Infertility can affect both men and women. Let’s take a closer look at male infertility—what causes it and how it can be addressed.

What is Male Infertility?

Infertility is defined as the inability to achieve pregnancy after 12 months or more of regular, unprotected sex. Specifically, male infertility refers to issues with sperm production or sperm health in those assigned male at birth.

What Happens If a Man is Infertile?

If a man is infertile, he is unable to successfully make a fertile female pregnant after a year of regular, unprotected intercourse.

How Common is Male Infertility?

A report by the World Health Organization (WHO) shows that approximately 1 in 6 adults globally (around 17.5%) experience infertility. Interestingly, infertility rates are similar across high-, middle-, and low-income countries. Men are solely responsible for about 20% of infertility cases and contribute to an additional 30-40%, meaning male factors play a role in roughly 50% of all infertility cases.

Who is at Risk for Male Infertility?

While male infertility doesn’t always have a clear cause, certain factors can increase the risk:

• Past prostate inflammation or genital infections
• Testicular injury or twisting (torsion)
• Early or late puberty
• Exposure of the genitals to high heat
• Prior hernia repair
• Undescended testicles
• Use of certain medications (for ulcers, depression, high blood pressure, etc.)

Symptoms of Male Infertility

The primary symptom is the inability to conceive. However, underlying issues may cause other symptoms, including:

• Sexual dysfunction (e.g., difficulty ejaculating, low libido, erectile dysfunction)
• Pain or swelling in the testicles
• Recurrent respiratory infections
• Loss of smell
• Enlarged breasts (gynecomastia)
• Decreased body or facial hair

Causes of Male Infertility

For conception to occur, several things must go right with male fertility:

1. Healthy sperm production: Requires functioning testicles and proper hormonal regulation.
2. Sperm transport: Sperm must travel from the testicles into the semen.
3. Sufficient sperm count: A low count is less than 15 million sperm per milliliter of semen or under 39 million per ejaculate.
4. Functional sperm: Sperm must be motile and capable of penetrating the egg.

Medical Causes of Male Infertility

Several health issues and treatments can lead to male infertility, including:

• Varicocele: Enlarged veins in the scrotum that reduce sperm quantity and quality.
• Infections: Can affect sperm production or health, or block sperm passage.
• Ejaculation issues: Retrograde ejaculation occurs when semen enters the bladder instead of exiting through the penis.
• Immune antibodies: Sometimes, the body produces antibodies that attack sperm.
• Tumors: Cancerous or benign tumors can disrupt reproductive function.
• Undescended testicles: Failure of the testicles to descend into the scrotum during development.
• Hormonal imbalances: Involving the pituitary, adrenal, or thyroid glands.
• Genetic disorders: Conditions like Klinefelter’s syndrome or cystic fibrosis.
• Prior surgeries: Procedures involving the scrotum, testicles, prostate, or abdomen can affect fertility.

Environmental and Lifestyle Causes

External factors that can negatively impact male fertility include:

• Toxins: Exposure to chemicals, such as those found in pesticides or personal care products, may harm sperm.
• Heavy metals: Lead and other metals can reduce sperm health.
• Lifestyle choices: Smoking, excessive alcohol, recreational drugs, and obesity can all contribute to infertility.

Can Male Infertility Be Treated?

While not all cases of male infertility can be reversed, many can be addressed with lifestyle changes, medical interventions, or assisted reproductive technologies.

Lifestyle Changes

Making certain adjustments can help improve sperm health:

• Maintaining a healthy weight
• Eating a balanced diet rich in whole foods and healthy fats
• Exercising regularly
• Quitting smoking, alcohol, and recreational drugs
• Minimizing exposure to environmental toxins
• Taking fertility-supporting supplements, such as CoQ10 and men’s fertility vitamins

Medical Interventions

Certain medications can affect fertility, and your healthcare provider may suggest alternatives. Surgery may be recommended in some cases, such as:

• Vasoepididymostomy: Removes blockages in the tubes that carry sperm.
• Varicocelectomy: Corrects varicose veins in the scrotum.
• Sperm retrieval: For direct sperm collection from the testicles.

Assisted Reproductive Technology (ART)

If natural conception isn’t possible, ART, such as In Vitro Fertilization (IVF), can assist sperm in meeting the egg to achieve pregnancy.

Can Male Infertility Be Prevented?

While male infertility can’t always be prevented, certain steps can reduce the risk:

• Avoid smoking, alcohol, and drugs.
• Limit exposure to harmful chemicals.
• Avoid prolonged heat exposure to the testicles.
• Maintain a healthy weight and diet.
• Consider fertility-supporting supplements.

By taking proactive steps to support fertility, you can empower your journey toward parenthood.