Published On By Dimitar Marinov [MD, PhD]

Male Infertility

Male infertility is affecting couples worldwide, where you could experience difficulty in contributing to conception even after a year or more of having regular, unprotected sex.

In an estimate, one in every 6 people of healthy reproductive age (about 15% of couples) have experienced infertility at some point in their lives.

The ability to conceive relies on the successful production, maturation, and transport of healthy sperm. However, various factors could disrupt this process, leading to male infertility.

Genetic factors, poor lifestyle, and hormonal balance might impair your fertility, causing frustration and increased self-doubt.

Thus, knowing the causes that are potentially affecting your reproductive health and seeking proper treatment may help you tackle infertility issues effectively.

We will share some of the best treatment options available for infertility and a few prevention methods to help you lead a healthy sex life.

What Is Male Infertility?

Male infertility is the condition that hinders a male ability to conceive with their partner because of reproductive system complications. In the United States, 10-15% of males facing challenges with conception may be linked with male infertility.

Factors that could affect your fertility include problems with making healthy sperm, having tubes in the body that are blocked, difficulty with fertilizing an egg, or problems with the egg sticking inside the body after fertilization.

Symptoms of male infertility may not always be obvious, but they may include feelings of inadequacy, depression, and grief.

Also, having symptoms like feeling tired, not being able to get an erection, feeling sad, gaining weight, or not caring about things might mean there are issues with your fertility.

Symptoms Of Male Infertility

Here are a few symptoms of male infertility:

  • Male infertility symptoms may include problems with sexual function, such as difficulty with ejaculation, reduced sexual desire, or erectile dysfunction.
  • You may also observe some physical signs, such as swelling, pain, or a lump in the testicle area.
  • Recurrent respiratory infections, the inability to smell, abnormal breast growth (gynecomastia), or decreased facial and body hair could also be indicators of underlying infertility issues.
  • A lower-than-normal sperm count, defined as less than 15 million sperm or a total sperm count of fewer than 39 million per ejaculate, may point toward male infertility.

Causes Of Male Infertility

  1. Azoospermia

    Azoospermia is a condition that indicates the absence of sperm in a man’s semen, often identified as a leading cause of male infertility. It can be categorized into two kinds: obstructive azoospermia, where a physical blockage prevents the discharge of sperm, and non-obstructive azoospermia, where the testicles are unable to produce sperm.

    Factors like genetic disorders such as Klinefelter syndrome, infections like mumps orchitis, hormonal imbalances, prior surgeries in the reproductive system, and certain medications could contribute to the development of azoospermia.

    Diagnosis of azoospermia typically includes a thorough medical history review, physical examination, hormone testing, genetic testing, and imaging studies to address the underlying cause.

  2. Genetic Diseases

    Genetic diseases may cause male infertility, with conditions like Klinefelter syndrome and cystic fibrosis, which can lead to reproductive challenges.

    Klinefelter syndrome results from an extra chromosome in men, leading to lower testosterone levels and reduced sperm production. It could significantly impact your fertility by affecting the quality and quantity of sperm.

    Cystic fibrosis is a chronic disease that negatively affects the lungs and digestive system, which may contribute to male infertility. A mutation in the CFTR gene causes cystic fibrosis and may lead to difficulty in sperm production due to its effects on various bodily systems.

  3. Oligospermia

    Oligospermia indicates having a lower-than-normal sperm count in men, which can significantly impact fertility and the ability to conceive. It could arise from various underlying causes, such as hormone imbalances, genetic disorders, and infections. If you have oligospermia, it may cause issues with sperm motility (asthenospermia) and sperm morphology (teratospermia), further reducing your chances of successful fertilization.

  4. Varicoceles

    Varicoceles is a condition of swollen veins in the scrotum, potentially impacting male fertility due to the enlargement of these veins. These enlarged veins could increase the temperature in the scrotum, leading to a detrimental effect on sperm production and quality.

    The presence of a varicocele may result in decreased sperm count, poor sperm motility, and abnormal sperm morphology, all of which contribute to male infertility.

    Treatment options for varicoceles include surgical procedures such as varicocelectomy, which includes tying off the affected veins to redirect blood flow to normal veins. It may help improve sperm quality and increase the chances of conception if you are struggling with male infertility due to varicoceles.

  5. Malformed Sperm

    Malformed sperm, a condition characterized by abnormalities in the structure of sperm cells, significantly impacts male fertility and reproductive health. It may affect sperm with heads that are too large or too small to have difficulty penetrating the egg’s outer layer, making fertilization challenging.

