There's a conversation that doesn't happen often enough in the fertility world. When you and your partner are struggling to conceive, it's usually the female partner who's first through the clinic door — first to be tested, first to start adjusting her lifestyle. And that's understandable, but here's the thing: men are half of the equation. Research consistently shows that male infertility plays a role in at least one-third of couples who are struggling to conceive — see our guide to understanding male infertility for a comprehensive overview.
Before we go any further, let's get something important out of the way: just like female infertility, male fertility challenges aren't about blame or fault. They're medical realities, and they deserve the same compassion and attention. In this article, we'll walk through some of the most common male fertility problems, what causes them, the signs to watch for, and — most importantly — practical steps you can take to protect and improve the health of your sperm and overall fertility.
What Causes Male Infertility?
Before we dive into the causes, let's take a step back and make sure you and I are on the same page with some key terms. Male fertility simply refers to a man's ability to achieve a pregnancy through intercourse with a female partner. Infertility is generally defined as the failure to achieve a pregnancy after 6-12 months (depending on your age) of actively trying to conceive. And then there's "subfertility" — a term you might come across that describes situations where conception is taking longer than expected, suggesting that you or your partner may have fertility levels below the optimal standard.
One thing I think is really worth knowing: being diagnosed as subfertile or even infertile doesn't necessarily mean you'll never be able to achieve a pregnancy naturally or with treatment. That distinction matters more than many people realise.
So what actually makes a man infertile? The honest answer is that it can stem from a whole range of factors. Technically, the inability to conceive with a female partner after a year of unprotected intercourse is defined as infertility. But the contributing factors — low sperm production, infections or inflammatory conditions including STDs, genetic predispositions, hormonal imbalances, the use of certain medications like steroids, and lifestyle choices involving drugs or alcohol, as well as chromosomal abnormalities — can often be addressed with medical intervention and lifestyle changes. For you, that's genuinely encouraging news.
How Can You Tell If a Man Is Infertile?
This is a question that comes up a lot, and it's a fair one. Many couples who struggle to conceive have more than one factor affecting their fertility, which is why understanding the diagnostic process matters. You and your partner should both consult a doctor and undergo screening and diagnostic tests. In some cases, a clear cause is never identified — this is called “unexplained infertility,” and up to 30% of infertile couples1 fall into this category. Diagnosing male-factor infertility problems typically involves:
- A physical examination and a review of your medical history: This includes examining your genitals and asking questions about any family conditions, chronic diseases, injuries, sexual history, or surgeries that could affect your fertility.
- A semen analysis: Also called a sperm count test, this exam analyses the health and viability of your sperm. A semen analysis measures three major factors of sperm health: the number of sperm contained in a single ejaculation, the shape of the sperm, and the movement, also known as the “motility” of the sperm.
Something worth keeping in mind about semen analyses: sperm counts can vary quite a bit from one test to the next. If your doctor has concerns about your sperm count, they'll likely order repeated tests over a set period to make sure the results are accurate and consistent.
Beyond a physical examination and a semen analysis, your doctor may want to run additional tests. These could include hormone testing to check your testosterone levels and other hormonal imbalances that could contribute to infertility. In some cases, your doctor might also recommend genetic testing to rule out any inherited conditions that could affect fertility. Imaging studies, such as a scrotal ultrasound, can help your doctor examine your reproductive organs for any structural abnormalities. Based on your results, your provider may suggest further specialised tests or refer you to a fertility specialist for additional evaluation and treatment options.
What Are the Signs of Infertility in Males?
This genuinely surprised me when I first started researching male fertility: in most cases, you'll notice no obvious symptoms at all. The main sign is simply your inability to achieve a pregnancy after a year or more of regular, unprotected sex. That said, in some situations — particularly those involving hormonal imbalances or other underlying conditions — there can be noticeable signs you should watch for. These may include:
- Problems with sexual function: Difficulties with sexual function, such as erectile dysfunction,2 can also be signs of male fertility issues, and may affect your ability to conceive.
