Infertility in men - What causes fertility problems in men?

The most common cause of infertility in men is typically due to an issue with sperm, which may include:

• A low sperm count
• Low sperm mobility
• Abnormally formed sperm
• Blocked sperm ducts

Men are constantly producing new sperm. It does, however, take between two and three months for sperm to mature, become motile (able to move) and have the ability to fertilise an egg. Unlike in women, a man’s age is not an indicator of his chances of conceiving, therefore, his age is not an indicator of his ‘biological clock’. Instead, the conditions under which the sperm is created will determine whether the sperm is healthy or not. Therefore, maintaining a healthy lifestyle is vital in ensuring the production of healthy sperm.

The causes of male infertility are further explained as follows:

• Issues with delivery of sperm – this includes sexual issues such as premature ejaculation as well as genetic diseases such as cystic fibrosis, or structural issues like a blockage in the testicle and damage to the reproductive organs. Retrograde ejaculation is another issue with the delivery of sperm and refers to when the sperm, which is typically ejaculated through the urethra, is redirected to the bladder. 
• Abnormal production of sperm – this is due to undescended testicles, genetic defects, infections such as chlamydia, mumps, HIV or gonorrhoea, or heart problems such as diabetes. Another issue can be varicocele, this is a disorder where the veins in the testes become enlarged, affecting the quality of the sperm.
• Damage to the testes due to cancer and cancer treatment – chemotherapy and radiation can affect sperm production resulting in very low levels of sperm.
• Pesticides, chemicals, radiation and other overexposure to environmental factors – this can include smoking cigarettes, excessive alcohol intake, taking certain medications such as specific antibiotics and steroids can also affect fertility. Recurrent exposure to heat can raise your body temperature and also affect sperm production, this includes long, hot baths, saunas, steam rooms and hot tubs (jacuzzies). 
• Chronic cannabis use - The chronic use of cannabis (more than three times a week) has a direct impact on sperm, particularly its physical appearance (morphology). However, the topic of the effects of cannabis on sperm quality has been a largely debated one. Despite alternate claims, there is concrete evidence to support the fact that chronic cannabis use may have a significant impact on the quality of sperm.
• Certain treatments for hair loss  - Certain treatments known as 5-alpha-reductase inhibitors contain an enzyme that is found naturally in the adrenal glands and is responsible for converting testosterone to DHT (dihydrotestosterone), which is a sex hormone. These drugs can have an effect on sperm production.