“According to the definitions of the World Health Organization, infertility is defined as the inability to get pregnant despite at least 1 year of unprotected intercourse. When we look at the causes of infertility, on average, the problem of infertility affects men and women equally. Infertility in couples is due to 40% male-related, 40% female-related, 10% male-female-related, 10% unknown reasons. For this reason, couples who have infertility problems should understand the problem and discuss it among themselves, these averages show us that infertility is not only a problem related to the woman but also a problem that concerns both the couple and has a solution. Embryologist Abdullah Arslan continued his words as follows: "Hormones, sperm production, transport of sperm in sperm channels and sexual functions affect male reproductive health. A disorder in any of these causes infertility. Embryologist Abdullah Arslan said, "It is useful to know some of the main diseases and special conditions that we see as causing infertility in men."
Undescended Testicle (Cryptorchism)
At birth or within one year at the latest, the testicles descend into the ovarian sac. Failure of both or one of the testicles to descend into the ovary is called cryptorchidism. In these individuals, sperm production is impaired because the testicles, which remain above the abdomen, are exposed to higher temperatures. If the testicles are surgically lowered into the ovarian sac between the ages of 1-2, reproductive health will not be adversely affected in the future. Men who are not treated early can also have children with assisted reproductive techniques.
Testicular Tumors
Infertility is common in men treated for testicular tumors. Drugs used in chemotherapy and radiotherapy treatment adversely affect sperm production. Sperm samples taken before tumor treatment in these patients should be frozen and stored.
Varicocele
It is the condition of enlarged veins that form around the testicles in the ovarian sac. Enlarged veins occur in 15% of men. Not all men with a varicocele are infertile, but approximately one-third of men evaluated for infertility have a varicocele.
infections
Infections in the reproductive organs can lead to infertility. Inflammatory reactions that occur during gonorrhea, tuberculosis and some bacterial infections lead to obstructions in the reproductive tracts. Bacterial infections can cause infertility by impairing sperm movement and damaging developing sperm cells. Especially when mumps is diagnosed at a late age, testicular involvement is observed and permanent damage occurs in the seminiferous microtubules where sperm production is made.
Obstruction in Reproductive Channels
Obstructions in the reproductive ducts prevent the outflow of sperm. Infections, injuries, surgical procedures can cause blockages in the channels. In some men, the ducts are not congenital. In cases where there is complete obstruction on both sides, there is no sperm in the semen.
Causes of the Nervous System
Injuries to the spinal cord; It causes no semen and sperm output, erectile dysfunction, sexual intercourse and decreased sperm production. In these cases, ejaculation can be performed with some special treatment methods.
Genetic Disorders
Testicular development and sperm production disorders and hormonal imbalance can be seen due to genetic disorders.
Kleinfelter Syndrome; In this condition, which is seen once in 500, there is an extra X sex chromosome besides the XY sex chromosomes. In these men with 47 chromosomes, the testicles are small and hard, and their sex-specific characteristics are underdeveloped. In these cases, there is no sperm production. In the milder form of this disease, called mosaic, there may be sperm production.
Many disorders in the sex chromosomes cause infertility. In many of these cases, the testicles and sperm production were adversely affected. Infertility is common in some muscle diseases, sickle cell anemia, Mediterranean anemia and bladder disorders. In cases of cystic fibrosis, another disease accompanied by infertility, the amount of semen and sperm count are low. In these cases, sperm ducts are not formed or developed.
Diabetes (Diabetes)
The underlying cause of diabetes is either a decrease in the production of insulin hormone, which regulates the sugar level from the pancreas, or a deterioration in the sensitivity of the organs to insulin. Normally, the insulin hormone allows glucose, which is the main sugar source, to enter the cells, whereas in diabetics, due to insulin deficiency, this process cannot take place both in the testicles and in the cells that make the hormones that feed the testicles, and they remain insufficient. As a result, with the decrease in sperm count and motility, deformity occurs and the chance of pregnancy decreases. In addition to this, a decrease in testosterone hormone, increase in sperm DNA damage and difficulty in having sexual intercourse are added to a picture that is difficult to cope with.
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