Causes of Infertility in Men
Male infertility can result from a wide range of complex factors. Accurate diagnosis and proper treatment depend on identifying the underlying cause. The most common reason for male infertility is related to problems in sperm production, quality, or motility. When the testicles—the male reproductive organs—fail to produce a sufficient quantity of healthy sperm, infertility becomes more likely. This may be due to hormonal imbalances, genetic disorders, or testicular trauma.
Another major issue in male fertility involves obstructions in the sperm transport system. Congenital abnormalities or infections can cause blockages in the ducts that carry sperm from the testicles to the penis, preventing normal ejaculation.
A leading and treatable cause of male infertility is varicocele, a condition where the veins in the scrotum become enlarged. This causes increased heat around the testicles, which negatively impacts sperm production and quality.
Hormonal imbalances involving the hypothalamus, pituitary gland, or testicles can disrupt the hormonal signals responsible for sperm production, resulting in a reduced sperm count and quality.
Sexually transmitted infections (STIs) or other medical infections can damage the reproductive tract or block sperm pathways. Environmental factors such as exposure to radiation, chemicals, or heavy metals can also impair sperm production. Additionally, lifestyle habits such as smoking, excessive alcohol consumption, poor diet, stress, and lack of exercise can significantly affect male fertility.
What Are the Symptoms of Male Infertility?
Trouble keeping an erection, Pain or swelling in the testicles, Issues with ejaculation (too early, too late, or none), Low sex drive, Changes in hair growth or hormone problems, Frequent respiratory infections or chronic illnesses affecting sperm, and genetic or health issues impacting fertility are the significant
Male infertility often shows no obvious symptoms, and is usually only identified when a couple has difficulty conceiving. However, in some cases, the following symptoms may indicate a fertility issue.
Male infertility symptoms:
- Inability to conceive after one year of unprotected sexual intercourse
- Sexual dysfunction, such as erectile difficulties, premature ejaculation, or low libido
- Abnormal semen—including changes in volume, color, or the presence of blood
- Swelling, lumps, or pain in the testicles, which may signal underlying issues such as varicocele
- Hormonal symptoms, such as reduced body or facial hair and abnormal breast enlargement (gynecomastia)
How Is Male Infertility Treated?
Treatment depends on the specific cause of infertility:
- Medication is often the first line of treatment, especially when hormonal imbalances or infections are identified. Hormone therapies help regulate testosterone and stimulate sperm production, while antibiotics may be used to treat infections.
- Surgical interventions may be necessary in cases of varicocele or blockages in the sperm ducts. Surgical correction can significantly improve fertility potential.
- Lifestyle changes are also essential. Quitting smoking, reducing alcohol intake, managing stress, maintaining a healthy weight, and following a balanced diet all support reproductive health.
Psychological support or counseling can be highly beneficial during fertility treatment, helping couples cope with emotional challenges.
How Is Male Fertility Tested?
To assess male fertility, various tests are performed, starting with a semen analysis (also known as a sperm test male or spermiogram). This test evaluates:
- Sperm count
- Sperm motility (movement)
- Sperm morphology (shape)
- Semen volume
The sperm sample is usually collected through masturbation in a private room at the clinic, though home collection may be possible under specific guidelines. The results provide key insights into the cause of infertility and help determine the most suitable treatment approach.
When Does Male Infertility Begin?
Male infertility doesn’t usually begin at a specific age—it may be present from birth or develop over time due to health or lifestyle factors. Signs of infertility typically emerge when a man attempts to conceive.
However, early indicators in childhood or adolescence can suggest future fertility issues:
- Undescended testicles (cryptorchidism) at birth can impact sperm production if not treated early
- Delayed puberty or testosterone deficiency may point to hormonal problems
- Mumps orchitis (inflammation of the testicles due to mumps) during childhood can damage sperm-producing tissues
Identifying and addressing these issues early can prevent long-term complications.
Male Infertility and IVF Treatment
In vitro fertilization (IVF) is one of the most effective assisted reproductive technologies for couples dealing with male infertility. Even in cases of low sperm count, poor motility, or structural abnormalities, specialized techniques can help achieve pregnancy.
Common Techniques Used in Male Infertility:
- ICSI (Intracytoplasmic Sperm Injection): A single healthy sperm is injected directly into the egg under a microscope.
- TESA (Testicular Sperm Aspiration): Sperm is extracted from the testicles using a fine needle.
- TESE (Testicular Sperm Extraction): A small tissue sample is taken from the testicles to retrieve sperm.
- PESA (Percutaneous Epididymal Sperm Aspiration): Sperm is collected from the epididymis using a thin needle—commonly used in cases of ductal blockage.
These advanced methods offer a chance of fatherhood even for men with no sperm in the ejaculate.
