Semen and sperm

One of the most common causes of infertility in men is poor-quality semen, that’s the fluid containing sperm that’s ejaculated during sex. Although many cases of abnormal semen are unexplained and lifestyle and general health are believed to play an important part.

Reasons for abnormal semen may include:

• abnormal sperm – sperm can sometimes be an abnormal shape, making it harder for them to move and fertilise an egg
• sperm that are not moving properly – this will make it harder for sperm to swim to the egg
• Lack of sperm – you may have a very low sperm count or no sperm at all.
• There’s a link between increased temperature of the scrotum and reduced semen quality, but it’s uncertain whether wearing loose-fitting underwear improves fertility.

Testicles

Damage to the testicles can affect the production quality and storage of sperm.

Damage can occur as a result of

• testicular cancer
• testicular surgery
• an infection of your testicle
• a problem with your testicles you were born with
• undescended testicles – when 1 or both testicles have not descended into the scrotum
• physical injury to your testicles

Ejaculation disorders

Some men experience ejaculation problems that can make it difficult for them to release semen during sex (ejaculate).

Hypogonadism

Hypogonadism is an abnormally low level of testosterone, the male sex hormone involved in making sperm. It may be caused by a tumour, taking illegal drugs, or Klinefelter syndrome (a rare syndrome involving an extra female chromosome).

Sterilisation

Some men choose to have a vasectomy if they do not want children or any more children. It involves cutting and sealing off the tubes that carry sperm out of your testicles so your semen will no longer contain any sperm. A vasectomy can be reversed, but reversals are not usually successful.

Medicines and drugs

Certain types of medicines including recreational drugs can sometimes cause infertility problems. Careful consideration will be needed if this is the case and you will need to be honest and open about your use of these drugs.

These include:

• sulfasalazine – an anti-inflammatory medicine used to treat conditions such as Crohn’s disease and rheumatoid arthritis; sulfasalazine can decrease the number of sperm, but its effects are temporary, and your sperm count should return to normal when you stop taking it
• chemotherapy – medicines used in chemotherapy can sometimes severely reduce sperm production
• herbal remedies – some herbal remedies, such as root extracts of the Chinese herb Tripterygium wilfordii, can affect the production of sperm or reduce the size of your testicles
• anabolic steroids – are often used illegally to build muscle and improve athletic performance; long-term abuse of anabolic steroids can reduce sperm count and sperm mobility

• Illegal drugs, such as marijuana and cocaine, can also affect semen quality.