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Male Infertility
can be classified into four main types:

1. No Sperm (azoospermia)

Possible causes include

  • Testicular Failure – inability to produce sperm for no apparent reason or due to trauma to the testicles, severe mumps infection after puberty, chemotherapy/ radiotherapy for cancer.

  • Absent/ blocked vas deferens - the testicles produce sperm, but the tubes which carry the sperm are blocked.

  • The pituitary gland does not produce sufficient hormones.

  • Genetic defects e.g. chromosomal abnormality such as Klinefelter's syndrome and Y chromosome deletion.

  • In some infertile men, the absence of sperm in their ejaculate is due to retro-grade ejaculation(during orgasm, sperm enter the bladder and mix with urine, rather than get ejaculated into the vagina). This is a rare condition and accounts for less than 1% of male infertility.
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    2. Poor sperm quantity or quality e.g. low motility  or a high percentage of abnormal sperm.

    This could be due to many factors such as

    • hormone deficiency
    • varicocele (abnormal swollen blood vessels around the testicles),
    • infection, fever
    • medication,
    • social drugs such as marijuana and cocaine, heavy smoking and excess alcohol.
    • frequent hot baths and saunas, warm work environment or tight underwear

    Minor deficiencies can be treated with intra uterine insemination while severe cases require ICSI.

     

    3. Dysfunctional Sperm

    Semen analysis is normal but 10% of the patients may have sperm which lack or have a defective fertilizing capacity , resulting in complete failure of fertilization or poor fertilization of the eggs in IVF.

     

    4. Inability to ejaculate into the vagina  

    This could be due to impotency, premature ejaculation, or the inability to ejaculate.

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