Male Infertility: Symptoms, Causes, Diagnosis, And More

Medically reviewed by G. Liakeas, MD FACT CHECKED

One in eight couples experience difficulties conceiving or maintaining a pregnancy.

A third of infertility is generally attributed to the female partner, a third to the male partner, and a third to a combination of issues affecting both couples or remains undiagnosed.

Clinical infertility is the inability to conceive if pregnancy is not confirmed after 12 months or more of regular, unprotected sexual activity.

Male infertility, like female infertility, is a clinical diagnosis that can only be determined after formal assessment and testing. However, both partners may contribute to the couple’s reproductive challenges.

High amounts of environmental contamination, such as pesticides, herbicides, and water pollutants, are more likely to cause male infertility.

Despite the fact that infertility has not been significantly rising, several recent experts claim that sperm counts have been dropping globally. In this article, we will be looking at all about male infertility.

Male infertility is the inability of a sexually mature male to become pregnant by a fertile female. It is responsible for 40–50% of infertility in humans.

Approximately 7% of all men are impacted. Semen quality is utilized as a proxy indicator of male fecundity since defects in the semen are frequently the cause of male infertility. 

If you believe you may have male infertility concerns, it is crucial to be evaluated because there may be treatments or reversible procedures available.

A semen analysis will be part of the initial assessment, and if the results are abnormal, a referral to a reproductive urologist is advised.

Symptoms Of Male Infertility

Even while there might not be any further overt indications of infertility, there are a few red flags to watch out for. These consist of:

  • Problems Regarding Erections

    Erectile dysfunction is the inability to keep an erection during sexual activity. This is another extremely typical sign of male infertility. It might be brought on by several neurological and psychological factors.

  • Premature Ejaculation

    Male infertility might also result from premature ejaculation. Similar to erectile dysfunction, premature ejaculation can stop sperm from reaching the egg. This is especially true if penetration occurs before premature ejaculation. 

    The delivery of sperm to the egg and subsequent fertilization, however, may be possible if premature ejaculation occurs during penetration. Premature ejaculation does not necessarily indicate infertility.

  • Low Sexual Drive

    Males typically produce more testosterone, a hormone that affects libido and sex drive. Their sexual desire or drive decreases if there is a drop in testosterone as a result of hormonal problems.

  • Kallmann Syndrome

    A hereditary condition characterized by delayed or nonexistent puberty.

    Hypogonadism or testicular dysfunction results from the Gonadotropins-Releasing Hormone (GnRH) neurons’ failure to follow a path from the olfactory area to the hypothalamus during fetal development.

Causes Of Male Infertility

Fertility can be impacted by a variety of biological and environmental variables.

  • Genetic Disorders

    Klinefelter’s syndrome and myotonic dystrophy are genetic disorders.

  • Several Illness

    These mostly consist of diabetes, a few autoimmune diseases, cystic fibrosis, and a few infections.

  • Varicoceles

    This is a condition in which the testicles have enlarged veins that make them overheat during ejaculation, changing the form and quantity of sperms.

  • Hormonal Disorders

    Issues with your hypothalamus or pituitary glands may have an impact on your ability to conceive.

  • Environmental Causes

    These include extended exposure to industrial chemicals, exposure to heavy metals, exposure to radiation.

  • Retrograde Ejaculation

    Sperm cannot leave a man’s body due to retrograde ejaculation, a disorder that prevents semen from properly ejaculating outward.

  • Psychological Factors

    Impotence and infertility in men can be brought on by emotional and psychological disorders, spinal cord injuries, and other factors.

  • Infections

    This could cause testicle atrophy as a result of infections like brucellosis, chlamydia, influenza, gonorrhea, mumps, smallpox, syphilis, tuberculosis, and typhoid. 

  • Hormone Replacement Therapy

    It is typically used to treat the low sperm counts and poor sperm motility that follow, as well as elevated FSH and LH levels.

Diagnosis Of Male Infertility

  • General Health Assessment

    Any current or previous genital injuries will be brought up by the medical professional. A physical examination will be conducted to look for any potential hernias, additional tumorous development, or prostate discharge or swelling.

    The man will have a comprehensive examination, and the medical professional will be able to spot any noticeable genital defect.

    The next round of diagnostic tests will be recommended if the patient doesn’t appear to have any obvious health issues.

  • Ultrasound Of Scrotum

    An ultrasound creates images of the internal organs, enabling the physician to examine the testicles for any structural issues.

    It is simple to diagnose issues like varicocele, which causes the veins in the scrotum to expand.

    Before moving on to other potential issues, it’s critical to rule out varicocele because it accounts for close to 40% of male infertility.

    The ultrasound may help the doctor identify testicular torsion, or twisting within the scrotal sac.

  • Checking The Sperm

    Male infertility can happen if there is insufficient sperm production to fertilize an egg, if the sperm is shaped improperly, or if it cannot swim as necessary. 

    The male will ejaculate into a specific container to collect a sample of his semen, which will be examined to see if any of these problems are present. This sample’s sperm count, health, shape, and motility will all be examined in a lab setting.

  • Testicular Biopsy

    To ascertain whether sperm production is normal, this test is performed. It is not a test that is frequently recommended for male infertility.

    A sample of sperm is taken from inside the testis using a needle, and then it is examined for structural issues in a lab.

    With the use of this diagnostic procedure, any issues, such as sperm with damaged outer layers, fragile DNA, or reduced motility, can be quickly discovered.

    If the sperm are healthy and normal, then sperm transit problems or duct blockages may be the root of the infertility.

Treatment For Male Infertility

Male-related infertility is treated with:

  • Holistic fertility and lifestyle adjustments can improve unhealthy behaviors including obesity, poor food, and smoking, all of which have an impact on fertility.
  • The process of intrauterine insemination (IUI) entails gathering, washing (cleaning), and concentrating healthy sperm before inserting them into the uterus.
  • A single, healthy sperm is injected into an egg to form an embryo, which is then put into a woman’s uterus during IVF with intracytoplasmic sperm injection (ICSI).
  • Men who are unable to ejaculate or make semen might still have their sperm removed by using a tiny needle to remove the semen from their testicles.
  • A man can once more produce healthy sperm in his semen after having a vasectomy.
  • Using another man’s sperm to fertilize a woman’s egg is known as sperm donation.
  • To change hormone levels that affect fertility, whether they are too high or too low, hormone treatment and drugs may be advised.


Some infertile men’s sperm counts can be increased by medication. An estrogen receptor blocker, like clomiphene citrate, which activates the hypothalamus and pituitary gland in the brain, may be prescribed by your doctor.

Follicle stimulating hormone (FSH) and luteinizing hormone (LH), which can boost sperm production, are produced as a result of this. It’s not necessarily impossible to have a child of your own even if you struggle with infertility.

Options for treatment exist. You can improve your chances of getting pregnant by working with your spouse and a urologist. 

You may be able to lower your risk if your infertility is impacted by lifestyle choices like smoking and working with particular chemicals.

Discuss additional risk factors and what you may do about them with your healthcare provider. Talk to your doctor about sperm banking if you will be receiving cancer treatment.

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