  6. Cancer Treatments

    Cancer treatments, particularly chemotherapy and radiation therapy, may cause temporary or permanent infertility in men by damaging sperm-producing cells. Chemotherapy drugs may target rapidly dividing cells, which include sperm-producing cells in the testes. It may lead to reduced sperm count (oligospermia) or even a complete absence of sperm (azoospermia).

  7. Testicular Injury

    Sports injuries or direct blows to the testicles could cause physical trauma, leading to testicular damage and affecting sperm production.

    Certain infections, such as mumps orchitis or sexually transmitted infections, may inflame your testicles, impairing their ability to produce a sufficient amount of healthy sperm.

    Surgical procedures, including the testicles or surrounding areas, may sometimes result in unintended damage to the testicular tissue, affecting fertility.

    Certain medications like Nitrofurantoin could contribute to testicular injuries, impacting sperm quality and potentially decreasing sperm count.

  8. Unhealthy Habits

    A sedentary lifestyle is indicated by little to no physical activity that may lead to excess weight gain, which is associated with reduced sperm quality and hormonal imbalances.

    Consuming processed foods, sugars, and saturated fats might cause inflammation and oxidative stress, negatively affecting sperm health and production. Toxic substances like environmental pollutants, pesticides, and heavy metals could disrupt the hormonal balance and impair sperm function.

    If you smoke tobacco, it may not only decrease sperm count and motility but also damage your sperm DNA.

    Excessive alcohol intake might lead to hormonal imbalances and decreased testosterone levels, impacting sperm production. It could adversely affect the Leydig cell, which is responsible for producing testosterone hormone.

Tests For Male Infertility

Diagnostic assessments may help you identify potential causes of male infertility and guide you with appropriate treatment strategies.

  • Semen analysis could help evaluate the volume and quality of sperm in a semen sample. It provides valuable information on sperm count, motility, and morphology, which are crucial in male fertility evaluation.
  • Imaging tests, like ultrasounds or MRIs, may help you identify any structural abnormalities in the reproductive system.
  • Blood tests are utilized to measure hormone levels and detect any genetic or chromosomal abnormalities that could be contributing to your infertility.
  • Urinalysis may be conducted to diagnose sexually transmitted infections or conditions like diabetes that could impact fertility.
  • In some cases, a testicular biopsy may be recommended to assess the testicles’ ability to produce sperm effectively. It includes extracting a small amount of testicular tissue for analysis.


Treatment Options For Male Infertility

  1. Surgery

    Surgical interventions may help address male infertility by offering various treatment options to improve reproductive health and fertility outcomes.

    • Vasectomy reversal could reconnect the vas deferens to restore the ability for sperm to be present in the semen, thus allowing for natural conception.
    • A vasoepididymostomy is another procedure that addresses blockages in the epididymis, facilitating the passage of sperm into the semen.
    • In cases where natural conception is not possible, sperm retrieval through testicular or epididymal biopsy may be performed to obtain sperm for use in assisted reproductive technologies like in vitro fertilization.
    • Varicocelectomy is a surgical procedure that might improve sperm quality by relieving the pooling blood in the testicles because of varicose veins in the scrotum. It could enhance fertility outcomes and increase the likelihood of pregnancy in some instances by removing these varicose veins.
  2. Lifestyle Changes

    1. Maintain a moderate weight: If you are underweight or overweight, it may affect your hormone levels and sperm production. Aim for a balanced weight to support optimal fertility.
    2. Eat more fruits and vegetables: Consume a diet rich in fruits and vegetables that could provide essential nutrients and antioxidants that can benefit sperm health.
    3. Engage in physical activity: Walking, jogging, or weight lifting might help you maintain a healthy weight, reduce stress, and support overall well-being.
    4. Manage stress: High levels of stress could impact hormone balance and fertility. Practicing stress-reduction techniques like meditation, yoga, or deep breathing exercises may promote relaxation.
  3. Assisted Reproductive Techniques

    Assisted reproductive techniques, or ART, offer a range of procedures that may help you achieve pregnancy when natural conception proves challenging.

    One such technique is Intracytoplasmic Sperm Injection (ICSI), where a single sperm cell is physically injected into an egg to promote fertilization.

    In vitro fertilization (IVF) is another common ART procedure. IVF stimulates the ovaries to create multiple eggs, which are then recovered and fertilized with sperm in a laboratory afterward. The resulting embryos are then moved to the uterus to establish a pregnancy.

