Infertility in Men - Male Reproductive System

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Retrograde Ejaculation

Retrograde ejaculation occurs when the muscles of the bladder wall do not function properly during orgasm and sperm are forced backward into the bladder instead of forward out of the urethra. Sperm quality is often impaired.

Retrograde ejaculation can result from several conditions:

• Surgery to the lower part of the bladder or prostate (the most common cause of retrograde ejaculation)
• Diseases such as diabetes and multiple sclerosis
• Spinal cord injury or surgery
• Medications such as alpha blockers used for enlarged prostate glands, tranquilizers, certain antipsychotics, or blood pressure medications may also cause temporary retrograde ejaculation.
• Aging

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Structural Abnormalities

Any structural abnormalities that damage or block the testes, tubes, or other reproductive structures can affect fertility.

Cryptorchidism. Cryptorchidism is a condition usually seen in newborn infants in which the testicles fail to descend from the abdomen into the scrotum. Cryptorchidism is associated with mild to severe impairment of sperm production.

Hypospadias. This is a birth defect in which the urinary opening is on the underside of the penis, can prevent sperm from reaching the cervix if not surgically corrected.

Blockage in the Tubes that Transport Sperm. Some men are born with a blockage or other problems in the epididymis, or ejaculatory ducts, that later affect fertility. Some men lack the vas deferens, the tube that carries sperm from the testicles out through the penis. Low semen levels in ejaculate may be associated with structural abnormalities in the tubes transporting the sperm.

Click the icon to see an image of an undescended testicle.

Click the icon to see an image of hypospadias.

Hormonal Deficiencies

Hypogonadism is the general name for a severe deficiency in gonadotropin-releasing hormone (GnRH), the primary hormone that signals the process leading to the release of testosterone and other important reproductive hormones. Low levels of testosterone from any cause may result in defective sperm production.

Hypogonadism is uncommon and is most often present at the time of birth. It is usually the result of rare genetic diseases that affect the pituitary gland. These conditions may include selective deficiencies of the hormones FSH and LH, Kallman syndrome, or panhypopituitarism, in which the pituitary gland fails to make almost all hormones. Hypogonadism can also develop later in life from brain or pituitary gland tumors or as a result of radiation treatments.