Wie häufig ist männliche Unfruchtbarkeit und was sind die Ursachen?

What is infertility?

Your fertility is your ability to conceive a baby through unprotected sex: Unfruchtbarkeit is when this becomes difficult. In most cases, it's not as straightforward as being either fertile or infertile - many factors can decrease, but not completely eliminate, your chances of having a baby.

In both men and women, fertility naturally declines with age, and for partners struggling to become pregnant, there is no clear cut-off point to say when a couple is infertile. Experts usually advise you visit your GP if you've not become pregnant after a year of trying.

Your GP may decide to test one or both of you for possible infertility causes. There are several health issues that can cause male infertility specifically, and finding a diagnosis means you can better understand your options and chances of conceiving naturally.

When it comes to fertility problems, men and women experience them fairly equally. According to a US national survey that spanned almost 20 years, around 9% of men and around 11% of women experience fertility problems¹.

Giulia Guerrini, lead pharmacist of digital pharmacy Medino, says that one in three infertility cases for couples are due to male reproductive issues; one in three infertility cases are caused by female reproductive issues; and the final third is made up of couples who are both diagnosed with health issues affecting fertility, or have both tested but aren't diagnosed with a specific cause².

Guerrini says that despite this even spread of causes, male infertility is a difficult subject for some people to discuss.

What can go wrong in a man's reproductive system - the body parts that allow him to make a baby? Guerrini explains:

"Without giving a full lesson on the birds and the bees, a man's testicles produce and store sperm, which is later ejaculated by the penis to combine with a woman's egg. As such, the majority of male infertility issues are problems that affect how the testicles work."

Testicle problems could reduce or eliminate your number of sperm, make them less mobile, or prevent them from ejaculating. Abnormal sperm doesn't automatically make you 100% infertile - depending on how your sperm is affected, your fertility may be decreased, rather than gone completely.

There are also several conditions that cause many men to worry over their long-term fertility. Following are a few common examples that demonstrate how the relationship between infertility and disease is rarely simple.

Can testicular cancer cause male infertility?

According to Vincent Wolverson, CEO of Hodenkrebs Wohltätigkeitsorganisation It's On The Ball, it is relatively rare for this form of cancer to cause male infertility in the long-term. "The majority of men who are treated go on to lead a normal sex life and are able to produce a family, as the remaining testicle will produce healthy sperm."

However, he adds that men who undergo Chemotherapie may experience temporary infertility during treatment, and that medical staff will be able to advise on this.

Can Crohn's disease cause male infertility?

Morbus Crohn, eine Form von entzündliche Darmerkrankung (IBD), is a long-term condition of the gut. The relationship between IBD and fertility is unclear and more research is needed. It's possible that the gut inflammation, the nutritional deficiencies this causes, and certain treatments including drugs and surgery could potentially impact your fertility when you have Crohn's disease.

It was also found that voluntary childlessness, not infertility, may also be contributing to lower birth rates among patients. The study suggested that this could be due to fears of those with the disease that birth abnormalities could be caused by IBD drugs and concerns of passing on the disease⁶.

Can haemorrhoids cause male infertility?

Hämorrhoiden - also called piles - are swollen veins in your anus and lower rectum, similar to varicose veins. While there is no evidence that this directly affects your fertility, studies have linked haemorrhoids with increased rates of Erektionsstörungen⁷, preventing you from having sex.

Both complications are treatable, meaning that any infertility troubles are usually temporary and reversible.

For around one in four couples struggling to conceive, the problem can't be traced to a single health issue. This may be frustrating, but in these circumstances, doctors usually encourage couples to keep trying. Around half of couples who don't get pregnant within a year will conceive the following year.

To improve your chances, address the unhealthy lifestyle habits that are proven to increase both female and male infertility.

1. National Health Statistics Report: Infertility and impaired fecundity in the United States, 1982-2010: National Survey of Family Growth.

2. American Urological Association: Diagnosis and treatment of infertility in men: AUA/ASRM guideline 2020.

3. Centers for Disease Control and Prevention: Complications of mumps.

4. NORD: Kallmann syndrome.

5. Mayo Clinic: Klinefelter's syndrome.

6. Gastroenterology & Hepatology: Sexual issues and fertility in male patients with inflammatory bowel disease.

7. Abdelaziz et al: The impact of surgical hemorrhoidectomy on male sexual function: A preliminary study.

8. Tommy's: How smoking affects female and male fertility.