13th Feb 2024

A male patient sitting with a female physician reviewing a document that may cover common male fertility problems.

Infertility is primarily thought of as a women’s issue. Typically, when a couple has difficulty conceiving, the female partner is the first to undergo various tests to rule out potential issues. diabetThe same goes for the time leading up to trying to conceive. We often consider the female partner as the one who needs to prepare for pregnancy. However, men are half of the equation when it comes to conception, and male infertility has been shown to affect at least one-third of couples who are struggling to conceive. 

It is essential to remember that, similar to female infertility, male fertility issues are not a matter of blame or fault. In this article, we’ll explore some of the most common male fertility problems, their potential causes, the signs and symptoms of male infertility, and steps you can take to protect and improve the health of your sperm and overall fertility. 

What Causes Male Infertility?

Before delving into the causes of male infertility, let’s take a step back to understand what some of the basic fertility terminology means. Male fertility refers to a man’s ability to achieve a pregnancy through intercourse with a female partner. Infertility, on the other hand, can be defined as a condition of the male or female reproductive system characterized by the failure to achieve a pregnancy after 6-12 months (depending on their ages) or more of actively trying to conceive. Finally, the term "subfertility" refers to situations where conception is more time-consuming than anticipated, suggesting that one or both partners may have fertility levels below the optimal standard.

However, it’s also worth noting that being diagnosed as subfertile or even infertile doesn’t necessarily mean you’ll never be able to achieve a pregnancy naturally or with treatment. 

Exploring the question of what makes a man infertile reveals that infertility stems from a variety of causes. Technically, the inability to conceive with a female partner after a year of unprotected intercourse is defined as infertility. However, numerous factors contributing to male infertility, such as 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.

How to Know if a Man is Infertile

Many couples who struggle to conceive have more than one factor affecting their fertility, making it essential to understand how to know if you're an infertile male. Diagnosing male infertility involves both partners consulting a doctor and undergoing a series of screening and diagnostic tests. In some cases, male infertility causes are never identified. This is called “unexplained infertility,” and up to 30% of couples worldwide1 are diagnosed with this condition. Diagnosing male-factor infertility problems 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 analyzes 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. 

One thing to remember regarding semen analyses is that sperm counts can vary significantly from one test to the next. If your doctor is concerned about your sperm count, they’ll likely order repeated tests over a set period to ensure accurate results. 

Beyond a physical examination and a semen analysis, additional tests may be necessary. These could include hormone testing to evaluate 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 scrotal ultrasound, may be used to examine your reproductive organs for any structural abnormalities. Your provider may suggest further specialized tests or refer you to a fertility specialist for additional evaluation and treatment options based on your results.

Signs of Infertility in Males

There are usually no obvious symptoms of male infertility; the main sign is the inability to achieve a pregnancy naturally after a year or more of regular, unprotected sex. In some cases, such as hormonal imbalances or other medical conditions, there may be some noticeable signs and symptoms. These may include:

  • Problems with sexual function: Difficulties with sexual function, such as erectile dysfunction,2can also be signs of male fertility issues. These issues may impact your ability to successfully achieve conception.
  • Testicular pain: Persistent or recurring pain in the testicles could be a symptom of an underlying condition affecting fertility, such as infection, inflammation, varicocele, or injury.3
  • 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,which can affect sperm production and fertility.
  • Changes in libido: A decrease in sex drive or libido can sometimes be indicative of underlying hormonal issues or other factors affecting fertility.
  • Issues with ejaculation: Problems with ejaculation, including low ejaculate volume or ejaculatory disorders like retrograde ejaculation6 (where semen enters the bladder instead of exiting the penis), 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: Certain chronic medical conditions, such as diabetes,8 thyroid disorders, or autoimmune diseases, may contribute to male infertility by affecting hormone levels or causing other medical issues.

It’s important to note that experiencing one or more of these symptoms doesn’t definitively mean that you’re infertile. If you’re concerned about your fertility, reach out to a healthcare professional for proper evaluation and guidance.

4 Common Male Fertility Problems

Various conditions may influence male fertility, including the following:

Sperm Disorders

As many as 80% of men9 with fertility issues have a low sperm count, making sperm disorders the most common cause of male infertility. Sperm disorders include defects in the quality or quantity of sperm produced. 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 lifestyle choices may also affect sperm quality and numbers. For example, smoking, consuming drugs, and taking certain medications can all lower sperm numbers. Other factors that influence sperm disorders include long-term chronic conditions and childhood infections (such as mumps), along with chromosome and hormonal problems. Azoospermia, which is a total lack of sperm, affects around 10% of infertile men.10

Blockage in Reproductive Organs

Sometimes, the tubes through which sperm travel can be blocked, potentially leading to infertility. These blockages can occur for several reasons, including infections, surgical complications, or congenital (birth) abnormalities. 

