Fertility In Men: A look at the Male Reproductive System and The roles of Vitamin in Male Fertility.

Fertility In human simply means the ability to reproduce young ones without medical assistant or intervention in form of drug, surgery or implants.

Fertility in human is made possible because of the proper structural and functional system of the reproductive system, as well as the hormonal system in the body. However, in a situation whereby there is a change in the structure of the reproductive system, and down regulation in the function of the reproductive system, as well as imbalance in the hormonal system, infertility is set to results.

Infertility as a condition can occur in both male and female. In order words, a man can become infertile (not being able to get a woman pregnant) and a woman can become infertile as well (not being able to get pregnant or conceive ). Although, there is a huge notion In the society, especially in this part of the world, that infertility is a woman condition, however, such believe is false, as infertility is attributed medically to be a condition that affects both male and female.

There are several factors that could pre-dispose a man or a woman to infertility. Some of the factors can be caused by a change in the structure or function of the reproductive system, or an imbalance in the hormonal system. However in order to know the causes of infertility in men, it is importance to have a proper understanding of the male reproductive system.

THE MALE REPRODUCTIVE SYSTEM

The male reproductive system is made of a group of organs whose activities are highly regulated by hormones called the sex hormones, that regulate sexual functions as well as reproductive growth.

Hormones are chemical Messengers of the body that are secreted by glands called endocrine glands in the body . These glands are actually ductless in nature , hence they secret the hormones directly into the blood stream. The blood, being a transport system in the body, then helps to transport the hormones to various organs of the body where their activities are needed and activated . The male reproductive organs are one of the organs in the human body where the activities of the hormones are heavily needed. Therefore it is of importance to have a balanced hormonal system for the proper functioning of the male reproductive system and organs; as hormones, even in their microscopic amounts, are capable of bringing about a major change in the male reproductive system. A slight deficiency in the hormonal level is capable of disrupting proper functioning of the male reproductive organs.

Several hormones are responsible for the proper functioning of the male reproductive system, however, the three (3) primary hormones are the testosterone, follicle stimulating hormones (FSH), and Luteinizing hormone (LH). The FSH &LH are usually produced in the brain in a gland called the pituitary or mastery gland. The LH is what stimulate the production of the male testosterone which is needed for male sex drive as well as other activities, while the FSH is important for the production of sperm in a process known as spermatogenesis.

The male reproductive organs have the function of producing, maintaining, and transporting sperm and semen. The sperm is the male reproductive cell (the smallest structural and functional unit of life) while the Semen is the rich protective fluid (rich in enzymes , zinc, potassium , fructose, citric acid, free amino acids, prostaglandin and phosphorylcholine ) around the sperm . The sperm is what fertilizes the ovum (egg) in the woman when discharged into the female reproductive system by the male reproductive organ (Penis). Sperm constitute about 10% of normal semen volume (2-3ml) per ejaculation.

The male reproductive system consist of internal and external part. The external part of the male reproductive system is made up of the Scrotum, the Testicles, the Epididymis, and the Penis. The internal part of the male reproductive system is made up of several organs such as the Vas deferens, the Urethra, the Seminal vesicles, the Prostate gland, the Ejaculatory duct, as well as the Bulbourethral gland.

The External Male Reproductive Organs

Penis

The penis is the external male reproductive organ that ejaculates semen containing sperm during sexual intercourse. This ejaculation is made possible because of the ability of the penis to stay erect during arousal. During arousal, the penis becomes filled with blood which causes it to become rigid and erect . This is made possible by the presence of three circular shape chambers located at the body of the cylindrical shaped Penis. These chambers are made up of tissues that are sponge-like and contains spaces that gets filled with blood when there is an arousal. The root or base of the penis is attached just to the wall of the lower abdomen, while the other end of the Penis called the glans or head is where there is the urethra opening through which semen and urine are expelled from the body. The glans contains highly sensitive nerves.

