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5.1.1 INFERTILITY IN MEN
A physician who tries to discover the reason for a couple's infertility will usually first examine the man. Not only is the male reproductive system simpler, but quite often the root of the problem can indeed be found in the male. A man's infertility may, of course, result from certain congenital defects (see "Genetic Defects" and "Sexual Malformations"). However, it may also be acquired. Certain diseases, for example, such as mumps in adulthood or gonorrhea, can produce sterility (see "Venereal Diseases"). Another cause of infertility or subfertility (insufficient or low fertility) may be a low sperm count. In this case, the man does produce live sperm, but in quantities insufficient for a successful impregnation. While it is true that only one sperm cell is needed to fertilize the female egg, usually at least 200 million of them have to be ejaculated at one time in order to give this one cell a statistical chance to reach its destination, In some cases, the sheer number of sperm cells is sufficient, but their proper development or their ability to move is impaired. Most often, however, a low sperm count, sperm deformities, and lack of movement are found to occur together. Obviously, this condition does not have to affect a man's sexual desire or performance at all. He is just unable to cause pregnancy in a fertile woman. In other words, such a man is not "impotent," but infertile.
However, there are also some men who are infertile because they are "impotent." They cannot cause pregnancy in spite of their normal sperm production because their inability to have or hold an erection prevents them from even performing coitus. These cases particularly recommend themselves to treatment by artificial insemination.
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