Behind the Scenes: Maximizing Male Fertility
You may not choose to become a father at aged 77, but from a strictly biological perspective, it is within the realm of possibility. Most men produce sperm for their entire lives.
The male reproductive system is relatively simple; as a result, it generally functions quite efficiently. Sperm are produced in the testicles and stored within the scrotum in a "sack" called the epididymis. During erection, but before ejaculation occurs, the sperm travel from the epididymis to the vas deferens. The vas deferens is the tube that is severed in a vasectomy. The sperm is then propelled to the urethra where they mix with other fluids to form semen, which is ejaculated through the tip of the penis.
Certain medical conditions can interfere with the proper functioning of the reproductive process. They include:
- Lack of Physical Structures or Blockages—Some men are born without a vas deferens or with tubal blockages. These conditions may be treated with surgery.
- Varicocele—The development of a varicocele, or varicose veins in the scrotum, which occurs in nearly 20% of men, can sometimes affect sperm production. Removing the veins may boost fertility, though the evidence favoring surgery remains incomplete.
- Retrograde Ejaculation—A condition in which semen travels in the wrong direction back into the bladder rather than being released through the penis. This can be caused by prostate and other types of surgery in the pelvic area. Drugs that close the opening from the urethra to the bladder can alleviate this problem.
- Diabetes and Multiple Sclerosis—These conditions can impair the nerves that promote normal ejaculation.
- Infections—Urinary tract, prostate, or tubal infections can cause blockages that can be treated by antibiotics. Gonorrhea and chlamydia are sexually transmitted infections that can scar the epididymis; however, these scars can be treated with microsurgery.
Last reviewedApril 2013by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.