Male Infertility – The Signs, Causes and Treatments

Couple sitting on bed with negative pregnancy test results - male infertility

What is Male Infertility?

Roughly 15% of couples can’t get pregnant while trying to conceive, and there are a variety of reasons for infertility in both men and women. In more than 1 out of 3 infertility cases, however, the issue is with the man. Usually, the cause is due to complications with the production of sperm or with sperm delivery.

Male infertility is a condition in men that decreases the odds of his female partner becoming pregnant. If you’ve been trying to conceive by having sex at least twice a week for one year or more without luck, infertility is likely the cause.

As a man, your fertility depends more or less on the quality and quantity of your sperm. If you have a low sperm count, or if your sperm cells are in poor condition, it will be difficult, if not impossible, to become pregnant.

If you know of any factors that might impact the likelihood of your having a baby, it’s best to get expert assistance early on. Ideally, both you and partner should be screened for any potential reproductive issues at the same time.

How Common is Male Infertility?

As mentioned before, research indicates that after 1 year of having unprotected sex, 15% of couples are unable to conceive, and after 2 years, 10% of couples still have not had a successful pregnancy. (1)

In contrast, couples who are younger than 30 years of age and generally healthy are able to conceive within the first 3 months 20% – 37% of the time. (2)

For approximately 20% of couples experiencing infertility, the problem is solely with the male partner. For another 30% of couples the issue stems from both partners.

Approximately 1 out of 20 men experiences a low sperm count, leading to infertility. But, only around 1 out of 100 men produces no sperm at all.

Signs of Male Infertility

In the majority of cases, no overt signs of infertility will be noticeable. There will typically be no issues with sexual performance, erections and/or ejaculation, and your semen will seem normal in appearance.

The only sure way to help determine the cause of the infertility is by getting medical testing.

Causes of Male Infertility

Infertility can be caused by conditions that impact the production of sperm cells or how the sperm moves (motility). These issues can usually be detected by taking medical tests to help determine the cause.

Approximately 2 out of 3 infertile men have issues with a low sperm count and/or sperm cells that don’t function properly.

Around 20% of infertile men have other physical conditions, such as those who’ve previously had a vasectomy but now want to father children. Obstructions or blockages in the tubes going from the testicles to the penis can prevent sperm from being ejaculated.

Around 10% – 15% of men experience male infertility due to a complete lack of sperm production, known as azoospermia.

Other less frequent causes of male infertility include:

  • Sexual issues that make it difficult for semen to enter the vagina (affects 1 out of 100 couples with infertility).
  • Deficient hormone levels produced by the pituitary gland that affect the testicles (affects 1 in 100 infertile men).
  • Antisperm antibodies – When a man or a woman’s immune system view sperm cells as invaders, the body will produce antisperm antibodies to destroy the sperm. It can be difficult, if not impossible, for sperm to fertilize an egg if enough of these antibodies come into contact with them (found in one in 16 infertile men). In most men, sperm antibodies will not affect the chance of a pregnancy, but in some men it can decrease fertility).

In some cases, the cause for male infertility is simply due to genetics. Certain changes to chromosomes or genetic mutations can cause infertility due to hampered sperm cell production or obstruction of the flow of sperm.

Typically, genetic causes of infertility are chromosomal conditions that negatively impact the production of sperm. These include:

  • Klinefelter syndrome – a condition of being born with an additional X chromosome.
  • Y chromosome deletions – a condition of having missing genetic material from the Y chromosome (which is important for the production of sperm).
  • Other genetic problems – For example, Down syndrome.

Male infertility can be caused by DNA mutations to individual genes, although it’s significantly less likely. It is probable that more genetic conditions will become known in the future that will help to shed light on sperm production issues that have no known cause.

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How Infertility is Diagnosed

Your physician will normally look at your medical history, perform a physical examination, and conduct a href=”” >semen analysis. This will determine the quantity, shape and motility of your sperm.

Your doctor may also do a blood test to measure the levels of hormones linked to sperm production, or do genetic testing. Occasionally, they will perform a urinalysis to check for the presence of sperm cells, which can be caused by retrograde ejaculation.

Additionally, your doctor may even suggest an ultrasound, MRI, or a testicular biopsy, which is a minor surgical procedure to remove tissue for testing.

Male Infertility Treatment

There are a variety of treatments for male infertility, but their effectiveness depends upon the root cause. 1 out of 8 infertile men have a condition that can be treated, and following treatment, are able to father a child naturally.

In many cases, incorporating into your diet or taking supplements to increase your sperm count can make a big difference.

In certain situations, your doctor may recommend seeking assisted reproductive treatment for you and your partner, such as IVF (in vitro fertilization). These procedures don’t treat or cure the cause of infertility, but they can lead to pregnancy for you and your partner, even if you have a very low sperm count.

Currently, there are no treatments that correct genetic-based infertility conditions. For men who aren’t able to father children naturally, assisted reproductive treatment is your best option for having biological children.

Can You Prevent Male Infertility?

There are several things that you can avoid that can negatively affect sperm production, including:

If the conditions of your workplace could impact your fertility, remember to wear protective clothing and follow all occupational health and safety guidelines. Additionally, it’s a good idea for couples trying to conceive to avoid exposure to harmful chemicals.

If you’ve had hormone treatment or surgery as a child to correct un-descended testes, it’s important to make your doctor aware due to the potential effects on fertility.

Does Age Affect Male Fertility?

Generally, healthy men who are in their 70s and older can still father children. However, men over the age of 40 will typically require more time for their partner to become pregnant.

This could be due to any number of reasons, including decreased sexual activity, a reduction in semen volume, changes in sperm motility, a decrease in the number of properly functioning sperm, or reduced sperm function and DNA quality.

The likelihood of the child having a genetic or chromosomal condition also increases for older men.

What to Do if You’re Concerned About Your Fertility

If you’ve been trying conceive for a period of 12 months without pregnancy, the best option for both you and your partner is to visit your doctor or a family planning clinic.

Infertility is an issue for many couples. Even if one partner has a child from a previous relationship, both partners should have medical testing. Infertility can be an indicator that you have other, potentially undiagnosed health problems, so it’s important that you both have it looked into.

When You Visit Your Doctor

When you go to the doctor, some questions you should ask include:

  • Should I take a blood test to make sure my reproductive hormone levels are normal?
  • If my semen analysis appears normal, will you perform any other tests?
  • Are there any lifestyle changes I can make to help improve sperm quality?

Additionally, some things to consider prior to your appointment are:

  • How long have you and your partner been trying for a pregnancy? During that period, have you been having sex at least two times a week?
  • Are you and your partner focusing on having sex when she’s ovulating, and do you know when that is?
  • As a child, did you have undescended testicles? Have you ever had pelvic surgery or cancer treatments?
  • Are you currently using any prescription medications, recreational drugs, or anabolic steroids?

Dealing With Male Infertility

Learning that you’re infertile can be an upsetting and distressing experience. There is still a persistent but wrongly-held belief that infertility is an issue that only affects women.

For this reason, many men are frequently surprised to learn that there’s a problem with their sperm. Infertility can affect a man’s sense of masculinity, confidence, and self esteem.

It’s only natural to be emotionally affected by infertility. Often, talking with your doctor, a therapist, or a counselor can help when dealing with any negative feelings you might be experiencing.

Finding support from your partner, family members, and friends can also help.

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