What Are the Causes of Male Fertility Problems?

by Robin Elise Weiss, Ph.D. Health Professional

One in eight couples will experience infertility — and while some people think mainly of infertility causes related to the female, the truth is that the male is the sole cause of infertility about one-third of the time. Other couples will experience fertility due to a combination of male and female factors. Read on to learn about some causes of infertility that are specific to men.

Sperm and egg x-ray.

Lack of quality sperm

Quality sperm is key to fertility. Sperm quality is tested in a semen analysis, a simple, non-invasive test for the man. There are a multitude of reasons why the quality of sperm might be poor, including that there isn’t enough of it, it is poorly formed, or it moves poorly. Any of these reasons can be caused by many factors, and sometimes even multiple factors within one person.

Healthy, smiling man listening to music out for a run.

Poor general health

A man who is in good health is less likely to have issues with sperm quality. Starting with the basics of good nutrition, healthy weight, no smoking, limited alcohol, and a good control of chronic diseases will help keep your sperm healthy. Preconceptional health visits for men are crucial to ensure you are in the best health possible to try to conceive.

Testicle anatomy diagram.

Structural issues with sperm delivery

There also may be structural issues with sperm delivery. Sometimes there are anatomical issues that prevent sperm from arriving at its destination, like missing structures, blockages, or even infections. Sometimes these disorders render a man completely infertile, while others only decrease the amount of sperm available in any one sample. This is why it is crucial to have a physical exam including an ultrasound and not simply the semen analysis.

Testicles in anatomy diagram.

Varicocele as a reason for male infertility

A varicocele is a varicosity in a vein serving the spermatic cord (which runs to and from the testes). This can reduce the amount of blood flow to the testicle and alter fertility. However, treatment may be beneficial. Though the data on whether having the surgical procedure to reduce the varicocele leads to an increase in live births is not yet available, data does suggest an increase in pregnancy rates.

Young man talking to doctor.

Vas deferens issues

About 8 percent of the time, the vas deferens, which transports sperm, is simply missing. For example, there are cases when a vasectomy is done accidentally during other surgeries, or when fertility is desired after a true vasectomy has been performed. If you have a disruption in the vas deferens, there are reversal procedures that have the potential to restore your fertility, or you can use assisted reproductive technologies. This does not mean you should consider vasectomy reversible.

In vitro fertilization.

Sperm production problems

There are a number of reasons why a man may have issues with sperm production. These issues could be caused by genetic problems that began well before puberty, like having undescended testicles. It can also be a result of some types of infections, including mumps. Sometimes it is caused by torsion or a twisting of the testicle. There are also causes related to medical treatments, chemotherapy, or even injuries.

Couple with fertility issues.

Problematic ejaculation

One of the most common causes of ejaculation problems is retrograde ejaculation. This is when the ejaculate does not leave the body via the urethra as it does in healthy men, but rather deposits into the bladder. There are treatments for retrograde ejaculation, and some are more invasive than others. However, they can work and can result in live births. Retrograde ejaculation is sometimes seen in men who have various levels of paralysis.

Couple talking to doctor about fertility issues.

Erectile dysfunction

Erectile dysfunction (ED) is another barrier to fertility. There are several different treatments for ED. However, ED is a complicated issue, particularly when paired with a decreased libido and infertility. You will need a team of professionals to help you determine the cause in order to treat it properly. Other forms of impotence can result from paralysis, which typically presents as a combination of issues.

Infertility form.

Endocrine disorders

Certain hormonal issues can cause infertility in men as well. One example might be a man with a pituitary tumor or pituitary problem that causes a lack of luteinizing hormone (LH) and follicle stimulating hormone (FSH). These issues may or may not be known prior to having trouble getting pregnant. Another cause of hormonal issues is current or previous anabolic steroid abuse and other illicit drugs.

Young couple in love.

Getting the treatment you need

Male fertility is often overlooked in society and potentially even in the physician’s office. However, it can be a significant cause of issues for couples trying to conceive. A thorough physical exam and a lengthy medical history can help your medical care team help you figure out what testing and treatment might be helpful in your quest to have a baby. It may involve medication, surgery, or assisted reproductive techniques like intracytoplasmic sperm injection (ICSI).

Robin Elise Weiss, Ph.D.
Meet Our Writer
Robin Elise Weiss, Ph.D.

Robin Elise Weiss, Ph.D., LCCE, CLC, AdvCD(DONA) is a childbirth educator, doula, founder of Childbirth.org, and the award-winning pregnancy and parenting author of “The Complete Illustrated Guide to Pregnancy” and more than 10 other books. Between her nine children, teaching childbirth classes, and attending births for more than two decades, she has built up an impressive and practical knowledge base. You can follow Robin on Twitter @RobinPregnancy, Instagram @Robineliseweiss, and Facebook @childbirthtrainings.