Primary infertility” is used to describe the condition of partners who have not been successful at reproducing after at least a year of regular intercourse.Secondary infertility” is used to describe couples who have conceived at least once before, but are having difficulty getting pregnant again.
Absence of sperm or low sperm count may be due to an infection associated with high fever that occurs after puberty. Mumps has long been associated with infertility in a man.Since each sperm takes about 74 days to mature, it is important to inform the doctor of any medical illnesses or other factors that occurred in the preceding 3 months. One common problem leading to infertility is a varicocele, an enlarged varicose-type vein commonly found above a testicle in about 15 percent of all men in the world.
A varicocele is a small flaw in the anatomy of a vein. If such a vein exists, surplus blood, and therefore too much heat, gets to the testicles, causing the sperm to die. Every man who has a varicocele is not infertile. However, about 30 percent of men who are infertile have a varicocele. The size of the varicocele seems to have no bearing on sperm count.
Varicoceles can be corrected with a simple surgical procedure or a new nonsurgical technique in which a tiny silicone balloon or coil is inserted into the area to close off the swollen vein, rerouting the blood to other blood vessels. Other physical conditions that might be found include an obstruction in the duct system that could block the outflow of sperm, or an infection, which could cause scarring that could stop the sperm. When an evaluation shows that a man’s testicles are producing plenty of healthy sperm but none appear in his semen, an obstruction of the tubes running from the testicles to the prostate is suspected.
Sperm production may be impaired by the use of alcohol or drugs, or exposure to toxic chemicals. Hot tubs, tight jeans may increase the temperature in the testes, lowering production of sperm. A woman’s use of douches or lubricants can kill sperm. Sometimes a man’s body reacts to its own sperm as if it were a foreign invader, producing antibodies to the sperm. The antibodies block conception by immobilizing the sperm or by preventing their passage through the woman’s cervical mucus.