A Complete Guide to Male Infertility – Causes, Symptoms, Diagnosis, and Treatments

By November 7, 2022 December 14th, 2022 No Comments
Male Infertility

Infertility is primarily defined as a situation where a couple is not able to conceive even after having unprotected sexual intercourse frequently for a longer period of time.

Infertility affects around 8%–12% of couples across the globe. It can affect both males and females. However, male infertility is a major cause of the failure to conceive in 50% of couples with infertility. 

Male infertility is the inability of a male to initiate conception with his female partner. This could be due to problems with the male reproductive system. However, it’s not impossible to treat male infertility if it’s diagnosed and treated at the right time.

So, if you are unable to conceive despite trying it frequently, then this article will guide you through everything about male infertility, right from the causes and symptoms to the diagnosis and treatment.

Causes of male infertility

Male sperm needs to combine with the female eggs in order to make the female partner pregnant. For this to happen, it’s vital for the following events to occur:

  • Production of healthy sperm: A healthy male reproductive system with well-developed reproductive organs can produce sperm with healthy function and motility (movement).
  • Presence of sperm in the semen: Internally, after formation and maturation, the sperm are transported to semen via delicate tubes in the body. This semen is then ejaculated during sexual intercourse.
  • Adequate sperm count: The chances of fertilization of the partner’s egg reduces when the semen contains a significantly low count of sperms. Usually, a low sperm count is defined as less than 15 million sperm in 1 mL of semen.
  • Transportation of the sperm to the female egg: Erection of the penis, and ejaculation of sperms in the female vagina to transport the sperms to the egg is essential during sexual intercourse for the couple, to initiate pregnancy.

These processes might get hindered due to various causes as mentioned below:

1. Clinical issues

Illnesses, infections, treatments, surgeries, and hormonal imbalances are the common forms of clinical issues that could lead to infertility.

  • Varicocele: It’s a condition where the veins responsible for transporting the semen from testicles swell and impair the transit of the sperm to the vagina.
  • Genetic defects: Kleinfelter’s syndrome, Kallman’s syndrome, and cystic fibrosis are the genetic syndromes that are mostly associated with male infertility.
  • Hormonal imbalance: Low testosterone levels and an imbalance in the hormones secreted from the pituitary, thyroid, hypothalamus, and adrenal glands can result into male infertility.
  • Issues with sexual intercourse: Premature ejaculation and other ejaculation related issues, erectile dysfunction, painful sex, and other psychological or relationship issues can be a major cause of male infertility as they could affect both, sperm quality and transit.
  • History of surgery: Vasectomy, prostate and abdominal surgery, or any surgery on the male genital organs can eventually affect the transportation of the sperm through different tubes and ducts. This could lead to male infertility.
  • Cancer and tumours: The radiation therapy and extensive set of medications given to treat cancer and non-malignant tumours can affect the male reproductive system and cause infertility.

2. Unhealthy lifestyle

Poor diet and sedentary lifestyle along with excessive stress could lead to obesity and nutritional deficiencies. This could directly affect the sperm quality in males. Apart from these, habits such as smoking tobacco and consuming alcohol can reduce the sperm count, affect sperm production and increase the risk of erectile dysfunction. This could lead to male infertility.

3. Toxins and Pollutants

Exposure to environmental toxins and pollutants such as industrial chemicals, heavy metals, and X-rays can affect the sperm production and quality of sperm produced in the male reproductive system. Additionally, the increasing external temperature can overheat the testicles, which in turn could significantly lower the sperm count. Thus, these environmental factors could also cause male infertility.

Some common risk factors are known to cause male infertility

Here are some of the most common factors that could increase the risk of developing male infertility:

  • Smoking
  • Drinking alcohol
  • Genital infections
  • Increased temperature of the testicles due to overheating
  • Frequent exposure to environmental toxins and pollutants
  • Overweight and obesity
  • Males who experienced early or late puberty
  • Poor lifestyle
  • Chronic diseases such as sickle cell anaemia
  • Testicle injuries
  • History of surgery of the abdomen or pelvic region

Symptoms of male infertility

The obvious symptom of male infertility is that it is difficult to conceive. If the female partner is not able to conceive even after trying for pregnancy for 1 year with sex without any birth control method, it could be a sign of male infertility.

Some of the complications that may arise due to male infertility are:

  • The stress of not being able to conceive 
  • Relationship difficulties
  • Higher risk of conditions such as testicular, colon, and prostate cancer in males.

Going to a healthcare provider is the best way to diagnose and treat male infertility.

How does the doctor diagnose male infertility?

The basic diagnosis methods that doctors use to diagnose male infertility are physical examination, medical history, and semen analysis.

