Infertility – from a man’s perspective
To understand infertility, one needs to understand
fertility.
Fertility:
Sperm facts:
Sperm is the male sex cell. Testosterone
helps to make these microscopic, tadpole-like cells in the testicles.
Production begins at puberty (when a boy has his first wet dream) and continues
into old age. It takes about 74 days for a sperm cell to mature. It has a head,
neck and tail. Sperm are stored in the epididymis and they’re ejaculated from
here during an orgasm.
Sperm are propelled through the vas
towards the prostate gland where they’re mixed with semen – a sticky, milky
mucous that nourishes, protects and helps sperm to swim. The seminal vesicles
add extra glucose to the mixture.
Before the sperm exit through the
urethra of the penis, the Cowper’s glands secrete the pre-cum to neutralize this normally acidic tube.
Sperm swim 8 inches or 20 centimeters per hour. Most migrate to the cervix (mouth of the woman’s womb)
within 90 seconds after ejaculation. Those that stay in the vagina for longer
than 2 hours become immobilized.
Infertility
Problems arise when:
Sperm production is low:
Between 40 and 300 million sperm
are needed to fertilize a single egg (ova)! This is because only 50% of the
sperm are normal and of these 50% only a few manage to survive the grueling journey from the testicles to the Fallopian tubes. A count of less than 20
million sperm is considered problematic.
What affects sperm production?
Heat – sperm are temperature
sensitive. Too cold or too hot and they die. The scrotal sac is designed to
deal with this problem. Too hot and the skin stretches so that the testicles
hang and cool down. Too cold and the skin contracts, bringing the testicles
closer to the body where they’re warmed up.
Treatment: Change from jocks to
boxers and don’t have a hot bath before having sex. Inflammation of the
testicles (usually caused by a STI/Sexually Transmitted Infection) must be treated
ASAP as should varicocele’s (varicose veins of the testicles and scrotum).
Other factors affecting sperm
production:
- Stress and overwork
- Diet
- Smoking – especially marijuana
- Drinking
- Some medications e.g. methotrexate used to treat arthritis
- Undescended testicles
- Trauma to testicles resulting in antibody reaction.
Short shelf-life:
Sperm stored too long in the epididymis become immobile.
Solution: Having regular sex
replaces and replenishes sperm, ensuring healthy sperm production.
Transporting sperm through the vas:
This delicate tube needs to be
undamaged by inflammation caused by infections.
Ejaculation problems:
Erectile dysfunction: Unable to
maintain an erection
Premature ejaculation: Besides the
normal pre-cum stimulated by the Cowper’s gland, premature ejaculation depletes
semen before penetration is achieved.
Retrograde ejaculation: This is
when semen is misdirected into the bladder.
These can be medical or
psychological causes and should be treated by a urologist, psychologist or sex
therapist depending on the cause (see my Facebook insert for details about the
urology clinic in Pretoria, South Africa).
And finally, …. oestrogen dominance
that’s polluting the environment is affecting fertility in men. This is mostly
a by-product of plastics that mimic oestrogen and recycled water from sewerage
that contains high levels of oestrogen from women using contraceptives and
hormonal replacement therapy. In some countries, this has already affected the
fish and alligators where females are outnumbering the male species.
Illustration from ‘The Miracle of
Life’: Francisco Redondo