The Scrotum

The Scrotum is the loose skin that is located right behind the penis. It houses the testicles and it contains many blood vessels and nerves . The Scrotum functions to protect the testes as well as help in regulating the testes temperature in accordance with the body temperature. The Scrotum contains special muscles in its wall that allows for contraction and relaxation, thereby moving the testicles closer to the body or further away from the body in a way of regulating its temperature

Fig 1: The male reproductive system

The Testicles

The testicles are housed in the Scrotum, and are held at both ends by a structure known as the spermatic cord . The testes are two for most men. The testes function for sperm production and for testosterone production. The testes are the organs responsible for the production of sperm cells in the body .

The Epididymis

The Epididymis lies just against the testes. They function to bring sperm produced by the testes to maturity. This is because the sperm from the testes are not matured and cannot fertilize the egg ( ovum) in the female reproductive system.

The Internal Male Reproductive Organs

The Urethra

The Urethra connects the bladder to the outside of the body. It is the tube that carries urine from the bladder. In men, it also functions to ejaculate semen to the outside of the body during sexual intercourse.

The Prostate Gland

The Prostate gland is located just below the urinary bladder, right in front of the rectum. The Prostate gland adds additional fluid to the sperm and helps to nourish the sperm. The Urethra that is opened at the glans of the penis is found running through the center of the prostate. The Prostate in its normal state is about the size of a walnut.

Fig 2: Male reproductive system

The Vas Deferens

The Vas Deferens is a muscular tube that arises from the epididymis into the pelvic cavity. The duty of the Vas deferens is to transport matured sperm to the Urethra for ejaculation.

The Bulbourethral Glands

These glands are in form of pea-size in structure. They are located just below the prostate gland at the side of the urethra. They function to produce slippery fluids that are released into the urethra in order to neutralize any form of acidity that may be present in the urethra due to the residual drop of urine in the urethra.

The Seminal Vesicles

The seminal vesicles also known as vesicular glands are found in the male pelvic region. They function to produce most of semen volume. They also combine with the vas deferens to form the ejaculatory duct that drains into the urethra.

CAUSES OF INFERTILITY IN MEN

Fig 3: Picture for illustration

Semen and Sperm

One of the major causes of infertility in men is associated with semen and sperm. Semen, as defined earlier, is that rich fluid that carries or is found around sperm . Once the sperm cells are produced in the testicles of the man, they are transported by tubes until they are mixed with semen to be ejaculated out of the penis through the urethra during intercourse. The normal Semen volume is about 2-3ml, while it contains 10% of sperm cells. The implication of this is that:

• There must production of healthy sperm by the testicles: The testicles are where sperm production takes place , while testosterone is one of the major hormones that trigger the production and maintenance of sperm in the testicles. Therefore, for there to be a production of healthy sperm that can fertilize the ovum (egg), the testicles must be producing adequate testosterone to trigger sperm production. While some conditions associated with the improper functioning of the testicles are reversible, some minerals and vitamins are known to contribute to the maintenance of the normal level of the testosterone in the blood, which in turn helps to boost libido, sex drive, and healthy sperm production.

• The produced sperm must be transported to the semen: Producing healthy sperm in the testicles is not enough to guaranty fertility, as the produced sperm needs to be transported through delicate tubes until they mixed up properly with Semen, and are ready to be ejaculated out of the penis into the female reproductive system for fertilization to take place. The implication of this is that there has to be no blockage in the process of transporting the sperm via the tube to be mixed with sperm.

• There has to be enough sperm present in the semen: The number of sperm present n the semen is an important factor to consider in the fertilization of the female egg (ovum). A low sperm count of less than 15 million sperm per millimeter of semen may not be enough to boost the fertility in male.

• There has to be enough volume of semen: Semen is a rich fluid that contains minerals and vitamins. The normal volume of the semen is 2-3ml with sperm containing around 10% of that volume . A drop in the volume of the semen may not be able to carry the required sperm that is needed to fertilize an egg . Wherefore it is of importance to proper level of the semen volume , and this can be with the help of some minerals and vitamins

• These must be proper sperm motility (movement): Abnormal motility of sperm may also become an issue leading to infertility in male .