    These ART procedures could be a viable option for you if you are facing male infertility issues. ART could significantly increase the chances of successful fertilization and pregnancy by avoiding certain barriers to conception, such as less sperm count or poor sperm motility.

  4. Medications

    Here are a few medications that could help improve male fertility by addressing various underlying issues such as hormonal imbalances, infections, and sperm production problems.

    • Clomiphene Citrate: Used to treat low testosterone levels by stimulating the pituitary gland to increase the production of hormones that promote sperm production.
    • Antibiotics: These are used to treat infections in the reproductive tract that could impair sperm production and function.
    • Aromatase Inhibitors (e.g., Anastrozole): Used to increase testosterone levels by preventing the change of testosterone to estrogen.
  5. Hormone Treatment

    Hormone therapy may help regulate hormone levels that are crucial for optimal sperm production, thereby enhancing the chances of conception. It could address underlying issues affecting sperm quality and quantity by targeting low testosterone levels and elevated estrogen levels. Through hormone modulation, the quality of sperm produced could be enhanced, increasing the possibility of successful fertilization and pregnancy.

  6. Counseling and Support

    Dealing with male infertility can be emotionally taxing, leading to feelings of stress, grief, inadequacy, and even depression. Thus, counseling sessions may help address the psychological impact of male infertility, helping you to develop effective ways to manage stress, communicate openly, and strengthen your relationship throughout the fertility journey.

    Support groups may offer a sense of understanding, allowing you to connect with people experiencing similar challenges and gain support from peers who can empathize with their experiences.

Prevention For Male Infertility

  • Avoid or stop smoking, drinking, and nonprescription drugs: Substance abuse may significantly impact sperm quality and fertility potential, making it crucial to stop these habits in your life to safeguard reproductive health.
  • Limit exposure to hazardous chemicals: Chemicals in the environment and workplace could disrupt hormone production and damage sperm, affecting fertility. Taking precautions and using protective equipment may help reduce this risk.
  • Stay up to date on vaccines: Certain viruses, such as mumps or sexually transmitted infections, may harm your fertility. Thus, ensuring vaccination against these diseases can protect your overall reproductive health.
  • Prevent testicular heat exposure: Prolonged exposure of the testicles to high temperatures, from hot tubs or saunas, could impair sperm production. Avoiding excessive heat in the genital area may help you maintain healthy sperm levels and fertility.

Frequently Asked Questions

  1. Can Male Infertility Be Caused by Stress or Mental Health Issues?
    Stress and mental health issues may impact male fertility. Psychological factors like stress, depression, and anxiety could contribute to hormonal imbalances affecting sperm production and quality.
  2. Are There Any Natural Ways or Supplements That Can Improve Male Fertility?
    Natural remedies and supplements like antioxidants, zinc, folic acid, and vitamin D may support male fertility. However, consult a healthcare expert before starting any new routine to ensure safety and effectiveness.
  3. Is There a Link Between Male Infertility and Certain Autoimmune Conditions?
    Autoimmune disorders may impact male fertility by affecting sperm quality or production. Consulting with a medical provider for personalized guidance is recommended.
  4. Can Male Infertility Be a Sign of Underlying Serious Health Conditions?
    Male infertility could indeed signal underlying serious health conditions. It may indicate hormonal imbalances, genetic issues, infections, or anatomical problems. Seeking medical evaluation for male infertility is essential to identify and address potential health concerns.


Male infertility could significantly impact your ability to conceive your partner. It might be emotionally stressful for both of you, leading to disappointment and anxiety.

However, with the help of lifestyle changes, medications, and hormonal treatment, you might overcome your challenges of infertility and achieve your goal of starting a family.

Maintaining your weight and managing your stress levels could support healthy sexual function, leading to better erections and sperm quality.

You may seek therapy under the guidance of an experienced medical expert to enhance your sperm mobility and count, potentially increasing your chances of conception.

Eating a healthy diet, making practical changes in your routine, and consuming nutrient supplements may help enhance your fertility.

  • The details in this article are for informational purposes only and should not be considered medical advice.
  • It is not recommended to disregard/delay seeking professional medical advice or treatment because of what you read or accessed through this article.
  • The results may vary from individual to individual.
  • It is recommended to consult your doctor for any underlying medical conditions or if you are on any prescribed medicines before trying any tips.

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