About six percent of males between the ages of fifteen and fifty struggle with infertility. Male infertility can be caused by a variety of problems. Some of the more common disorders are listed below.
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- Deficient Sperm Production: Ninety percent of male infertility is caused by the failure to produce enough sperm. Azzospermia occurs when no sperm is produced while olibospermia is diagnosed when few sperm are produced. Since most sperm are destroyed before ever reaching the egg, the more sperm there are the better the chances that one will successfully fertilize the egg. However, a low sperm count, or a total sperm count of less than 5 million/ml, does not necessarily mean that a man is infertile if the sperm that he does have are healthy, properly formed, and mobile.
A low sperm count is determined by analyzing a semen sample. Over the last few decades, sperm count has been declining steadily. Many studies have linked this alarming trend to our modern high-fat, nutrient-deficient diet. Since sperm are highly vulnerable to free radical and oxidative damage, healthy sperm formation requires an adequate and ready supply of the proper nutrients and antioxidants. Other possible reasons for low sperm count include increased scrotal temperature (elevated temperatures hinder the maturation of sperm), varicoceles, environmental factors (pollution and exposure to heavy metals), and exposure to synthetic estrogens such as those found in birth control pills and in livestock.
- Varicocele: A varicose vein around one of the two spermatic cords can cause blood to pool in the testes; this, in turn, causes the temperature to increase in this area. Higher temperatures decrease sperm production and can lead to infertility. Fortunately, this problem can be fixed by surgery.
- Infections: Twenty-eight to seventy-one percent of infertile men show some signs of an infection of their reproductive organs. The presence of antisperm antibodies, which attack and destroy the sperm, are usually a good indicator that an infection is present. Of these infections, chlamydia trachomastis is the most common and the most serious. This disease is sexually transmitted and can damage the epididymis and the vas deferens in the male. Such infections are usually treated with an antibiotic.
- Ductal Obstruction: Blockage or damage to the spermatic tubes which is usually caused by a sexually transmitted disease, infections, or a congenital abnormality.
- Ejaculatory Dysfunction: These disorders are characterized by the failure to deliver sperm to the vagina. Impotence, or the inability to maintain an erection for intercourse, can be caused by a high fat diet (fatty deposits clog the arteries in the penis), by drugs used to treat high blood pressure, and by the nerve damage caused by diabetes.
- Other Disorders: Other disorders that can cause male infertility include abnormal development or damage of the testes (caused by endocrine disorders or inflammation), disorders of accessory glands, coital disorders, exposure to diethylstilbestrol (DES) a synthetic estrogen used in the 1950's and 1960's that caused cysts in the male reproductive tract, undescended testicles, and in rare cases genetic disorders such as a chromosomal abnormality.
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- Polycystic Ovarian Disease: This disease is the most common cause of ovulation disorders in women and is characterized by the presence of many minute cysts in the ovaries, by excess production of androgens, and by infrequent periods (obliomenorrhoea) or absent periods (amenorrhoea). The failure to ovulate is the most common cause of female infertility and can occur for no apparent reason or as the result of stress, hormonal imbalances, and various diseases and disorders of the reproductive system (some of which will be described below).
- Age: After the age of 30 the quality of your eggs begins to diminish, and it becomes harder to become pregnant and carry a fetus to term. The older a woman is the more likely it is that her eggs will have chromosomal abnormalities.
- Pelvic Inflammatory Disease: This infection of the reproductive tract can lead to blocked or damaged fallopian tubes and is usually caused by sexually transmitted disease, miscarriages, abortions, childbirth, or an intrauterine device.
- Ovulatory Dysfunction: This disorder occurs when a woman's ovaries are not producing eggs or are producing fewer eggs than usual because of age, hormonal imbalances, or other problems.
- Uterine Fibroids: These benign uterine tumors occur in 40% of women and can interfere with embryo implantation or fetal growth.
- Endometriosis: This disorder occurs when the tissue which lines the uterus (the endometrium) grows into growths or lesions outside of the uterus (usually on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and the rectum; the outer surface of the uterus; the lining of the pelvic cavity; the bladder, bowel, vagina, cervix, vulva, and in abdominal surgical scars). In sync with the menstrual cycle, this tissue builds up, breaks down, and sheds each month; but unfortunately, it has no way of leaving the body. As a result it causes internal bleeding, breakdown of blood and tissue from the lesions, and most often inflammation which can cause pain, infertility, scar tissue formation, adhesions, and bowel problems. The cause of this disorder is unknown although there are many theories.
- Prenatal Exposure to Diethylstilbestrol (DES): DES is a synthetic estrogen given to some women who were deemed at risk for miscarriage during the 1950's and 1960's. Women whose mothers took DES while pregnant with them are at high risk for certain reproductive tract cancers and menstrual irregularities, as well as abnormally shaped uteruses that can lead to repeated miscarriages.
- Pelvic Adhesions: These are usually caused by surgery or infection, and occur when scar tissue forms between two or more internal organs. When this tissue affects the ovaries or fallopian tubes, infertility can result.
- Immunological Infertility: This disorder occurs when the woman's system produces antisperm antibodies which destroy her partner's sperm.