Male Infertility

If you and your partner have been trying for a year or more to have a child, you might be experiencing male infertility.

Male infertility can often be treated with medication or surgery.

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On this page

• What Is Male Infertility?
• What Are the Symptoms of Male Infertility?
• How Do You Diagnose Male Infertility?
• How Do You Treat Male Infertility?

What is Male Infertility?

Doctors define male infertility as the inability to conceive a child after one year of unprotected sex, or six months if you and your partner are over 35.

Studies have shown that in this one-year window, about 12% to 15% of couples under age 35 are unsuccessful in conceiving a child. Another 10% will remain unsuccessful after two years of unprotected sex.

In these situations, both partners must see their health care providers to diagnose infertility.

How common is male infertility?

Infertility in men isn't uncommon. It affects about 9% of men in the U.S. and is the issue for a third of infertile couples.

What causes male infertility?

Many things can cause male infertility, including:

• Antibodies.
• Environmental factors, such as exposure to certain chemicals.
• Genital infections.
• Prostatitis.
• Cancer treatments.
• Spending long periods of time in hot tubs.
• Sexually transmitted infections (STIs).
• Varioceles (a collection of varicose veins in the scrotum).
• Heavy alcohol consumption.
• Smoking cigarettes or marijuana, or being exposed to secondhand smoke.
• Genetic disorders.

What are male infertility risk factors and complications?

Male infertility risk factors

Like with their partners, age can also be a factor in male infertility. Couples having difficulty conceiving often include a male partner over age 40.

Since infertility in men can have several causes, you should speak to your doctor if you've experienced:

• An injury to the testicles.
• Exposure to toxins like cadmium, lead, or mercury.
• Heavy alcohol drinking.
• Heavy substance use, including marijuana, heroin, or cocaine.
• High blood pressure.
• Mumps as a child.
• Radiation or chemotherapy.
• Use of anabolic steroids or overuse of testosterone.
• Weight issues or, if you're currently overweight.

Complications of male infertility

Male infertility can lead to emotional and psychological issues, which can also affect sperm quality.

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What are the Signs and Symptoms of Male Infertility?

How can you tell if you're infertile? Unfortunately, infertility requires couples to make a consistent effort in trying to conceive over time.

In general:

• In couples under the age of 35, a six-month period of unprotected sex without conception may be a sign of infertility.
• For couples over 35, a period of one year or longer may be a sign of infertility.

If you and your partner are finding it difficult to conceive, you should both consult your doctors. Male infertility can often be corrected with proper diagnosis.

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How Do You Diagnose Male Infertility?

Male infertility can be diagnosed by your primary care provider at a routine check-up. But if infertility has been an ongoing issue, you might want to see a urologist.

Your doctor might ask you if you’ve had a high fever recently and ask questions about your family and medical history, as well as about your sex drive.

They may also do a physical exam to look at your:

• Penis — For any discharge or swelling that might be signs of an infection or sexually transmitted disease.
• Testicles — For signs of a hernia, malformation, damage, or a mass (tumor).
• Body hair — A lack of hair might signal a hormone imbalance.
• Scrotum — For abnormal veins (varicocele) that can affect sperm quality.

All of these conditions might affect your body’s testicular or ejaculatory functions.

If your doctor can't diagnose your infertility through a physical exam, they might ask for a sperm sample for semen analysis.

Tests to diagnose male infertility

Semen analysis

Semen analysis is one of the most important tools in determining male infertility and sperm abnormalities.

Once sperm enters the vagina, it must travel through cervical mucus and the cervix to reach the uterus to fertilize an egg. Conditions that impede this process may be attributed to male infertility.

A trained urologist will perform the analysis and look for these factors:

• Concentration — Measures how close the sperm are together in the sample. Low concentration may be a sign of a problem.
• Count — The number of sperm in the entire sample. A low count may make conception difficult.
• Morphology — The number of normally shaped sperm. Abnormally shaped sperm may not be able to fertilize an egg.
• Motility — The percentage of sperm moving forward. Sperm must be able to move forward to fertilize an egg.
• pH — The acidity of your semen. High acidity can kill sperm or affect their motility.
• Volume — The amount of semen in the sample. Low volume may cause infertility.
• White blood cells (leukocytes) — May be a sign that an infection is affecting your fertility.

A unique aspect of sperm production is that ejaculated sperm is developed in the testicles three months before they're released. So, the determining factors may or may not still be present in the sperm sample you provide.

Genetic testing

Male infertility is sometimes caused by a genetic disorder, such as Klinefelter’s syndrome. In these cases, doctors must do genetic testing to determine the cause.

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How Do You Treat Male Infertility?

Doctors have several options for treating male infertility, depending on the cause of your infertility.

Lifestyle changes

In certain cases, your doctor may simply recommend that you refrain from heavy alcohol consumption or drug use.

Medicines to treat male infertility

Your doctor might prescribe an oral hormone treatment to balance your hormones or a medication to treat erectile dysfunction. They also refer you to an endocrinologist, who may recommend drug therapies that affect the hypothalamus or thyroid.

Surgery for male infertility

If you have abnormally formed tubes in the testicles that are blocking the transport of sperm from the testicles to the penis, you may need surgery to repair them. Likewise, if you have a varicocele.

Testicular surgery can be done as outpatient surgery, and recovery takes about one to two weeks. These surgeries are typically performed by a urologist.

Assisted reproductive technology for male infertility

Couples who need assistance to get pregnant can find assisted reproductive technology (ART) to be very effective in producing a fertilized egg.

These therapies include:

• Intracytoplasmic sperm injection (ICSI) — One single sperm is injected into a mature egg before being placed in the uterus.
• Intrauterine inseminations (IUI) — Sperm is injected directly into the uterus.
• In vitro fertilization (IVF) — Sperm is introduced to an egg in a laboratory to create an embryo. The embryo then is placed into the uterus after a few days or frozen for future transplant to the uterus.

ART procedures may require the use of donor eggs or sperm for couples who can't produce their own healthy sperm or eggs, or for same-sex couples. Donor eggs or sperm may also be used as a preventive measure should the mother or father carry a genetic disorder that's likely to be passed down to the baby.

By UPMC Editorial Staff. Last reviewed on 2024-09-05.