- Testicular pain: Persistent or recurring pain in the testicles could point to an underlying condition affecting fertility, such as infection, inflammation, varicocele, or injury.
- Inability to smell: While less common, a loss of the sense of smell (anosmia) could indicate certain genetic conditions, particularly a disease called Kallmann syndrome,4 or hormonal imbalances that may impact fertility.
- Decreased facial or body hair: A noticeable decrease in facial or body hair growth may suggest hormonal imbalances, notably low testosterone levels,5 which may affect sperm production and overall reproductive function.
- Changes in libido: A drop in your sex drive can sometimes point to underlying hormonal issues or other factors affecting fertility.
- Issues with ejaculation: If you notice low ejaculate volume or experience ejaculatory disorders like retrograde ejaculation6 (where semen enters the bladder instead of exiting the penis), these can be signs of male infertility.
- Recurrent respiratory infections: Some genetic conditions that affect fertility, such as cystic fibrosis,7 can also manifest with recurrent respiratory infections due to excessive or abnormal mucus production.
- Gynecomastia: Enlargement of breast tissue in males, known as gynecomastia, can sometimes be associated with hormonal imbalances or other conditions affecting fertility.
- Chronic medical conditions: Chronic conditions you may be living with — such as diabetes,8 thyroid disorders, or autoimmune diseases — can contribute to male infertility by disrupting hormone levels or causing other medical issues.
Of course, experiencing one or more of these symptoms doesn't automatically mean you're infertile. But if any of this resonates with you, or if you've been wondering about your fertility, it's worth reaching out to a healthcare professional. Getting a proper evaluation can give you real clarity and a path forward.
What Are the 4 Most Common Male Fertility Problems?
Now let's get into the specifics. Several conditions can influence your fertility, and understanding them is your first step toward doing something about it. Here are the four most common:
Sperm Disorders
This one's the big one. As many as 80% of men9 with fertility issues have a low sperm count, making sperm disorders the most common cause of male infertility by a significant margin. Sperm disorders cover defects in the quality or quantity of sperm your body produces, including sperm DNA fragmentation. Your sperm may:
- Be abnormally shaped (teratozoospermia)
- Be low in concentration (oligospermia)
- Have poor motility (asthenospermia)
- Not be made at all (azoospermia)
Some men are born with sperm deficiencies, but your lifestyle choices can also play a real role. Smoking, recreational drugs, and certain medications can all lower your sperm count. Other contributing factors include long-term chronic conditions and childhood infections (such as mumps), along with chromosome and hormonal problems. Azoospermia, which is a total absence of sperm, affects around 10% of infertile men.10
Blockage in Reproductive Organs
Sometimes the tubes that carry your sperm can become blocked — and when that happens, your sperm may be unable to reach the ejaculate at all. These blockages can develop for several reasons, including infections, surgical complications, or congenital (birth) abnormalities you were born with.
Hormone Imbalances
Just as hormones play a crucial role in female fertility, they're equally important on your side. Hormonal imbalances, especially those involving reproductive hormones like testosterone and gonadotropins, can interfere with your normal sperm production and function. Conditions like hypogonadism (where your body doesn't produce enough testosterone) or hyperprolactinemia (elevated prolactin levels) can both negatively affect your fertility.
Varicocele
You may not have heard of varicocele, but it's actually quite common. It's a condition where the veins within your scrotum become enlarged — similar to varicose veins in the legs. Research suggests that about 15% of all adult men have this condition.11 A varicocele can impair your testicular function and raise testicular temperature, which can in turn hurt your sperm production and quality. The encouraging news? Varicoceles are a leading cause of male infertility and are often treatable through surgical intervention to improve your fertility outcomes.
