Most Common Causes of Infertility in Men; Symptoms, Diagnosis & Treatments

Male fertility mainly relies on the quality and quantity of a man’s sperm. When the number of sperm a man will ejaculate is considerably low or is of low quality, then it will be difficult or sometimes impossible to cause pregnancy.

Infertility of the male is only diagnosed when both partners have been tested and the reproductive problem has been found to be in the male.

male infertility

How Common Is It?

It may not be known to many, but it is indeed a widespread problem. This is because, in every 5 infertile couples, about 1 of the problems lay only in the male partner [1].

In fact, according to sources, the ratio of a male fertility problem with a low sperm count is 1:20, but only 1 in every 100 male subjects has no sperm when ejaculating.

Symptoms of Male Infertility

There might be no obvious signs of infertility. As a matter of fact, the process of intercourse, erection, and ejaculation happens without any problem at all.

In most cases, the appearance and quantity of the semen ejaculated will generally seem normal to the eyes. Only medical tests can determine if a man is really infertile.

What Does It take to Get a Woman Pregnant?

The male partner must be able to produce healthy sperm.

This will involve the formation and growth of the male reproductive organ when he is going through puberty.

Likewise, he should have at least one functional testicle and his body must be able to produce testosterone, as well as other hormones in order to trigger and maintain the production of sperm.

Sperm must be carried into the semen.

After sperm are created in the testicles, a number of delicate tubes will transport them until the sperm is able to mix with the semen and then ejaculate out from the penis.

Enough sperm is needed to go with the semen.

In the case when the number of sperm in the semen is low, there is a possibility that you will not be able to fertilize the egg of your partner.

Semen is said to have a low count when it has only 15 million sperm per milliliter of semen or less than 39 million every ejaculate [2].

Sperm needs to be able to move and must be functional.

In cases when the mobility or movement of the sperm is not normal, there is a possibility that it may not be able to penetrate or reach the egg of your partner.

Medical Causes of Male Infertility

There may be a number of health issues as well as medical treatments that can cause male fertility problems. Here are some of these issues, according to medical studies.

  • Varicocele. This type of problem is caused when there is swelling of veins draining the testicle. This is a common reversible cause in male infertility. Although it is not fully known if varicocele really causes infertility, it is still related to abnormal testicular temperature regulation. The reduction of sperm quality is mainly caused by varicocele. Treatment for varicocele should improve the sperm count and function and would potentially enhance the outcome via assisted reproductive techniques, which include in vitro fertilization.
  • Ejaculation problem. Retrograde ejaculation will occur when semen enters the bladder during orgasm, instead of emerging at the tip of the penis. It is said that there are different health conditions that will cause retrograde ejaculation, which includes spinal injuries, surgery of the bladder, urethra or prostate, medications, and diabetes. Those with spinal injuries or certain diseases might not be able to ejaculate semen, even if they can still produce sperm. Thus, there are cases where sperm can be retrieved to be utilized in assisted reproductive techniques.
  • Infection. Some types of infections might interfere with the production or health of the sperm. In fact, this can cause scarring that will block the passage of sperm. Such would include inflamed epididymis or testicles and some infections transmitted sexually, such as HIV or gonorrhea [3]. Despite the permanent testicular damage that can be caused by infections, sperm often can still be retrieved.
  • Tumors. Cancers and certain non-malignant tumors can also affect the male reproductive organs. Moreover, in some cases, male fertility can be affected by surgery, chemotherapy, and radiation that treats tumors.
  • Antibodies attacking sperm. There are antibodies that also act as anti-sperm. These are immune system cells identifying sperm as invaders attempting to eliminate them.
  • Undescended testicles. During male fetus development, the testis lies in the abdominal cavity and descend into the scrotum before birth. In rare cases, there is a failure of the testis to descend from the abdominal cavity into the scrotum, a sac normally containing the testicles. The reduction of fertility mostly happens to men having this condition.
  • Tubular defects that transport sperm. Various tubes carry the sperm, but they can be blocked due to some causes, which include surgery, trauma, and prior infections. This may also be caused by abnormal development, which includes cystic fibrosis or some other inherited conditions.
  • Hormonal imbalance. Infertility results from disorders of the testicles or an abnormality that affects other hormonal systems, which include the pituitary, hypothalamus, adrenal, and thyroid glands. Male hypogonadism, or having low testosterone and other hormonal abnormalities, may also have some impact on this case.
  • Chromosomal defects. Males having inherited disorders, including Klinefelter’s syndrome will cause abnormal development of the reproductive organs in the male. This is the case when males are born with 2 X chromosomes and 1 Y chromosome, instead of 1 X and 1 Y chromosome.
  • Sexual intercourse problems. This will include trouble maintaining or keeping an erection enough for sexual intercourse, painful intercourse, premature ejaculation, and anatomical abnormalities.
  • Celiac disease. This is a digestive disorder that might be caused by sensitivity to gluten. Fertility may only be improved after adoption of a gluten-free diet [4].