Therefore some of the medical conditions that could cause infertility in male include:

Varicocele

Varicocele is a condition whereby there is an abnormal swelling of the vain that drains the testicles. Although the condition could be reversible, often times it comes with little or no symptoms and can cause low sperm production, thereby decreasing the quality of sperm, and leading to infertility in men. Varicocele condition disrupts the normal blood circulation in the blood vessels that are near the spermatic cord. Although there may be blood flow in the region, but the flow may be difficult. Absence of proper blood supply is equivalent to absence of proper oxygen supply to the tissues of the genitals, which in turn affect their functions. In severe cases where varicocele may cause pain, testicular atrophy or infertility, surgery may be required to correct the affected vein, thereby redirecting the blood flow into the normal veins. In the absence of infertility and severe pain, over-the-counter painkillers might be recommended.

Hormonal imbalance

Abnormal hormone production can lead to infertility in male. This could arise from underlying conditions affecting the glands that are responsible for the production of the hormones. Low level of testosterone can result to infertility and low sex drive as well as the production of unhealthy sperm. Treating underlying conditions, as well as taking recommended supplements of minerals and vitamins that can help boost the hormonal level and testosterone level in the blood, are the possible means of correcting hormonal imbalance that results to infertility in male.

Infection and Tumors

Some infections such as the inflammation of the epididymitis or the testicles, are capable of causing scars that can lead to the blockage of the passage of sperm through the transport duct. Other infections include gonorrhea, HIV, etc. If left untreated, These infections are capable of causing permanent damages to the testicles thereby leading to infertility. It is advisable to go for proper medical check up and get all infections treated.

Tumors of the glands that produce the needed hormones related to reproduction can also lead to infertility in male. Some of the glands are pituitary gland, adrenal gland, etc.

Sexual Intercourse Problems

Some problems associated with sexual intercourse are capable of causing infertility. Some of the problems may be pyschological; having relationship problems that interfere with sexual activities with ones partner. Others incluede erectile dysfunction (problem with keeping or maintaining an erection that is enough for penetration), having pre-mature ejaculation, or developing other anatomical related abnormalities such as hypospadias.

Problems Associated With Ejaculation

During ejaculation, semen passes from the testicles into the opening of the penis to be ejaculated out. However, a condition called retrograde ejaculation could occur whereby semen enters the bladder backwards intead of moving forward out of the penis.

Celiac

Celiac is a digestive disorder that results from a high level of sensitivity to a protein that is found in wheat gluten. This condition is capable of contributing to male infertility as it slows the motility (movement) of sperm. There is the tending of fertility improving following adoption of a gluten-free diet.

Medications

Certian medications such as those used for cancer treatment (chemotherapy), Ulcer drugs, arthritis drugs and other kinds of certian drugs, are capable of impairing the production of sperm, thereby leading to infertility.

Surgeries

Prostate, testicular surgery, vasectomy, scrotal surgeries, are some of the surgeries that can lead to lack of sperm during ejaculation.

Chromosomal Defects

A condition known as Klinefelter's syndrome can occur, whereby a male child is born with XX and one Y chromosome in place of one X and one Y chromosome. This condition can cause abnormal development of male reproductive organs. There are other genetic conditions associated with male infertility such as cystic fibrosis and Kallmann's syndrome.

Failure of testicles to descend from the abdomen into the scrotum during fetal development: This can happen to one or both testicles. This condition can lead to decrease fertility in men.

Presence of Oxidants

Oxidants are molecules that are called reactive oxygen, whose presence are capable of causing oxidative stress. Oxidative stress is one of the major causes of diseases in the body, including infertility in male. Oxidants level in the body are kept under control by the presence of anti-oxidants in the semen. However when the level of the oxidants rises above the level of anti-oxidants in the semen, there tend to be oxidative stress present. The oxidant molecules are capable of causing infertility by causing damage to sperm cell membrane as well as sperm cell DNA.

Other causes include of infertility in male include:

Environmental Causes: such as exposure to industrial chemicals, exposure to heavy metals, exposure to radiation or X-rays, overheating of the testicles due to exposure to high temperature.

Lifestyle: Excess alcohol intake (capable of reducing testosterone levels, and causing erectile dysfunction), tobacco intake (capable of causing low sperm count), drug abuse and obesity.

