- Physical Problem #1 - Variocele:
Variocele is the presence of varicose veins in the scrotum. These abnormal enlargements of veins are found behind and above the testicles.
Male infertility results when the veins swell too much and cause damage to the valves that regulate blood flow around the testicles. This will increase the temperature in the organs to the point of damaging and killing the sperm.
About 15% of all men experiences a varicocele sometime in their lives. Variocele also affects about 40% of all men who have infertility problem.
A varicocele can result if there is an injury to the scrotum or testicle.
It is easily detected by an examination of the testicles and it is more common to find it in the left testicle.
A minor surgery is often used to correct a varicocele problem. This is done on an outpatient basis. Its success rate is about 60%.
- Physical Problem #2 - Sperm Duct Blockage:
The Ejaculatory duct, Vas Deferens and Epididymis form the male's sperm ducts, the tubes that carry the sperm.
A potential block or damage can happen anywhere along this complex system of tubing and result in male infertility.
If this happens, a man can still ejaculate into a woman, but his semen won't contain any sperm to fertilize her egg.
The obstruction and blockage could be caused by a scarring tissue from a previous surgery, a hernia repair, past or present infections or inflammations from a sexually transmitted disease, or the condition could be congenital.
This condition can be diagnosed by a physical examination, an x-ray or by doing a testicular biopsy to examine the tissue.
Treatment depends on the cause of the blockage, the location and length of the problem. Sometimes a micro surgery can be done to reverse the damage. If this fails, the man can resort to the methods of artificial insemination and IVF.
- Physical Problem #3 - Genetic Absence of Vas Deferens:
The Vas Deferens is part of the complex system of sperm duct through which the semen is ejaculated.
Some men are born without the Vas Deferens. A man with such a birth defect may be carrying one of the genetic mutations associated with Cystic Fibrosis, though he may not be actually having Cystic Fibrosis himself. (Cystic Fibrosis is a congenital disease caused by a defective gene, resulting in the clogging of the lungs, intestines and pancreas with thick mucus).
If a man is born without the Vas Deferens, his sperm will have no passage way to travel through to his urethra and to finally impregnate a woman.
Currently, there is no treatment for a missing Vas Deferens. However, since such a man can still produces semen, sperm can be collected from the Epididymis which stores sperm, and used for in vitro fertilization later.
- Physical Problem #4 - Hypospadia:
Hypospadia is a birth defect in which the urethra opening is on the underside of the penis. The penis with this defect is usually bowed in shaped and shorter than normal.
This deformity can lead to male infertility because when the man ejaculates, his semen will be deposited lower in the vagina, making it harder for his sperm to make it into the uterus.
The problem is usually repaired through surgery.
- Physical Problem #5 - Undescended Testicles - Cryptorchidism :
Cryptorchidism refers to undescended testicles. This is a congenital problem that affect a small percentage of boys when their testicles fail to descend into their scrotum as infants.
A male baby's testicles develop inside the body and normally descend into the scrotum just before birth or just afterwards. However, sometimes one or both testicles do not ever descend and cannot be felt in the scrotum.
Male infertility may results because by remaining inside the body, the man's undescended testicles will be subjected to a higher temperature and this will affect his sperm production.
Undescended testicles are also more prone to cancer.
However, in most cases, they do eventually descend when the child is a few years old. If not, surgery is required to lower them into position. For best results, such a surgery should be done before school age. These surgeries on adults are not as effective.
- Physical Problem #6 - Retrograde Ejaculation:
A retrograde ejaculation refers to the ejaculation of semen into the bladder rather than out through the urethra. This happens when the neck of the bladder is not closing properly. Thus when the man ejaculates, some or all of his semen is washed back into the bladder, get mixed with urine and expelled during urination.
Male infertility results because retrograde ejaculation makes conception impossible.
This condition could be caused by a prior surgery to the bladder or it could be a structural defect that the man has since birth. Diabetes has been blamed for this condition too. It is also associated with certain high blood pressure medications. Men who have suffered spinal cord injuries or who are paraplegic are more prone to this condition.
You will know if your spouse has the condition. If you see that he has cloudy urine after ejaculation, do advise him to check it out with his doctor.
The doctor may require him to produce a urine sample after sex and examine it for the presence of sperm.
This condition can sometimes be treated with drugs. Or sperms can be retrieved using a testicular biopsy in conjunction with the ICSI and IVF procedures.
