male infertility on one side

Overview

Male infertility on one side means that a problem in one part of a man's reproductive system, such as one testicle or one tube, is making it harder for a couple to become pregnant. It is not the same as having no sperm at all. Many men with one-sided problems can still father a child.

Male infertility affects about 1 in 7 couples. Problems on only one side are fairly common, especially varicoceles, which may appear in about 15% of all men.

It can affect men of any age, but it is most often looked into when a couple has been trying to conceive for more than a year without success.

Symptoms

Common symptoms

• Usually there are no symptoms.
• A dull ache or heaviness in the scrotum (the sack below the penis).
• Swelling or a lump in one testicle.
• A feeling of small, twisted veins around the testicle (like a bag of worms).
• Trouble getting a partner pregnant, even after trying for a year.

Symptoms in children

• Infertility itself does not affect children, but a condition such as an undescended testicle may affect fertility in later life.

Symptoms in older adults

• Men over 50 may have other health issues, such as hormone changes or medical conditions, that can add to a one-sided problem.

Causes

Main causes

• A varicocele – enlarged veins in the scrotum that can raise temperature in the testicle.
• An undescended testicle – when a testicle does not move down into the scrotum in childhood.
• A previous infection, such as mumps or a sexually transmitted infection, in one testicle.
• Injury or surgery to the scrotum or groin.
• A blockage in one of the tubes that carry sperm.

Risk factors

• Smoking and heavy alcohol use.
• Being overweight.
• Using illegal drugs or anabolic steroids.
• Exposure to some chemicals or radiation.
• Having had a hernia repair or other surgery in the groin area.

When to see a doctor

See a doctor urgently if:

• You have sudden, severe testicle pain – call your local emergency number right away.
• You find a hard lump or a change in a testicle – see a doctor that same day.

Book a routine appointment if:

• You and your partner have been trying to get pregnant for over a year without success.
• You have noticed swelling, pain, or a dull ache in your scrotum that is not going away.
• You are planning a pregnancy and are worried about your fertility.

Diagnosis

A doctor usually begins by asking about your health, family history, and any symptoms. They will also gently examine your testicles and the nearby tubes.

Tests that may be done

• Physical exam of the scrotum and testicles.
• A semen analysis – a sample of semen is checked under a microscope for sperm count and movement.
• An ultrasound – sound waves create an image of the inside of the scrotum.
• Blood tests – to check hormone levels that affect sperm production.

What to expect at your appointment

Most leading tests are simple and painless. You might be asked to produce a semen sample in a private room at a clinic. The doctor will explain each step openly.

Treatment

Treatment depends on the cause. In many cases, a varicocele can be fixed with surgery, which may improve sperm quality. If a blockage prevents sperm from getting out, an operation can sometimes open it. A doctor may also suggest medicines that help with hormone balance.

Self-care at home

• Wear supportive underwear if you have a heavy or aching feeling.
• Avoid very hot baths, saunas, or tight clothing around the groin.
• Cut down on smoking and alcohol.
• Try to stay at a healthy weight and exercise regularly.

Medical treatments

Your doctor may suggest medicines to treat an infection or adjust hormone levels. They might also talk about assisted reproduction options, such as intracytoplasmic sperm injection (ICSI), where a single sperm is placed directly into an egg. These approaches do not use brand-name drugs; your team will explain what is right for you.

When is surgery considered?

Surgery is often used to repair a varicocele or to remove a blockage in the sperm tubes. It can also fix an undescended testicle. Surgery is not right for everyone, so your doctor will help you weigh the risks and benefits.

Living with this condition

Living with a one-sided fertility problem can feel stressful, but it does not affect your daily physical health. Many men live full, active lives. It may help to keep up your usual routine and to stay open with your partner.

Lifestyle tips

• Stay active, but avoid movements that strain your groin for long periods.
• Give up smoking. Ask your pharmacist or local stop-smoking service for support.
• Limit alcohol and avoid recreational drugs.
• Keep your phone and laptop away from your lap to avoid extra heat.

Diet and exercise

Eat a diet rich in fruits, vegetables, whole grains, and lean proteins. Exercise, such as walking or swimming, is good for your health, but avoid overheating your groin with very intense workouts in a sauna or hot room.

Mental health and emotional wellbeing

Trying to conceive can be emotionally draining and may cause anxiety or depression. It is normal to feel frustrated or sad. Talk to your partner, friends, or a counsellor about how you are feeling.

Prevention

Not all causes can be prevented, especially if there is a varicocele or a blocked tube. But you can take steps to protect your fertility by avoiding smoking, eating well, and staying at a healthy weight.

Complications

If left untreated

• If a varicocele is left alone, it might further lower sperm quality over time.
• An undescended testicle that is not treated can carry a small risk of testicular cancer.
• A blockage in a tube may lead to a damaged testicle if not evaluated.

Long-term outlook

The outlook is generally positive. Many men with a one-sided problem can have children with the help of treatment. Working closely with a healthcare team gives you the best chance of a successful pregnancy.

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