1. Physical examination:

The doctor examines the male genital regions to look for any visible inflammation or lumps.

2. Medical history:

In this step, the doctor asks about any genetically inherited reproductive disorders, family history, and the history of chronic health conditions such as sickle cell anemia, injuries, and surgeries.

3. Semen analysis:

The doctor may also ask for semen samples for semen analysis. The sample can be provided by simple masturbation and ejaculation. This sample is then tested in the laboratory for sperm count, function, and mobility.

Along with the confirmatory tests for male infertility, the doctor might also order the following additional tests to know the exact cause of infertility:

  • Ultrasound of the scrotum
  • Testis biopsy
  • Hormonal tests for testosterone and other hormones released from pituitary glands and hypothalamus
  • Genetic tests
  • Post-ejaculation urine analysis

Rarely, some additional sperm function tests are also used to determine how effectively the sperm can survive after ejaculation, how well they can enter an egg, and whether there are any issues with the fertilisation of the egg.

Is there a way to treat male infertility?

Yes, modern medical science has opened up a myriad of treatment options for male infertility!

The list of the most common and effective options is mentioned below:

1. Medications and hormonal treatments:

The doctor may provide antibiotics in order to treat the infections in the reproductive tract. Treating these infections might help to cure male infertility.

In situations when infertility is caused by imbalanced levels of specific hormones or difficulties with the way the body processes hormones, the doctor may offer hormone replacement therapy or drugs to treat infertility.

2. Counselling and medications for sexual intercourse disorders:

Erectile dysfunction or premature ejaculation that could affect the transportation of the sperm to the egg can be treated with medication or counseling. 

3. Surgery

The doctor may also suggest a surgery to correct male infertility issues that prevent sperm from being produced, developed, or ejaculated. Varicocele surgery, i.e., removing the twisted and inflamed veins in the scrotum, is often suggested to improve the sperm quality.

4. Artificial reproductive technology: 

Depending on the health and needs, doctors may choose artificial reproductive technology to help the female partner conceive even when the male partner has infertility. These treatments may entail acquiring sperm by regular ejaculation, surgical extraction, or from donor males. The sperm is subsequently implanted into the female genital tract or utilised in in vitro fertilisation or intracytoplasmic sperm injection.

Some of the methods under artificial reproductive technology are:

  • Artificial insemination: Many healthy sperms from male partner are palced at the cervix entrance or in the uterus of the female.
  • In vitro fertilization (IVF) and gamete intra-fallopian transfer (GIFT): In these techniques, the egg from female partner is attempted to fertilization by multiple sperms from the male partner in the laboratory or in the partner’s ovarian tube. After successful fertilization, the embryo is implanted in the female uterus.
  • Intracytoplasmic sperm injection (ICSI): It’s a metho in which a sperm is used to fertilize an egg under the microscope and the fertilized egg is then inserted in the uterus to initiate the pregnancy.

Some home remedies and lifestyle changes to treat male infertility

Along with the medications, counseling, and other treatment options, lifestyle changes and home remedies are also worth trying to treat infertility! Check the details in this section:

  1. Have sexual intercourse frequently in the middle of your partner’s menstrual cycle i.e., between the two consecutive periods. This can increase the chances of fertilization.
  1. Increasing the frequency of sexual intercause and having it every day or every alternate day can also improve the chances of fertilization.

Pro-tip: Increase the frequency of sex at least 5 days before ovulation to boost the chances of pregnancy for your partner.

  1. Using sperm-safe lubricants is recommended to avoid the adverse effects of the lubricants available in the market.
  1. Healthy diet, regular exercise, stress management and healthy weight management are the key aspects to improve male fertility.
  1. Including foods rich in Co-enzyme Q10, Folic acid and zinc (combination), Carnitin, Selenium, Vitamin C and E can also help to enhance male fertility. 


Thus, male infertility can be a cause of infertility in 50% of the couples struggling to conceive. There are many clinical, environmental, and lifestyle factors that could cause male infertility. However, the major risk factors noted to date are smoking, consuming alcohol, certain medications, surgery, genetic disorders, overheating of testicles, and cancer. 

Male infertility can be treated in the majority of cases when diagnosed and treated at the right time. Hence, if you have been trying to conceive without any birth control methods for 1 year and are still not getting any results, it is recommended to talk to your doctor and check if you/your partner is suffering from male infertility. Once diagnosed, there are multiple treatments for male infertility depending on the root cause. Apart from these treatments, it is also essential to improve the lifestyle and cut down on bad habits such as smoking and alcohol for better treatment of male infertility.

Dr. Sudheer Rai
Dr. Sudheer Rai

Chief Operating Officer at Grant Medical Foundation, Ruby Hall Clinic, Pune

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