| Condition | Prevalence | Key Signs | How It’s Diagnosed | Treatment Approaches |
|---|---|---|---|---|
| Low Sperm Count/Poor Sperm Quality | Accounts for approximately 80% of male fertility cases. | Often no noticeable symptoms; may present as difficulty conceiving after 12+ months of trying. | Semen analysis measures sperm count, motility, morphology, and viability; may require repeat testing. | Lifestyle changes (weight management, reduced stress, antioxidant supplementation); medical treatment or assisted reproduction if indicated. |
| Reproductive Tract Blockages | Present in a subset of men with male factor infertility; may be due to infection, vasectomy, or congenital absence. | No sperm detected in semen (azoospermia) despite normal sperm production; may cause pain or swelling. | Semen analysis showing azoospermia; imaging studies (ultrasound); testicular biopsy if needed. | Surgical repair or bypass procedures; assisted reproductive techniques such as IVF with ICSI if surgery not possible. |
| Hormonal Imbalances | Account for a smaller percentage of male infertility cases; treatable when identified. | Low testosterone may cause reduced libido, erectile dysfunction, or fatigue; low LH/FSH disrupts sperm production. | Blood tests measuring testosterone, LH, FSH, and prolactin; may include pituitary imaging. | Hormone replacement therapy or medications to stimulate hormone production; addresses underlying pituitary or testicular dysfunction. |
| Varicocele | Present in approximately 15% of men; even higher prevalence among infertile men (30–40%). | Enlarged veins in the scrotum; may feel like a “bag of worms”; often painless but may cause discomfort or aching. | Physical examination; ultrasound confirms diagnosis and assesses severity. | Surgical repair or embolisation to improve blood flow and reduce testicular heat; may improve sperm quality in some men. |
What Are the Most Effective Tips for Boosting Male Fertility?
Whether you've been diagnosed with male-factor infertility or you're simply looking for ways to give yourself the best possible chance at conception, here's what the evidence tells us: preconception care for men genuinely helps improve pregnancy outcomes. That's worth saying twice.
With that in mind, here are some practical things you can do to support your fertility:
Eat healthy: A balanced diet that includes fruits, vegetables, lean proteins, and whole grains gives your body vital nutrients for optimal reproductive health. Incorporating antioxidant-rich foods like berries, leafy greens, and nuts into your meals can help protect your sperm from oxidative damage.12
Exercise regularly: Regular physical activity benefits your overall health, including fertility. That said, there's a balance to strike — excessive or intense exercise can sometimes negatively impact sperm production. It's also worth avoiding activities that generate extreme heat in the genital area, such as prolonged cycling or hot tub use, to help preserve sperm quality.
Get enough sleep: Don't underestimate this one. Good quality sleep is crucial for your hormone regulation and sperm production. Aim for 7-9 hours per night.
Limit alcohol: Heavy drinking can impair your sperm production and quality. Keeping alcohol to moderate levels — or skipping it altogether — can help improve your fertility outcomes.
Maintain a healthy weight: Being underweight or overweight can disrupt your hormone balance and affect your fertility. Working toward a healthy weight through a balanced diet and regular exercise can make a real difference.
Consider taking a fertility supplement: Certain supplements may help support your fertility by providing key nutrients essential for sperm production and function. Some that may be worth considering include:
- L-Carnitine: Important for healthy sperm formation and motility.13
- L-Arginine: Some research suggests L-arginine may support blood-flow regulation and sperm motility, though evidence is mixed.
- Maca Root: In a small uncontrolled study of 9 healthy men, maca supplementation was associated with improvements in semen parameters,14 though larger controlled trials are needed.
- Zinc: Essential for sperm production15 and linked to sperm quality, with deficiencies often resulting in poor sperm health. Rich dietary sources encompass oysters and organ meats.
- Vitamin C: As an antioxidant, vitamin C may help protect sperm DNA from oxidative stress.16
And finally — and I can't stress this enough — don't hesitate to seek professional help if you're experiencing difficulties with fertility. A healthcare professional specialising in reproductive health can provide personalised advice, evaluations, and treatments tailored to your situation. Always consult with a healthcare provider before starting any new supplements or making significant changes to your lifestyle.
