17201 Male Infertility

Overview

Male infertility is when a man has difficulty getting his partner pregnant. It often involves problems with the number of sperm, their shape, or how well they move. Other issues, like blockages or hormone imbalances, can also play a role. It does not mean you cannot become a father, but it may take longer or need medical help.

Yes. Infertility is common, affecting about 1 in 7 couples. Male factors are involved in about half of these cases.

Male infertility can affect men of any background, usually during their reproductive years. Sometimes it has a clear cause, but often it happens without any obvious explanation.

Symptoms

Common symptoms

• No obvious symptoms – sometimes the only sign is not being able to conceive
• Problems with sexual function, such as trouble keeping an erection or low sexual desire
• Pain, swelling, or a lump in the testicle area
• Changes in body hair, breast growth, or other signs of hormone changes
• A low sperm count found during a semen test

Symptoms in children

• Male infertility is mostly a concern for adults. However, certain signs in boys – like testicles that have not moved down into the scrotum – may need early review to protect future fertility.

Symptoms in older adults

• Fertility naturally declines with age. Older men may have lower sperm quality and slower conception, but this does not usually cause health symptoms.

Causes

Main causes

• Varicocele – enlarged veins in the scrotum that can raise temperature and lower sperm quality
• Infections, such as certain sexually transmitted infections or prostate inflammation
• Ejaculation problems, like retrograde ejaculation (semen going into the bladder)
• Hormone imbalances from the brain or testicles
• Genetic conditions, such as Klinefelter syndrome
• Blockages in the tubes that carry sperm
• Medications, radiation, or surgery that affects the reproductive system

Risk factors

• Advancing age
• Smoking tobacco or using recreational drugs
• Drinking too much alcohol
• Being overweight or obese
• Exposure to toxins, pesticides, or heavy metals
• Using saunas, hot tubs, or tight clothing that raise scrotal temperature
• Long periods of sitting or cycling
• Stress, anxiety, or poor sleep

When to see a doctor

See a doctor urgently if:

• Sudden severe testicular pain or swelling – call your local emergency number
• Blood in your semen or a worrying lump – see a doctor the same day

Book a routine appointment if:

• If you and your partner have been trying to conceive for 12 months without success
• If you are over 40 and trying to conceive – your doctor may suggest earlier evaluation
• If you have known risk factors, such as a previous testicular surgery or a family history of infertility

Diagnosis

A doctor will start by asking about your medical history, lifestyle, and any symptoms. They will also do a physical examination. If needed, they will arrange tests to check your sperm and hormone levels.

Tests that may be done

• Semen analysis – a sample of semen is examined under a microscope for sperm count, shape, and movement
• Blood tests – to check hormone levels, including testosterone and follicle-stimulating hormone
• Physical examination – to look for varicocele, blockages, or other issues
• Genetic testing – if a genetic cause is suspected
• Ultrasound – imaging of the scrotum or prostate to see structural problems

What to expect at your appointment

Diagnosis usually happens in steps. Your doctor may refer you to a fertility specialist. You will be asked to provide a semen sample, typically after 2–5 days of no ejaculation. The results help guide the next steps. You are not alone in this – your partner may also be tested, as both sides matter.

Treatment

Treatment depends on the cause, and many issues can be addressed. Options range from simple lifestyle changes to assisted conception. Your healthcare team will talk you through the best path for your situation.

Self-care at home

• Quit smoking and limit alcohol
• Reach and maintain a healthy weight
• Exercise regularly, but avoid overheating the testicles
• Manage stress with relaxation or counseling
• Avoid recreational drugs and anabolic steroids

Medical treatments

Medical treatment may include hormone therapy if a hormone imbalance is found. Antibiotics are used for underlying infections. In some cases, medicines can help with erectile problems or ejaculation issues. Assisted reproduction techniques, such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), are commonly used to help sperm meet an egg. Your doctor will explain what is appropriate without naming specific brands or doses.

When is surgery considered?

Surgery might be recommended to fix a varicocele, repair a blockage, or retrieve sperm directly from the testicles for use in assisted reproduction.

Living with this condition

Living with male infertility often means coping with emotional ups and downs. It can feel stressful, but open communication with your partner and healthcare team helps. Take things one step at a time.

Lifestyle tips

• Get enough sleep and manage stress
• Keep your scrotum cool – avoid hot baths and tight underwear
• Stay physically active but avoid excessive endurance cycling
• Limit alcohol and caffeine
• Talk to your partner regularly about how you both feel

Diet and exercise

A balanced diet rich in fruits, vegetables, whole grains, and lean proteins supports overall health and may improve sperm quality. Regular, moderate exercise like brisk walking or swimming is beneficial. Avoid extreme workouts that cause exhaustion or raise body temperature too much.

Mental health and emotional wellbeing

Infertility can trigger sadness, guilt, anger, or anxiety. These feelings are normal. It is important to acknowledge them and seek support. Talking to a counselor or joining a support group can make a big difference.

Prevention

Not all causes of male infertility can be prevented, especially genetic ones. However, many lifestyle-related risks can be reduced. Quitting smoking, moderating alcohol, staying active, maintaining a healthy weight, and avoiding harmful chemicals all help protect fertility.

Complications

If left untreated

• Continued difficulty conceiving, which may lead to emotional distress
• Strain in relationships due to stress and disappointment
• Underlying health issues, such as hormonal problems, may go unnoticed

Long-term outlook

The outlook is hopeful. Many causes of male infertility can be treated successfully. Even when natural conception is not possible, assisted reproduction offers good chances for many couples. Advances in fertility care continue to improve outcomes.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.