Hormone Imbalances

Like in women, male hormones play a critical role in the male reproductive system, so hormonal imbalances, especially those related to reproductive hormones like testosterone and gonadotropins, can interfere with normal sperm production and function. Certain medical conditions like hypogonadism, characterized by the body’s inability to produce adequate amounts of testosterone, or hyperprolactinemia, an increased level of prolactin hormone, can negatively impact fertility in men.

Varicocele

Varicocele is a common condition characterized by the enlargement of veins within the scrotum, similar to varicose veins in the legs. Estimates show that about 15% of all adult men have this condition.11 Varicocele can lead to impaired testicular function and elevated testicular temperature, which can negatively impact sperm production and quality. Varicoceles are a leading cause of male infertility and are often treatable through surgical intervention to improve fertility outcomes.

Tips for Boosting Your Fertility

Whether you’ve been diagnosed with male-factor infertility or you’re just looking for ways to maximize your chances at conception, there’s good evidence that preconception care for men helps improve pregnancy outcomes. 

With that in mind, here are some things you can do to optimize your fertility:

Eat healthy: A balanced diet that includes fruits, vegetables, lean proteins, and whole grains provides vital nutrients for optimal reproductive health. Incorporating antioxidant-rich foods like berries, leafy greens, and nuts can help protect sperm from oxidative damage.12

Exercise regularly: Regular physical activity benefits your overall health, including fertility. On the other hand, excessive or intense exercise can sometimes negatively impact sperm production. Avoid 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: Prioritizing enough good quality sleep is crucial for hormone regulation and sperm production. Aim for 7-9 hours of sleep per night.

Limit alcohol: Excessive alcohol consumption can impair sperm production and quality. Limiting alcohol intake to moderate levels (or abstaining altogether) can help improve fertility outcomes.

Maintain a healthy weight: Being underweight or overweight can disrupt hormone balance and negatively impact fertility. Try to maintain a healthy weight through a healthy diet and regular exercise.

Consider taking a fertility supplement: Certain supplements may help enhance male fertility by providing key nutrients essential for sperm production and function. Some beneficial fertility supplements include:

  • L-Carnitine: Important for healthy sperm formation and motility.13
  • L-Arginine: Supports blood flow regulation, sperm count, and motility while also protecting sperm from DNA damage.
  • Maca Root: Maca root is a nutrient-dense superfood that provides essential nutrients14 for optimal sperm production.
  • 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: This powerful antioxidant can help protect testes from stress-related damage, supports healthy sperm production, and reduces sperm clumping.16

Finally, as previously noted, don’t be afraid to seek professional help if you’re experiencing difficulties with fertility. A healthcare professional specializing in reproductive health can provide personalized advice, evaluations, and treatments to address any underlying issues and improve your chances of conception. Always consult with a healthcare provider before starting any new supplements or making significant changes to your lifestyle.

Boost Fertility with FertilitySmart

At FertilitySmart, we understand that male infertility can be a challenging and stressful issue for both you and your partner. So whether you’re struggling with common male fertility problems, such as sperm quality, motility, or hormone imbalance, or you just want to improve your chances of achieving a healthy pregnancy, our clinically tested supplements are designed to support you in this journey. 

Our premium fertility supplements are specifically designed for men and made from natural formulas that don’t require a prescription. They’re crafted with a safe and effective blend of amino acids, herbs, vitamins, and minerals, scientifically proven to enhance reproductive health and optimize sperm production. Explore our products, including our award-winning male fertility supplementConceive for Men, to find the best support for your fertility needs.

Citations

1 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/

2 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

3Zhang, 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/

4 Dodé, C., & Hardelin, J.-P. (2008, Nov 5). Kallmann syndrome. Nature News. https://www.nature.com/articles/ejhg2008206

5 Di Guardo, F., Vloeberghs, V., Bardhi, E., Blockeel, C., Verheyen, G., Tournaye, H., & Drakopoulos, P. (2020, Oct 29). 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

7 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

8 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

9 Anawalt, B. D. (2022, Oct 4). UpToDate. Uptodate.com. https://www.uptodate.com/contents/approach-to-the-male-with-infertility

10  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

11  Varicocele. (n.d.). www.hopkinsmedicine.org. Retrieved February 6, 2024, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/varicocele#:~:text=Varicocele

12 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

13 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

14 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/

15 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 Fertilization. Journal of Reproduction & Infertility,19(2), 69–81. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010824/#:~:text=Zn%20therapy%20improves%20sperm%20quality

16 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