Most people tend to think it’s the woman’s problem if a couple is not able to have children, especially in India.

But a man can also have conditions that make it difficult for a couple to have children. Because a man’s contribution to procreation is the sperm, anything that affects the production of sperm, or its form (medically, ‘morphology’) or movement (’motility’), can affect a man’s fertility.

Some common things that can make a man less fertile or infertile:

1. Smoking, drinking alcohol, abusing drugs

All of these reduce the number of sperms produced by the testes. Alcohol and drugs can cause the testicles to shrink, and even second hand smoke can reduce a man’s fertility.

2. Genetic and hormonal problems

Men with problems with their pituitary or hypothalamus (which control the production of testosterone) or genetic issues like Klinefelter’s syndrome (when men have a XXY pattern of sex chromosomes) have fewer, unhealthier sperm.

3. Diseases

Many infections that affect the urinary or reproductive systems impair fertility. Mumps, which causes inflammation of the testicles, can reduce sperm production. Sexually transmitted diseases like gonorrhea and chlamydia can make men infertile. Chlamydia, in fact, has no symptoms except infertility.

4. Environmental causes

Exposure to lead, pesticides, and herbicides can affect the hormones and reduce fertility. If the testes is exposed to heat, for example in a sauna or from a laptop placed over the crotch, it will produce fewer sperm.

5. Lifestyle causes

Malnutrition, obesity, and diabetes reduce a man’s fertility. Men, like women, suffer declined fertility as they age.

If a couple has not been able to conceive after one year of unprotected and frequent intercourse, both the man and woman need to consult a doctor. About 30% of the time the problem is with the man alone. The rest of the time, the problem is either with the woman alone or with both of them, or the cause is never found.

Read more about men and infertility:

1. About male infertility

2. Vatican newspaper blames the contraceptive pill for male infertility

3. 50% of male infertility in Kolkata is caused by pollution

4. There is a worldwide fall in sperm count and quality

The Oscar for the 39 minutes documentary - ‘Smile Pinki’ was overshadowed by the Oscars awarded to ‘Slumdog Millionaire.’ For a second let us presume Slumdog Millionaire was not in reckoning for Oscar and only Smile Pinki had won the Oscars from India – imagine the media publicity and the good it would have done to the children suffering from Cleft Lip or cleft palate or both. Imagine how we would have gone gaga and perhaps the Indian Govt. itself may have got involved in this programme. ‘Smile Pinki’ attempts to throw light on the global problem (more in developing countries) of children suffering from Cleft Lip or cleft palate.

Why there are hardly any children borne with congnital defects in the developed countries - You may wonder why is this. Well the answer is simple – all pregnant women undergo screening ultrasound and if there is any defect found - the fetus is quicklly aborted - no question asked - irrespective of the magnitude of the defect. Nobody wants to raise children with defects in this world of designer babies. So many abortions – the free choice is obviously with parents – to abort or no. Wonder if the Vatican has ever looked at this issue or if there are any international guidelines for parents to follow. In developing world this is not the case – no routine screening ultrasound especially among the poor and hence higher incidence of congenital defects including – cleft lip/ palate etc (especially among the poor).

The stats from Smile Train programme on cleft lip make interesting reading -

• According to Smile Train statistics, greater than 4.7 million children belonging to developing countries live with unrepaired clefts in their upper lip/palate, a condition that is completely treatable

• In India 35,000 children are born each year with a cleft in their upper lip /palate ; more than half of these children do not get treatment simply because they are too poor

• Each of these affected children could be brought back to normal life, Pinki -style, with a simple 45 minutes surgery that would cost as little as Rs. 8000 ( approx. $250).

• Children with these deformities are isolated and traumatized. Many of them do not attend schools;some of them are even killed at birth or , even worse, abandoned

• As adults they fail to get regular jobs and are not in demand in the marriage market