Male infertility

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at June 16, 2016
StartDiseasesMale infertility

Male infertility involves a problem with an aspect of the male reproductive system that impacts a man's ability to fertilize an ovum through the process of sexual intercourse. Medical experts consider abnormalities in a male's sperm count, sperm shape, and sperm motility as reasons for male infertility. In addition, causes of male infertility can include obstructions within a man's body that prevent the proper delivery of sperm into a woman's body for fertilization of an ovum. In some cases, a combination of these factors may exist resulting in male infertility.


Definition & Facts

Up to 15 percent of couples who are trying to conceive are said to experience infertility issues. Infertility exists when a couple has had unprotected sex frequently for a period of at least one year without conceiving a child. The inability to conceive a child can be very frustrating for a couple, cause psychological stress, and harm relationships.

It can be difficult to ascertain the root cause of the problem as female infertility is another potential cause of a couple's infertility. There are two types of infertility: primary and secondary. Primary infertility involves never having been able to conceive while secondary infertility involves once having been able to conceive but presently being unable to do so.

There are instances in which male infertility is the result of a more serious disease. For example, a tumor may cause an obstruction within the male reproductive system, impacting fertility. Erectile dysfunction or the inability to achieve an erection necessarily impacts a man's ability to participate in the conception process though by itself is not a cause or indication of infertility.

Symptoms & Complaints

The most obvious sign of male infertility is the inability of a couple to conceive a child, while outward physical symptoms of male infertility depend upon the underlying cause, of which there are many. Signs can include difficulty ejaculating, problems maintaining an erection, testicular pain, testicular swelling, and a testicular lump.

Some surprising complaints may also be rooted in the same issue that is causing male infertility. These include the inability to smell or recurring respiratory infections. Other symptoms could include excessive body or facial hair as well as abnormal male breast growth. A person should see a doctor if one or another of these symptoms appear to exist.

A low sperm count is an obvious sign of male infertility. However, this determination is usually never made unless one of the other signs or symptoms is first experienced. Again, the most likely sign or symptom is going to be an inability to conceive. 


Numerous causes exist for male infertility. These can include genetic disorders, environmental factors, and health and lifestyle choices. Medical causes of male infertility include varicocele, which is the most common type of reversible male infertility. It involves the swelling of the veins that drain the testicles. A blockage of the epididymis may also cause infertility.

Other causes include infection, which is also treatable, and antibodies that attack sperm. Ejaculation issues such as retrograde ejaculation in which the semen goes up into the bladder rather than out through the urethra are causes of male infertility as are hormonal imbalances. Other medical causes are undescended testicles, tumors, and previous surgeries.

Environmental causes are exposure to industrial chemicals, radiation exposure, and the overheating of the testicles that can occur from visiting saunas regularly. Additional contributing factors to male infertility include drug use, alcohol use, and tobacco use.

Diagnosis & Tests

There are a number of ways to diagnose and test for male infertility. These include a physical examination and a review of medical history. A common test is a semen analysis. Semen is obtained from a patient and sent to a laboratory for analysis of the sperm's motility, quantity, shape, viscosity, semen volume, among other characteristics.

Other tests for male infertility are transscrotal ultrasound, hormone testing, post-ejaculation urinalysis, genetic testing, and specialized sperm function testing. In addition, a patient might be submitted to a transrectal ultrasound. In some instances, a doctor may recommend more than one type of test or examination in order to ascertain if a man is suffering from infertility. 

Treatment & Therapy

Treatment and therapy for male infertility is connected to the underlying cause of the condition. For example, if a lifestyle choice or issue is the cause of male infertility, changing or altering that choice or issue would be the recommended course of treatment or therapy in most cases.

If an obstruction or a tumor is the underlying cause for male infertility, surgery would be the recommended course of treatment. The nature of the surgery depends upon the actual issue at hand. For example, if a tumor exists, the surgery would be primarily designed to remove that tumor. 

If infection appears to the cause of male infertility, treating that infection with antibiotics would be the course of action recommended by a doctor. Hormone treatments and associated medications are other types of treatments for male infertility. Men should be wary of testosterone replacement therapy (TRT). Studies have shown that testosterone replacement therapy is directly linked to infertility.

Assisted reproductive technology is an option which includes in vitro fertilization. One such technique that often successfully addresses male infertility is intracytoplasmic sperm injection. During this procedure, one sperm is directly inserted into the female's egg for fertilization before being implanted back into the female for gestation.

Prevention & Prophylaxis

Some types of male infertility can be prevented. Men can reduce their risk of infertility by avoiding testosterone replacement therapy, saunas, smoking, drug use and alcohol use.

Men should conduct regular testicular self-exams and seek regular checkups with their doctors to stay vigilant about any structural abnormalities with their reproductive organs such as lumps. Men should also feel comfortable addressing any sexual dysfunction issues with their doctors that may be indicative of an underlying cause of infertility.