Reduced male fertility

Causes

Fertility problems in men are often related to deviations in the sperm cells. These can be caused by disorders in:

• Sperm production
• Sperm transport 
• Hormones that stimulate sperm production

It is however important to be aware that in at least half the cases there is no proper medical explanation for reduced male fertility.

Sperm production

Problems in sperm production can lead to reduced sperm count, reduced motility or sperm shape abnormalities. 

Numerous factors can be at the base:

• Infection or inflammation of the testes (e.g. mumps virus or STDs such as gonorrhea) 
• Varicocele (testicular varicose vein)
• Scar tissue after injury or damage to the scrotum and testes 
• Torsion of the testes, cutting off the blood supply to the testes
• Undescended testes or other deviating positions 
• Genetic disorders
• Damaged separation between the seminal ducts and blood vessels
• Medication that reduce fertility (sometimes temporarily) (e.g. anabolics)
• Chemotherapy and radiation
• Pesticides and chemical substances

Sperm transport

Even if the sperm is of good quality, it still needs to reach the egg cell. A disorder in sperm transportation is another cause of reduced male fertility. 

Potential reasons for a transportation disorder:

• Erectile dysfunctions, where the penis is not firm enough, or not firm for long enough, to have normal sexual intercourse. 
• Premature ejaculation, where the semen is not ejected deep enough in the vagina.
• Retrograde ejaculation, where semen flows back to the man's bladder.
• Obstruction of the ejaculatory ducts, which leads to a lack of sperm in the ejaculate (e.g. in case of cystic fibrosis or after vasectomy).

Hormones stimulating sperm production 

Sometimes the body does not produce sufficient hormones that stimulate sperm production. 

Such a disorder can also lead to reduced male fertility. 

Treatment

Below you will find a number of potential treatments for this disorder. After the diagnosis, your doctor will, in consultation with you and the other doctors of the team, choose the best solution for you. Your treatment can therefore deviate from the therapy or therapies proposed below. 

Examinations and diagnosis

In case of (suspicion of) this disorder, we will perform the following examinations.