Environmental Causes of Male Infertility

  • Industrial chemicals. Overexposure to benzenes, xylene, toluene, herbicides, pesticides, organic solvents, lead, and painting materials could lead to low sperm count.
  • Radiation or X-rays. Radiation can definitely reduce sperm count, but it will return to normal eventually. However, high doses of radiation can reduce the production of sperm permanently.
  • Heavy metal exposure. Infertility can be caused by exposure to heavy metal or lead.
  • Overheating of testicles. This can happen when temperatures get elevated. Despite the absence of solid proof, the frequent use of hot tubs or saunas can temporarily impair sperm production. Long hours of sitting and wearing tight clothing can lead to an increase in temperature, which can cause the reduction of sperm count.

Health and Lifestyle Causes of Male Infertility

  • Illicit use of drugs. Muscle strength and growth stimulants, such as anabolic steroids, reportedly cause testicles to shrink. It will also likely reduce the production of sperm. Likewise, the use of marijuana and cocaine can temporarily reduce the quality and number of sperm.
  • Tobacco smoking. Those who smoke heavily can have a lower sperm count than those who do not. Male fertility can also be affected by secondhand smoking [5].
  • Alcohol intake. The consumption of alcohol should be able to lower the levels of testosterone. It can also cause erectile dysfunction and will decrease sperm count. At the same time, fertility problems can be related to liver diseases due to excessive drinking [6].
  • Emotional stress. Certain hormones that produce sperm can be disrupted with stress. In fact, prolonged or severe emotional stress can affect sperm production, which includes fertility problems.
  • Weight problems. There are several ways obesity can impair fertility, which includes directly affecting the sperm and causing hormonal changes that reduce the fertility of the male.

Diagnosis of Male Infertility

infertility diagnosis

If couples have tried to achieve pregnancy without success, consult a local physician, family planning clinic or women’s health clinic can help via initial testing. Both partners will require proper testing, even as one already has a child from a previous relationship.

Medical history can be included in the diagnosis for the male, including a physical examination together with semen analysis for sperm count, shape, and sperm movement in the ejaculate.

Alternatively, you can use blood tests to check hormone levels controlling sperm production. In some cases, testicular biopsies and genetic investigations are applied.

Treatment of Male Infertility

Only 1 in 8 infertile males can be treated. This is a case where couples can naturally become pregnant after treatment. The doctor will recommend that couples must seek assisted reproductive technologies, which include IVF or in vitro fertilization.

Although ART will not be able to treat or cure the cause of infertility, they can still help couples achieve pregnancy. This can happen even if the sperm count is quite low.

Another form of IVF is intracytoplasmic sperm injection, or ICSI, in which the single sperm is placed directly into the egg. This will be done by piercing the outer covering of the egg. This method is useful for men with a low sperm count.

Sperm will be removed carefully from the epididymis or collected from the semen. Pregnancy can be achieved via ICSI, even if few sperms will be produced. For IVF, the resulting embryos will be placed into the uterus of the woman after fertilization.


  1. A unique view on male infertility around the globe -ncbi [Link]
  2. How to Increase Sperm Count [Link]
  3. Sexually transmitted infections: impact on male fertility. -ncbi [Link]
  4. Reproductive changes associated with celiac disease -ncbi [Link]
  5. Smoke, alcohol and drug addiction and male fertility -ncbi [Link]
  6. Smoke, alcohol and drug addiction and male fertility -ncbi [Link]
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