Supporting Male Fertility with FertilitySmart
We get it — dealing with male infertility can feel isolating and stressful, for both you and your partner. Whether you're navigating common male fertility problems like sperm quality, motility, or hormone imbalance, or you simply want to give yourself the best shot at achieving a healthy pregnancy, our supplements are formulated to support you through this journey.
Our male fertility supplements are food supplements designed for men, formulated with a blend of amino acids, herbs, vitamins, and minerals — including the nutrients discussed in this guide — chosen for their role in supporting your normal reproductive health and sperm production. Explore our products, including Conceive for Men, to learn more about nutritional support for your male fertility journey.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. This article provides educational information about male fertility and should not be considered a substitute for professional medical diagnosis or treatment. Consult a qualified healthcare provider for personalised evaluation and care.
Frequently Asked Questions
Can male infertility be reversed?
Many causes of male infertility are treatable or manageable. Sperm disorders related to lifestyle factors often improve with dietary changes, exercise, and supplementation. Varicocele can be corrected surgically, and hormonal imbalances may respond to medication. However, some causes — such as genetic conditions or severe testicular damage — may require assisted reproductive techniques like IVF with ICSI rather than direct reversal.
How long does it take for male fertility treatments to work?
Spermatogenesis — the production of sperm in the testes — takes around 74 days, with a further ~14 days for sperm to mature in the epididymis. That’s why any lifestyle changes or supplements you start typically need at least 3 months before they show measurable improvement in your semen analysis results. Surgical interventions like varicocele repair may take 6–12 months to fully improve sperm parameters, while hormonal treatments vary depending on the underlying condition.
Does age affect male fertility?
Yes, although less dramatically than female fertility, male fertility does decline with age. Research suggests that sperm quality, including motility, morphology, and DNA integrity, gradually decreases after age 40. Older paternal age has also been associated with longer time to conception and slightly increased risks of certain genetic conditions in offspring.
What is a normal sperm count and how is it measured?
A normal sperm count is generally defined as 16 million or more sperm per millilitre of semen, according to the WHO 2021 6th-edition lower reference limit. A semen analysis measures sperm concentration alongside motility (movement), morphology (shape), and total volume. Results can vary between samples, so your doctor will typically recommend two or more analyses taken several weeks apart for accurate assessment.
Can stress cause male infertility?
Chronic stress can negatively affect male fertility through several mechanisms. Elevated cortisol levels may suppress testosterone production, while stress-related behaviours such as poor diet, reduced sleep, and increased alcohol consumption can further compromise sperm health. Research suggests that stress management techniques, regular exercise, and adequate sleep can help support your reproductive hormone balance.
Should both partners be tested for infertility at the same time?
Yes, fertility specialists recommend that both partners undergo evaluation simultaneously rather than testing one partner first. Male factor infertility contributes to approximately one-third of all infertility cases, and in many couples, both partners have factors affecting conception. Getting tested together — with a semen analysis for the male partner and ovulatory and hormonal assessments for the female partner — leads to faster diagnosis and more effective treatment planning.
Important Disclaimer: This article is for informational purposes only and does not constitute medical advice. If you are experiencing fertility concerns, consult with a qualified healthcare provider or fertility specialist for personalised evaluation and treatment recommendations. The information presented should not be used for self-diagnosis or self-treatment. If you are considering any supplements, discuss them with your healthcare provider, especially if you are taking medications that may interact with supplements.
