Male infertility is due to low sperm production, abnormal sperm function or blockages that prevent sperm delivery. Illnesses, injuries, chronic health problems, lifestyle choices and other factors can contribute to male infertility.

Approximately 15% of couples are infertile. This means they are unable to conceive a child even though they’ve had frequent, unprotected sexual intercourse for a year or longer.

 

Symptoms

The main sign of male infertility is the inability to conceive a child. However, in some cases, an underlying problem such as an inherited disorder, hormonal imbalance, dilated veins around the testicle or a condition that blocks the passage of sperm can cause symptoms.

 

Symptoms of male infertility include:

  • Inability to conceive a child
  • Problems with sexual function (difficulty with ejaculation, reduced sexual desire or erectile dysfunction)
  • Pain, swelling or a lump in the testicle area
  • Recurrent respiratory infections
  • Chromosomal or hormonal abnormalities such as decreased facial or body hair
  • Sperm count that’s lower than normal

 

Causes

Problems with male fertility can be caused by numerous health issues and medical treatments, including:

 

  • Varicocele: This is a swelling of the veins that drain the testicle. It’s the most common reversible cause of male infertility. This can prevent normal cooling of the testicle, lead to a reduced sperm count and fewer moving sperm.
  • Infection: Certain infections such as sexually transmitted infections (chlamydia and gonorrhea), inflammation of the prostate (prostatitis) and inflamed testicles due to mumps (mumps orchitis) can interfere with sperm production, sperm health or block the passage of sperm.
  • Ejaculation issues: Retrograde ejaculation occurs when semen enters the bladder instead of emerging out of the penis during an orgasm. Various health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, medications and surgery of the bladder, prostate or urethra.
  • Antibodies that attack sperm: Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful and attempt to eliminate it.
  • Tumors: Cancers and benign tumors can affect the male reproductive organs directly or they can affect the glands that release reproduction-related hormones such as the pituitary gland. In some cases, surgery, radiation or chemotherapy to treat tumors can affect male fertility.
  • Undescended testicles: In some males, one or both testicles fail to descend from the abdomen into the scrotum during fetal development.
  • Hormone imbalances: Infertility may be the result of disorders of the testicles or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands.
  • Sperm duct defects: The sperm ducts (tubes that carry sperm) may be damaged by an illness or injury. In some cases, the sperm ducts or the part of the testicle that stores sperm (epididymis) may be blocked.
  • Chromosome defects: Inherited disorders such as Klinefelter’s syndrome cause abnormal development of the male reproductive organs. Other genetic conditions associated with infertility include cystic fibrosis, Kallmann’s syndrome and Kartagener syndrome.
  • Problems with sexual intercourse: These include erectile dysfunction, premature ejaculation, painful intercourse, anatomical abnormalities, psychological or relationship problems.
  • Celiac disease: A digestive disorder caused by sensitivity to gluten can cause male infertility.
  • Certain medications: Testosterone replacement therapy, long-term anabolic steroid use, cancer medications, certain antifungal medications, ulcer drugs and other medications can impair sperm production.
  • Prior surgeries: Vasectomy, inguinal hernia repairs, scrotal or testicular and rectal cancer surgeries can prevent from having sperm during ejaculation.

 

Environmental causes:

 

  • Industrial chemicals
  • Heavy metal exposure
  • Radiation or X-rays
  • Overheating the testicals

 

Other causes:

 

  • Illegal drug use
  • Alcohol use
  • Smoking
  • Emotional stress
  • Obesity
  • Prolonged bicycling

 

Risk factors

Risk factors associated with male infertility include:

  • Smoking
  • Drinking alcohol
  • Certain illegal drugs
  • Being overweight
  • Certain past or present infections
  • Exposure to toxins
  • Overheating the testicles
  • A prior vasectomy or major abdominal or pelvic surgery
  • Being born with a fertility disorder or having a blood relative with a fertility disorder
  • Certain medical conditions such as tumors and chronic illnesses
  • Certain medications or treatments such as surgery or radiation therapy
  • Performing prolonged activities such as bicycling or horseback riding

 

Complications

Complications of male infertility include:

 

  • Surgery or other procedures to treat an underlying cause of low sperm count or other reproductive problems
  • Expensive reproductive techniques
  • Stress and relationship problems related to infertility
  • Increased risk of inherited syndromes such as cystic fibrosis and Klinefelter syndrome
  • Increased risk of hormonal abnormalities
  • Increased risk of cancer including testicular, colorectal, melanoma and prostate cancer

 

Prevention

The following tips may prevent some types of male infertility:

  • Don’t smoke
  • Limit or abstain from alcohol
  • Avoid use of illegal drugs
  • Maintain a healthy weight
  • Don’t get a vasectomy
  • Avoid heat
  • Reduce stress
  • Avoid exposure to pesticides, heavy metals and other toxins