The book of Genesis tells us that one of the first mandates that the creator gave Adam and Eve was to be fertile and multiply. Some people take this to heart seriously, especially for men. But when problems arise that concern fertility in a couple, it is usually the women who first subject themselves to evaluation.

Studies have shown that half the time, the problem has something to do with the men. Men with diabetes are more prone to this problem, especially when their blood sugar level is up. This may create a strain in the couple’s relationship if the diabetic men are perceived as less romantic or “less sweet” to their wives if they have fertility problems.

The main sign of male infertility is the inability for couples to get pregnant. There may be no other obvious signs or symptoms of male infertility. However, if male infertility is caused by a hormonal problem, the man may manifest with reduced hair growth on the face or body, or a low sex drive.

Here are some facts about the human sperm. The sperm must be properly shaped and able to move toward the egg for fertilization to occur. If the shape and structure of the sperm are abnormal or the movement is impaired, the sperm may not be able to reach or penetrate the egg. There has to be enough sperm in the semen to make pregancy likely. A normal sperm concentration is greater than 20 million sperms per millimeter of semen. A count of 10 million or fewer sperms per millimeter of semen indicates low sperm concentration.

Causes of male infertility include: abnormal sperm production or function, impair delivery of sperm, general health and lifestyle issues, and exposure to certain environmental factors.

Abnormal sperms or sperms with abnormal functions may be due to any of the following conditions:

• Varicocele. A swollen vein in the scrotum that may prevent normal cooling of the testicle, leading to reduced sperm count and motility.
• Undescended Testicle. When one or both testicles fail to descend from the abdomen into the scrotum durin fetal development. Because the testicles are exposed to the higher internal body temperature, compared with the temperature in the scrotum, sperm production may be affected.
• Testosterone deficiency (male hypogonadism). When low levels of the male hormone, testosterone, are produced by the testicles, there may be a lack of development of male sexual characteristics and sperm production.
• Infections. Sexually transmitted diseases (STDs) can cause scarring and block sperm passage.

These problems with the delivery of sperms from the male to the female reproductive organ can result in infertility:

• Difficulties with erection of the male sexual organ (erectile dysfunction), premature ejaculation, painful intercourse (dyspareunia), or psychological or relationship problems. Erectile dysfunction is a common complication of chronic diabetes, especially when it is uncontrolled.
• The absence of ejaculate (semen) may occur in men with spinal cord injuries or diseases. This fluid carries the sperms from the male to the female sexual organ.
• Retrograde ejaculation occurs when semen enters the bladder during orgasm rather than emergin out through the male organ.Cause of retrograde ejaculation include diabetes, bladder, prostate or urethral surgery, and certain medications.
• Birth defect can cause the urinary (urethral) opening to be abnormally located on the underside of the male organ.
• Antibodies that target sperm and weaken or disable them usually occur after male sterilization (vasectomy).

Some common causes of infertility related to health and lifestyle include:

• Alcohol or drug dependency. Use of cocaine or marijuana may temporarily reduce the number and quality of sperms.
• Smoking. Men who smoke may have a lower sperm count than those who don’t smoke. Second-hand smoke also may affect male fertility.
• Stress. Sperm count may be affected by excessive or prolonged emotional stress. Infertility, on the other hand, can affect social relationships and sex life, further increasing emotional stress.
• Severe injury, major surgery or cancer. Certain diseases or conditions, such as kidney disease and liver cirrhosis can interfere with normal sperm production.
• Age. A gradual decline in fertility is common in men older than 35 years.
• Deficiencies in nutrients. Vitamin C, selenium, zinc, and folate are needed for prostate health.
• Being overweight. Hormone changes that reduce male fertility can occur with excess body weight.

Environmental elements can also reduce sperm production or function:

• Pesticides and other chemicals. Herbicides and insecticides may cause female hormone-like effects in the male body. Lead exposure also may cause infertility.
• Overheating the testicles. Frequent use of saunas or hot tubs can temporary impair sperm production and lower sperm count. Sitting for long periods or wearing tight clothing also may increase the temperature in the scrotum and reduce sperm production.
• Exposure to radiation or X-rays. With high doses of radiation, sperm production can be permanently impaired.
• Cancer and its treatment. Both radiation and chemotherapy treatment for cancer can impair sperm production. The closer radiation treatment is to the testicles, the higher the risk of infertility.

Many types of male infertility are not preventable. However, there are a few things that you can avoid that are known causes of male infertility:

• Don’t have a vasectomy. If there’s any possibility you’ll want to father a child in the future, opt for other forms of birth control. Even if reversed, a vasectomy may still affect fertility.
• Avoid illicit drugs. Use of anabolic steroids, marijuana and cocaine can impair sperm production.
• Don’t drink too much alcohol. Heavy alcohol use can lower testosterone levels, cause erectile dysfunction and decrease sperm production. Drink no more than two drinks a day.
• Quit smoking. Smoking is linked to impaired fertility. Fertility may improve when you stop smoking.
• Avoid exposure to excessive heat. Steer clear of extended or regular use of hot tubs, saunas and steam baths. High temperatures are thought to temporarily impair sperm production.
• Don’t put on or lose too much weight. Being overweight or too thin can reduce sperm count. Consume the right amount of calories and have regular exercise.
• Don’t be in haste. Practice safe sex. Past prostate or other genital infections such as sexually transmitted disease can affect fertility. Nothing is better than loyalty to a single partner.
• Avoid exposure to toxins, certain drugs, and medications. Examples include heavy metals, industrial chemicals, radioactivity and anabolic steroids.
• Don’t bring the blood sugar up. Men with uncontrolled diabetes experience more erectile dysfunction and retrograde ejaculation. Follow the dietitian’s advice on proper diet, do regular exercise and take the prescribed medications to control your blood sugar to target.

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