Medical causes of subfertility

Testicular diseases

Diseases of testis and epididymis, such as inflammation, varicocele or testicular torsion affect mostly younger men and are very serious, as they may affect fertility when treated with a delay.

Hormonal dysfunction

Hormones, in particular the hormone FSH, control the production of sperm in the testicles. Hormone treatment is recommended with insufficient production or effect of FSH.

Varicose veins in the testicles (varicocele)

Varicoceles are varicose veins in the testicles and the spermatic cord. Approximately 15% of all men are affected by this. Untreated varicocele frequently causes male infertility as the build-up of blood in the scrotum leads to an increase in temperature in the testes by 0.5-1° C, which in turn has an adverse effect on sperm production. In 25-40% of infertile men, varicoceles are the cause of infertility.

Antibodies to sperm

As sperm are not produced until the age of puberty, the body may recognise them as foreign and thus produces antibodies to sperm. These antibodies can reduce the chances of getting the female partner pregnant.

Disorder of vas deferens

The final maturation of sperm occurs in the epididymis. The epididymis is a duct system of two to four metres length, through which the sperm is transported. Even minor infections can lead to blockage. Due to this disruption of sperm transport, sperm cannot mix with seminal fluid; there are not enough or abnormal sperm in the ejaculate.