THE ROLES OF MINERAL AND VITAMIN IN BOOSTING MALE FERTILITY

In order to maintain fertility in male, it is of importance to have all the male reproductive organs functioning properly. Secondly, there is need to have normal level of hormones (testosterone), semen volume (2-3 ml), sperm found in semen (to avoid low sperm count), sperm quality (healthy sperm), sperm motility (movement), as well as normal level of blood flow (as the blood is responsible for transporting most of the hormones, and also needed to fill the Penis for erection).

Fig 3: Picture for illustration

Some of the minerals and vitamines that play such important roles in male fertility and reproductive organs include:

1. Zinc

Zinc is one of the essential minerals that play a crucial role in the male reproductive system. Zinc contributes immensely to male fertility and reproduction as it plays a role in increasing testosterone levels, increasing sperm count, boosting sperm motility, as well as testosterone metabolism. A combination of Zinc mineral and vitamin C have the potentials of protecting the sperm cells from oxidative stress, which is capable of destroying or damaging the sperm cell membrane and DNA. Zinc also has the tendency of increasing Semen volume. Studies have shown that the Semen contains more Zinc present in it than in the blood. What this implies is that when there is adequate level of Zinc in the male reproductive system, there would be adequate volumen of semen that can in turn contain the required amount of healthy sperm needed for fertilization. Each ejaculation is said to contain 5mg of Zinc.

2. Selenium

Selenium is a mineral supplement that contributes to spermatogenesis (the process of sperm formation) by functioning as an antioxidant. When combined with vitamin E, selenium has the capacity of decreasing the damage that is caused by free radicals in the sperm. Selenium also has the capacity of improving the sperm motility, which in turn helps in boosting fertility in male.

3. Vitamin D

Vitamin D is one of the essential vitamins that plays several roles in the body, such as improving the body's muscular function, and boosting the immune system. Vitamin D also plays an important role in male reproductive system. Research has shown that Vitamin D has positive effect in increasing sperm motility by activating important molecular pathways useful in sperm motility. Vitamin D also has the capacity of increasing Semen quality. This has been shown by research to be the most consistent effect of Vitamin D.

4. Folic Acid

Folate or folic acid as it is known is a B-vitamin, which plays several important roles in cell division, development of red blood cells, as well as in DNA production. The measure of folate level in Semen has been found to be associated with sperm count. Sperm motility is also affected by folate level, as low level of folate has been shown to be associated with decreased sperm count and motility. Study has also revealed that the combination of Zinc and Folic acid lead to up to 75% increase in normal sperm count in infertile male.

5. Vitamin C

Vitamin C is an essential vitamin with a high level of antioxidant potentials. Vitamin C helps protect the body's cell against oxidative stress and free radicals that are capable of damaging the DNA. The sperm cell DNA are also protected from oxidative stress damage by Vitamin C. The combination of Vitamin C and Zinc are highly protective of the sperm cell against oxidative damages.

6. Vitamin E.

Vitamin E is another essential vitamin with antioxidant effects that help to protect the sperm cell membrane from damage by free radicals. Vitamin E also helps to improve sperm motility. Vitamin E as a supplement for men with infertility has been shown to result to an increased chance of fertility.

7. Vitamin B12

Vitamin B12 is an essential vitamin that plays important roles in cell division. Vitamin B12 plays a crucial role in cell replication as well as in sperm production. A deficiency in Vitamin B12 can lead to low sperm count. Therefore, Vitamin B12 is needed for boosting male fertility and development of healthy sperm cells. Vitamin B12 is also needed for red blood cell formation.

8. Magnesium

Magnesium is a mineral supplement that has positive impact on male fertility. Magnesium helps to increase the sperm motility as well as sperm production. Sperm motility is triggered by the release of ATP by ATPase enzyme. Magnesium is highly needed in this process of ATP release that helps increase sperm motility.

9. Omega 3 fatty acids

Omega 3 fatty acids are essential fatty acid that also play crucial role in male fertility by providing the sperm cell with the right amount of structure needed for development. Studies have revealed that fertile male posses more omega 3 fatty acids in their body compared to the non fertile male counterparts.

10. Lycopene

Lycopene is the natural pigment that is found in tomatoes. Research has shown that lycopene has a boost on male fertility as it improves sperm count in men.

Oghorodi A.M.