously studied, and many medicines are commonly prescribed without knowing whether they impair fertility. Anabolic steroids are known to severely impair sperm production. Cocaine or heavy marijuana use appears to temporarily reduce the number and quality of sperm by as much as 50%. Sperm actually have receptors for certain compounds in marijuana that resemble natural substances and which may impair the sperm’s ability to swim and may also inhibit their ability to penetrate the egg.
Sexual Problems
In less than 1% of males with infertility problems, a problem with sexual intercourse or technique will affect fertility. Impotence, premature ejaculation, dyspareunia (painful intercourse), or psychological or relationship problems can contribute to infertility, although these conditions are usually very treatable.
Lifestyle Factors
Stress may interfere with the hormone GnRH and reduce sperm counts. Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that affect the offspring. (Alcohol does not appear to affect fertility unless it is so abused that it has caused liver changes.) Obesity and excessive endurance exercise may also reduce sperm production, but losing weight and reducing exercise levels can reverse the problem. Low levels of dietary selenium and zinc, which are necessary for the formation and maturation of sperm, are associated with an increased risk of infertility. Some experts believe that vitamin C deficiency causes the sperm to clump together (agglutinate), which impairs movement. Frequent intercourse was suspected for awhile of reducing fertility because of the time required to replenish sperm, but this is unproved. A number of studies have found no negative effects on fertility from wearing tight trousers, briefs, or athletic supports, even every day. Men are at risk for infertility, however, only when the testes are exposed for prolonged periods to internal body temperatures, which occurs only rarely, such as in men with undescended testicles.
Tests used to diagnose male infertility
Physical Exam
A urologist will usually perform a physical examination to detect any abnormalities, such as a varicocele in the testes and prostate problems. Checking the size of the testicles is also helpful. Smaller–sized and softer testicles along with tests that show low sperm count are strongly associated with essential problems in sperm production; a low–sperm count in men whose testicles have normal size and consistency indicate possible obstruction. The temperature of the scrotum can be determined with a test called scrotal thermography. The physician may also take a urine sample to detect sperm in the urine (indicating retrograde ejaculation).
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