Male Symptoms of Fertility Issues

Male fertility is one of the most common causes of infertility accounting for nearly 1/3 of the cases. For couples facing problems with fertility, it is just as important for the male partner to undergo a medical evaluation, as it is the female. In males there may be some symptoms which may directly or indirectly effect fertility. The causes of male infertility extend from systemic endocrine disorders, to specific reproductive organ abnormalities. It is important to remain alert of such symptoms, and to seek evaluation from the physician.

Cryptorchidism

Fertility concerns can occur even before the male reaches puberty. Cryptorchidism is a medical condition where the testis fails to descend into the scrotum. In some cases the testis will eventually descend, but in others surgery will eventually be required. An empty scrotal sac is an important indication of underlying fertility problems.

Varicocele

Varicocele is a fairly common cause of infertility in males. It is primarily caused by defects in the venous drainage, in the groin. The veins within the spermatic cord fail to drain blood out of the scrotum and testicles. This causes oedema within the testicles leading to defects in sperm production. The defect in sperm production is due to the elevation in temperature, caused by the trapped blood in and around the testicles. Important physical symptoms of varicocele, include abnormalities in testis structure. They feel like a bag of worms”. This can be felt and appreciated by the patient himself and can direct this finding to his physician.

Endocrine Abnormalities

Endocrine abnormalities can greatly affect the male’s reproductive capacity. Hormonal changes due to various conditions such as hypothyroidism, and pituitary tumours. Elevations in TSH can inhibit FSH and LH production. These hormones play a key role in controlling sperm production. Elevated TSH levels as seen in patients with primary hypothyroidism, leads to inhibition of FSH, and even LH. Symptoms of hypothyroidism include, fatigue, weight gain, decreased appetite, and excessive sleepiness. These symptoms, although general, can be due to endocrine abnormalities, and lead to infertility.

Pituitary Hormone

Kartagner's syndrome is another important medical condition which can lead to infertility. It is characterised as a motility disorder where the cilia (tiny hair cells) are immotile. The immotility also affects sperm cells rendering them immotile and unable to reach the egg. Other symptoms of this disease include respiratory problems, dextrocardia (the heart is on the right side). Although Kartagner’s syndrome is rare, it may be an important consideration in men who have difficulties with fertility.

Although male fertility can be attributed to a variety of causes, it is important to understand some of the symptoms associated with it. Symptoms alone, however is insufficient in making the diagnosis. A further evaluation with the doctor can help confirm a specific diagnosis, and determine the cause of the infertility issues. Other times causes of infertility, present without symptoms. In such cases a complete fertility work up including a semen analysis and blood work will be required. It is also important to discuss your sexual history and any history of sexually transmitted diseases. Sexually transmitted diseases can have an impact in fertility potential as well.