References
- Sadeghi, M. R. (2015, Jan-Mar). Unexplained Infertility, the Controversial Matter in Management of Infertile Couples. Journal of Reproduction & Infertility. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322174/
- Liu, Y., Wang, T., Pu, Z., & Wang, Y. (2022, May 27). Sexual Dysfunction in Infertile Men: A Systematic Review and Meta-analysis. Sexual Medicine. https://www.sciencedirect.com/science/article/pii/S2050116122000423
- Zhang, X., Zhang, J., Cai, Z., Wang, X., Lu, W., & Li, H. (2020, Apr). Effect of unilateral testicular torsion at different ages on male fertility. The Journal of International Medical Research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175056/
- Dodé, C., & Hardelin, J.-P. (2008, Nov 5). Kallmann syndrome. European Journal of Human Genetics. https://www.nature.com/articles/ejhg2008206
- Di Guardo, F., Vloeberghs, V., Bardhi, E., Blockeel, C., Verheyen, G., Tournaye, H., & Drakopoulos, P. (2020, Nov 26). Low Testosterone and Semen Parameters in Male Partners of Infertile Couples Undergoing IVF with a Total Sperm Count Greater than 5 Million. Journal of Clinical Medicine, 9(12), 3824. https://doi.org/10.3390/jcm9123824
- Retrograde ejaculation. Mount Sinai Health System. (n.d.). Retrieved February 6, 2024, from https://www.mountsinai.org/health-library/diseases-conditions/retrograde-ejaculation
- Naz Khan, F., Mason, K., Roe, A. H., & Tangpricha, V. (2022, Mar). CF and male health: Sexual and reproductive health, hypogonadism, and fertility. Journal of Clinical & Translational Endocrinology, 27, 100288. https://doi.org/10.1016/j.jcte.2021.100288
- Condorelli, R. A., La Vignera, S., Mongioì, L. M., Alamo, A., & Calogero, A. E. (2018, May 24). Diabetes Mellitus and Infertility: Different Pathophysiological Effects in Type 1 and Type 2 on Sperm Function. Frontiers in Endocrinology, 9. https://doi.org/10.3389/fendo.2018.00268
- Anawalt, B. D. (2022, Oct 4). UpToDate. Uptodate.com. https://www.uptodate.com/contents/approach-to-the-male-with-infertility
- Azoospermia. (2023, Oct 26). www.hopkinsmedicine.org. Retrieved February 6, 2024, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/azoospermia#:~:text=Around%2010%20percent%20of%20infertile
- Varicocele. (n.d.). www.hopkinsmedicine.org. Retrieved February 6, 2024, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/varicocele#:~:text=Varicocele
- Walke, G., Sagar Gaurkar, Prasad, R., Tejaswee Lohakare, & Mayur Wanjari. (2023, July 27). The Impact of Oxidative Stress on Male Reproductive Function: Exploring the Role of Antioxidant Supplementation. Cureus. https://doi.org/10.7759/cureus.42583
- Aliabadi, E., Soleimani Mehranjani, M., Borzoei, Z., Talaei-Khozani, T., Mirkhani, H., & Tabesh, H. (2012, Mar). Effects of L-carnitine and L-acetyl-carnitine on testicular sperm motility and chromatin quality. Iranian Journal of Reproductive Medicine, 10(2), 77–82. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4163266/#:~:text=L%2Dcarnitine%20increases%20sperm%20motility
- Gonzales, G. F., Cordova, A., Gonzales, C., Chung, A., Vega, K., & Villena, A. (2001, Dec 3). Lepidium meyenii (Maca) improved semen parameters in adult men. Asian Journal of Andrology, 3(4), 301–303. https://pubmed.ncbi.nlm.nih.gov/11753476/
- Fallah, A., Mohammad-Hasani, A., & Colagar, A. H. (2018, Apr-June). Zinc is an Essential Element for Male Fertility: A Review of Zn Roles in Men’s Health, Germination, Sperm Quality, and Fertilisation. Journal of Reproduction & Infertility,19(2), 69–81. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010824/#:~:text=Zn%20therapy%20improves%20sperm%20quality
- Gyun Jee Song, Norkus, E. P., & Lewis, V. (2006, May 26). Relationship between seminal ascorbic acid and sperm DNA integrity in infertile men. International Journal of Andrology, 29(6), 569–575. https://doi.org/10.1111/j.1365-2605.2006.00700.x
Marina Carter
Fertility Health Writer at FertilitySmart
Marina Carter is a specialist health writer with nearly a decade of experience in reproductive health, fertility nutrition, and research-informed conception support. She has authored over 30 in-depth articles for FertilitySmart, translating peer-reviewed research into clear, practical guidance for individuals and couples on their fertility journey. Read full bio →