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Infertility refers to the inability to conceive or carry a child to term. According to the Centers for Disease Control and Prevention (CDC), infertility affects about 6 million American women and their partners. A problem or obstruction at any point during conception prevents pregnancy from taking place.

For about a third of infertility cases, either physicians can find no cause, or the cause can be traced to conditions in each partner that interact to cause infertility. About a third of cases can be traced to causes specifically in the male, and about a third to causes in the female [see Pregnancy Miracle Book ].

Male Infertility Factors

Historically men were assumed to be fertile if they were capable of sexual intercourse. As a partial consequence of this attitude, research on fertility has traditionally emphasized problems in women. More recently, however, physicians have found that the male partner is the primary cause of infertility in about 30 percent of cases. Causes of male infertility can be categorized intosperm abnormalities,structural problems, ormedical disorders.

1. 1.Sperm Abnormalities

Low sperm countis the most frequent cause of male infertility. Although ultimately only one sperm is required for fertilization, men whose semen (fluid produced during ejaculation) contains less than 20 million sperm per milliliter frequently have infertility problems.

In addition to the quantity of sperm,the quality of spermmay affect male fertility. Physicians determine sperm quality according to its motility (ability to move) and its physical structure. Poor motility will prevent sperm from swimming the long distance from the woman's vagina to the fallopian tubes to fertilize an egg.

Sperm that have structural problems will also have problems penetrating an egg. Other conditions that can compromise sperm quality includegenetic impairmentssuch as damaged deoxyribonucleic acid (DNA), the genetic information critical in the development of a fertilized egg; ordegradationthat may result if sperm is stored too long after its formation.

1. 2.Structural Problems

Some men have anatomical abnormalities that impair or prevent fertility. The most common structural problem affecting male sperm levels is avaricocele,a tangle of swollen veins surrounding the testis.

Other testicular problems includetorsion, in which one testis is twisted, orundescended testicles, in which the testes are located in the abdomen instead of in the scrotum, the external pouch of skin that normally holds the testes.

The vas deferens(tubes that carry sperm from the testes to the penis) may be blocked because of a past infection or injury, or may be absent altogether due to a congenital abnormality. Other structural problems may prevent a man from ejaculating or cause his ejaculation to propel the sperm backward into his bladder rather than out through the penis.

1. 3.Medical Disorders

A number of medical disorders may cause male infertility. Infections such assexually transmitted infections,prostatitis(infection of the prostate gland), andmumpscontracted as an adult may lead to scarring and obstruction of the reproductive organs.

Certainmedications, including some prescribed to control high blood pressure (calcium channel blockers and beta blockers), ulcers (cimetidine), and depression (MAO inhibitors), can impair testicular function.

Exposure to high levels ofenvironmental toxins, including lead, mercury, and certain pesticides, may also affect male fertility. Some men have insufficient hormone levels, resulting in low sperm count or improper testicular function.

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