Careful Fertility Evaluation of the Male Partner History can Uncover the Causes of Male Infertility
A history of having offspring within the previous 2 years is reassuring, although sperm quality can change over time. A careful fertility evaluation of the male partner’s history can suggest potential problems in the male:
Prior male reproductive surgery such as varicocele repair, hernia repair, and vasectomy reversal can lead to development of anti-sperm antibodies. Sperm are considered as foreign by the immune system. Surgeries can cause a break of the semen-blood barrier to allow sperm to enter the vascular system and be recognized by the immune system. Anti-sperm antibodies can bind to the head of the sperm to prevent fertilization or bind to the tail to impair motility.
Prior male reproductive infections that involve the prostate, the epididymis, and the testes can lead to production of anti-sperm antibodies. In addition, pus in the semen can lower sperm viability.
History of diabetes or hypertension can make a man susceptible to erectile dysfunction and sexual difficulty. Anti hypertension drugs such as the calcium channel blockers can impair sperm motility and fertilization potential by impeding the movement of calcium ion. Alternative medications should be used if possible.
Decreased libido may suggest a hormonal imbalance. Abnormal release of pituitary hormones can lead to sub optimal production of testosterone, leading to abnormal sperm production.