Infections And Infertility

What types of infection cause fertility problems?

Infection in the testes (orchitis) can damage the sperm-producing tubes (seminiferous tubules) and stop sperm production.

Infections in the reproductive tract caused by sexually transmitted infections, particularly untreated gonorrhoea, may cause blockages in the tail of the epididymis or other parts of the male genital tract.

Non-specific epididymo-orchitis or prostate infections may sometimes cause blockages along the reproductive tract.

Although an infection is often only temporary, severe damage can leave men permanently infertile.  Mumps is the most common infection of the testes but is less likely to occur following the introduction of immunisation programs for children.

How does mumps cause infertility?

Mumps that spreads to the testes is called mumps orchitis. Mumps orchitis is the most well known infection of the testis and is caused by an infection with the mumps virus. Mumps orchitis does not always accompany mumps, but when it occurs after puberty can cause major swelling and pain. It can also totally destroy the sperm-producing tubes (seminiferous tubules) and permanently stop sperm production. Mild cases of mumps orchitis may only stop sperm production for six to twelve months. Mumps vaccine is available and boys should be immunised in infancy to avoid infection and possible infertility in adult life.

How do sexually transmitted infections affect fertility?

Sexually transmitted infections, such as gonorrhoea, can damage or block the epididymis so that sperm cannot pass from the testis into the ejaculate.  Because the testis only contributes a small part to the ejaculate, these blockages do not obviously change the amount of fluid ejaculated but no sperm will be found in the ejaculate (azoospermia).

What is epididymo-orchitis?

Epididymo-orchitis is caused by viral or bacterial infections of the testes and epididymis.  Pain and swelling usually last for several days.  Epididymo-orchitis sometimes happens with urinary tract infections and can cause permanent blockages to sperm transport and testicular damage but this is rare.

Early treatment with antibiotics is recommended to prevent testicular damage becoming too severe.

How do prostate infections cause infertility?

Since the ejaculatory duct passes through the prostate gland, infections of the prostate can cause swelling and block off part of the reproductive tract that passes through the prostate. This can also stop sperm from being ejaculated. Because the prostate and seminal vesicles contribute most of the fluid to the ejaculate, a blockage near the prostate can sometimes reduce the volume of ejaculate. Infections of the prostate and seminal vesicles can also cause inflammatory cells to pass into the ejaculate, which may damage the sperm.

Very rarely, a man may have a congenital abnormality (a problem they have been born with) in which lumpy growths or ‘cysts’ in the prostate gland have formed. These cysts can also cause blockage of sperm at this level.

Can surgery repair blockages in the epididymis?

Some couples become pregnant naturally after surgery to remove blockages caused by infections.  The success of surgery depends on the amount of damage and where the blockage is located in the reproductive tract.  Blockages near the testes (as in the epididymis) are particularly hard to fix because of the smaller size of the tube and difficulty in locating the site(s) of blockage.  Sperm antibodies are also often a problem for men with these blockages and may also reduce the chance of natural pregnancy.

You should discuss with your surgeon what they believe your success rate might be for this type of procedure.

Can blockages in the prostate be treated?

Treatment of the infection in the prostate gland may remove the blockage and allow the flow of sperm again.

Sometimes surgery to remove cysts in the prostate is performed by inserting an operating telescope through the penis. Removal of the cyst by surgery can remove the blockage to sperm transport so that the man is able to achieve a pregnancy naturally following the surgery.

What are the risks with surgery?

All surgery, particularly where there is a general anaesthetic, has some risks that need to be discussed with the doctor.

The risks with these operations are small, however, sometimes bleeding and infection can develop at the site of the operation.

Are there other ways to treat sperm blockages?

In vitro fertilisation (IVF) or other forms of assisted reproduction may be performed if men wish to have a family and do not wish to have surgery, or surgery was unsuccessful, to remove the blockage.  A biopsy, or sample of the testis, is taken to find sperm that can be used for ICSI/IVF procedures.

Most people assume that infections cause only temporary problems with their health. In fact, if an infection is not treated properly or quickly, it can cause serious problems throughout your body. And this includes your fertility.

What Type of Infection Will Affect My Fertility?

Almost any type of infection that makes an impact on your immune system can impair your fertility. In particular, those that affect your reproductive tract, including the prostate, epididymis or the testis, can hinder your fertility. It is unlikely that an infection will impair your fertility so much as to make you sterile, though.

Most of the time, the effects of an infection are only temporary. While a pesky cold or some other type of infection may lower your sperm count or slow down your sperm’s motility, more often than not, your sperm will rebound back to normal in a few months.

Those That Damage

There are some infections, however, that can do serious damage if not looked after right away. Sexually transmitted diseases, or STDs, are the most common infection associated with male infertility. If they are left untreated, you are repeatedly infected, or have frequent flare-ups, scarring and blockage in the reproductive tracts can occur. Mycoplasma, an organism often found in sexually active men, can attach itself to sperm cells, thereby impeding motility.

Another illness that is often associated with male infertility is the mumps. Men who contract the mumps after puberty are at risk of developing fertility problems. This is because the illness can lead to orchitis, or inflammation of the testicles. While this complication is rare, if it does occur, it can impair sperm production and sometimes lead to permanent sterility.

Getting Treatment

Unfortunately, many times infections do not cause any symptoms. STDs in particular are known for not producing any signs or symptoms. As a result, getting treatment for the infection may be delayed or never occur causing permanent damage to the reproductive organs. If your sperm production or reproductive tracts have been extensively damaged, it may be necessary to use surgical sperm retrieval methods in combination with ICSI and IVF. Alternately, you may decide to use a sperm donor in combination with IUI.

 In cases where symptoms do emerge or the infection is caught early on, antibiotics may be prescribed which should clear up the problem, thereby minimizing any damage to your fertility. If damage, such as scarring or blockage, has already occurred in your reproductive tract, then surgery may be done that can clear up the block or remove the scar tissue.

Treatment

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