Learn about how causes of infertility can be organized into pre-testicular, intratesticular, post-testicular, and extra testicular causes and how these may impact a man’s fertility.
There are many potential causes of male infertility. Some conditions may impact a man’s fertility in more than one way. A definitive cause for infertility will not be found in some men. Your doctor will work with you to try to find causes for fertility that are
- Reversible
- Treatable
- A threat to your health
- Or may impact the health of your child
Potential causes of infertility can be organized into pre-testicular, intratesticular, post-testicular, and extra testicular causes.
Pre testicular
Pre-testicular conditions effect the chemical signals that tell the testicle to make testosterone and/or make sperm. These signals come from a parts of the brain called the hypothalamus and pituitary gland. Pretesticular causes of infertility include:
- Hypothalamic disorders
- Pituitary disorders
- Brain tumors
- Radiation or surgery on the brain
- Exogenous testosterone/anabolic steroids
Extra testicular
Sometime the amount of sperm and/or the quality of the sperm can be effected by conditions unrelated to the reproductive organs or by exposures to certain substances or drugs. Extra-testicular causes of infertility include:
- Severe illness
- Heat (such as hot tubs or saunas)
- Obesity
- Medications
- Cigarettes
- Excessive alcohol consumption
- Recreational drugs (e.g marijuana)
Post-testicular
Sperm is mixed with fluid from the prostate and seminal vesicles to form semen. The semen must make it into the vagina to reach the egg and cause a natural pregnancy. Conditions that block sperm from entering the semen, or prevent the semen from being ejaculated into the vagina can cause infertility. Post-testicular causes of infertility include:
- Genital tract infection
- Vasectomy
- Spinal cord injury
- Surgeries in the pelvis
- Problems with ejaculation or erections
- Severe hypospadias
Testicular
Damage to, or poor function of, the testicle can affect how well the testicles can make sperm. Testicular causes of infertility include:
- Torsion of the testicle
- Undescended testicle
- Genetic disorders
- Primary testicular failure
- Scrotal trauma
- Varicocele
- Epididymitis/infection
- Cancer treatments (such as radiation or chemotherapy)
