Male infertility overview

Overview

Male infertility means a man has difficulty getting his partner pregnant after a year of regular, unprotected sex. It is usually due to problems with sperm production, sperm function, or blockages that stop sperm from reaching the egg.

Yes, male infertility is common. It affects about 10–15% of men trying to conceive and contributes to around half of all infertility cases in couples.

Male infertility can affect men of any age, but fertility naturally declines after age 40. It is most often diagnosed when a couple has trouble getting pregnant after trying for a year.

Symptoms

Common symptoms

• No obvious symptoms – many men with infertility feel healthy.
• Changes in sexual desire or erectile function.
• Pain, swelling, or a lump in the testicles.
• Problems with ejaculation, such as low semen volume or pain.

Symptoms in older adults

• Similar to common symptoms, but older men may also notice lower sex drive or reduced sperm quality due to age.

Causes

Main causes

• Varicocele – enlarged veins in the scrotum that overheat the testicles.
• Infections – such as sexually transmitted infections or mumps after puberty.
• Ejaculation problems – including retrograde ejaculation where sperm flow backward.
• Immune system issues – antibodies attacking healthy sperm.
• Hormonal imbalances – problems with the pituitary gland or testosterone production.
• Genetic conditions – such as Klinefelter syndrome or Y-chromosome deletions.
• Blockages – in the tubes that carry sperm from the testicles.

Risk factors

• Smoking or using tobacco.
• Drinking too much alcohol.
• Using recreational drugs (like marijuana or steroids).
• Being overweight or obese.
• Taking certain medicines – always speak to your doctor before stopping prescribed medication.
• Overheating the testicles (from hot baths, saunas, or tight underwear).
• High stress levels.
• Previous injury or surgery to the groin area.

When to see a doctor

See a doctor urgently if:

• Sudden, severe testicular pain – call your local emergency number immediately.
• Redness, swelling, or fever in the scrotum area.

Book a routine appointment if:

• After 12 months of trying to get pregnant (or 6 months if your partner is over 35).
• If you have any risk factors (like previous infections, surgery, or genetic conditions) sooner.
• If you notice changes in sexual function, ejaculation, or testicular size.

Diagnosis

A doctor will start by asking about your medical history, lifestyle, and any symptoms. Then they will perform a physical exam and likely recommend a semen analysis to check sperm count, shape, and movement.

Tests that may be done

• Semen analysis – the main test for male infertility.
• Blood tests – to check hormone levels (like testosterone and FSH).
• Genetic testing – to look for inherited causes.
• Scrotal ultrasound – to see the testicles and blood flow.
• Post-ejaculation urine test – to check for retrograde ejaculation.
• Testicular biopsy – rarely needed, to check sperm production.

What to expect at your appointment

Your doctor will explain each test and what it involves. For a semen analysis, you will need to provide a sample, usually by masturbation at the clinic or at home. Results are often available within a few days. You may also be referred to a fertility specialist.

Treatment

Treatment depends on the underlying cause. Many cases can be managed with lifestyle changes, medications, or minor procedures. Some causes are not curable, but there are still ways to help you father a child, such as assisted reproductive techniques like IVF.

Self-care at home

• Stop smoking and avoid tobacco products.
• Limit alcohol to no more than 14 units per week.
• Stay a healthy weight – even modest weight loss can help.
• Avoid overheating the testicles (skip hot baths, saunas, tight underwear).
• Manage stress with relaxation techniques, exercise, or counseling.

Medical treatments

Medications may be used to treat hormonal imbalances or infections. Your doctor might recommend medicines to improve sperm production or function. Never start or stop any medication without consulting your healthcare provider.

When is surgery considered?

Surgery may be an option for some causes, such as varicocele repair to improve sperm quality, or procedures to remove blockages in the sperm ducts.

Living with this condition

Living with infertility can be emotionally challenging. It is important to communicate openly with your partner and seek support from healthcare professionals. Treatment may take time, and results are not guaranteed, but many men find ways to cope and move forward.

Lifestyle tips

• Exercise regularly, but avoid overheating or extreme endurance sports.
• Eat a balanced diet rich in fruits, vegetables, whole grains, and healthy fats.
• Avoid smoking, recreational drugs, and limit alcohol.
• Get enough sleep and manage stress.

Diet and exercise

A balanced diet with plenty of antioxidants (like vitamin C, vitamin E, and selenium) may support sperm health. Regular moderate exercise helps maintain a healthy weight and reduces stress. Talk to your doctor or a dietitian for personalized advice.

Mental health and emotional wellbeing

Infertility can cause feelings of sadness, anxiety, guilt, or low self-esteem. These feelings are normal, but if they persist, consider speaking to a counselor or therapist. If you have thoughts of harming yourself, reach out to a crisis helpline immediately.

Prevention

Not all causes of male infertility can be prevented, but you can reduce your risk by maintaining a healthy lifestyle, avoiding tobacco and excessive alcohol, staying a healthy weight, and avoiding things that overheat the testicles. If you have a known risk factor, talk to your doctor early.

Complications

If left untreated

• Infertility itself does not cause physical harm, but it can lead to emotional distress and relationship strain.
• If an underlying cause like a varicocele or infection is not treated, it could cause testicular discomfort or, in rare cases, affect hormone levels.

Long-term outlook

The outlook for male infertility is often hopeful. Many causes are treatable, and with medical help, many couples can achieve pregnancy. Even if biological parenthood is not possible, there are options such as donor sperm, adoption, or surrogacy. Your healthcare team will guide you through the possibilities.

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