Testicular Failure

When a man is diagnosed with testicular failure, a number of specific causes for male infertility can be indicated. Testicular failure is an umbrella term used to refer to the testis inability to properly produce sperm or hormones.

Causes of Testicular Failure
There are a number of reasons why a man’s testicles may fail to work. This includes chromosomal abnormalities that have been present since birth; testicular trauma; testicular torsion; and diseases or infections that affect the testicles (i.e. mumps and testicular cancer). Additionally, regular use of certain drugs as well as medications can have a direct impact on testicular function.

Certain lifestyle factors can also make an impact on your testicle’s ability to work properly. Some activities, like riding a motorcycle, can lead to constant, low-level injury of the scrotum thereby causing testicular problems. Regular use of recreational drugs and steroids have also been linked with testicular damage and impairing the production of sperm. Men who had an undescended testicle at birth are also at an increased risk of experiencing testicular failure later in life.

Is it Only My Fertility that is Affected?
Depending on the type of testicular failure you are experiencing, you may experience more than just infertility.

When testicular failure results in the male body’s incapability to produce the proper amount of male hormones, a man will likely be diagnosed with hypogonadism. This condition causes the testicles to not produce enough testosterone, the male sex hormone, while producing too much FSH and LH. As a result, a man may notice a loss of libido, enlarged male breasts, and a decrease in muscle mass. When this condition is present from birth, it can also lead to the failure to start puberty.

Diagnosing Testicular Failure
Making a diagnosis of testicular failure can be done through a testicular exam as well as through blood tests. Blood testing is done to evaluate the levels of testosterone and gonadotropins (FSH and LH) in a man’s system. Abnormal levels of these hormones will suggest testicular failure.

During a physical exam, your doctor will look for signs of testicular atrophy (shrinkage) and tumors (which can indicate testicular cancer). In men where the condition is present at birth, a lack of clearly defined genitals, resulting in a sexually ambiguous child, is indication of congenital testicular failure.

However, when testicular failure results in problems with sperm production, often it is only through semen analysis or other types of testing that the condition is recognized.

Sperm Production Issues
Testicular failure can cause the following problems with producing sperm:

Sertoli Cell-Only Syndrome: This condition refers to men whose seminiferous tubules are lined with sertoli cells but lack the cells that help sperm cells divide. As a result, a man is thought to have azoospermia.

Maturation Arrest: While sperm production starts off normally, at some point during its development, maturation completely stops. This causes sperm in the ejaculate to not be fully developed.

Hypospermatogeneses: This occurs when too few sperm are produced effectively causing little to no sperm being present in a man’s ejaculate.

Treating Testicular Failure
Men whose fertility problems stem from hormonal imbalances can be treated through testosterone replacement therapy. However, if the hormonal imbalance is found to be caused by recreational or prescribed drug use, it is likely that testicular function can be recovered if these medications are cut out or altered. Likewise, if a particular action, such as motorbike riding, is found to be impairing testicular function, you may be required to stop this particular activity.

Unfortunately, though, many times testicular failure cannot be adequately treated in order to restore function. Men who are found to have sertoli cell-only syndrome, maturation arrest or hypospermatogeneses will likely require the use of surgical sperm retrieval methods to recover viable sperm. These sperm can then be used with ICSI and IVF to produce a pregnancy.

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