What Causes Male Infertility? Let's Talk About It

Trying to conceive (TTC) can be an emotional rollarcoaster – for both partners.

But what happens when you find out male infertility is now part of the equation?

We know how PCOS, fibroids, and even endometriosis can play a part, but what about conditions affecting men?

Male infertility is a complicated condition, and it can be difficult to diagnose and treat.

Still, that it’s the primary cause in up to 50% of infertile couples means it’s definitely worth talking about.

You’re not alone.

We’re having the conversation.

In this article: 📝

What is male infertility?

Male infertility is defined as a man’s inability to cause a pregnancy after one year of having unprotected intercourse.

It can be caused by a variety of factors and is divided into two types:

• Primary infertility: When a man has never achieved a pregnancy
  
• Secondary infertility: When a man has been able to achieve a pregnancy in the past but can no longer do so.

As for the types and causes of male infertility? We got the expert-approved deets down below.

5 types of male infertility

Male factor infertility can range from low sperm count and poor sperm motility (movement) to abnormal sperm shape and even hormonal imbalances.

Let’s look at each in a little more detail:

1. Low sperm count

This is defined as having less than 15 million sperm per milliliter of semen.

For context, the average sperm count is around 75 million sperm per mL. Damn.

2. Poor sperm motility

So, sperm has to swim with a forward progression of at least 25 micrometers per second to be defined as having healthy motility.

If a man has what is considered to be poor mobility, this can take on different types, including:

• Sluggish progressive motility (AKA. too slow)
  
• Non-progressive motility (anything less than 5 mm per second)
  
• No mobility

3. Sperm morphology

As in the size and shape of the sperm—the size of its head, DNA content, midpiece appearance, and the structure of the tail

Sperm morphology can affect how it moves and the quality of its genetic code.

And this is because the shape of the sperm’s head affects its ability to penetrate the egg, while the sperm’s tail and midpiece impact its motility.

4. Sperm chromosomal abnormalities

According to a 2005 study, about 5.1% of infertile men have chromosomal abnormalities.

And the most common form is associated with the inability of man’s genetic code to successfully produce sperm (a process known as spermatogenesis).

5. Hormones

Hormones play a direct role in the production of sperm.

And three hormones, in particular, have a starring role in the production of sperm: follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone.

These hormones are preciously balanced against one another, meaning an imbalance in one can cause a cascade of imbalance—directly affecting male fertility.

In some cases, the cause of male infertility is completely unknown.

What we do know is that almost 10% of men are considered to be infertile.

And male infertility issues have substantially increased over the past 50 years, with the mean sperm density and volume decreasing by over half from 1973 to 2018.

So, let’s get into it.

What is the most common cause of male infertility?

Just like women, there are a host of risk factors that can contribute to male infertility.

Age naturally plays a significant role, with men over 40 being more likely to experience infertility.

But then, so does lifestyle choices, environment, and medical history.

So, what causes male infertility?

Let’s look at the possibilities in detail:

1. Health and Lifestyle

Lifestyle factors play a significant role in the production of semen quality and healthy motility.

Unsurprisingly smoking and excessive alcohol consumption have both been linked with increasing infertility risk.

In particular, studies have shown excessive drinking decreases testosterone and sperm production.

Same goes for anabolic steroids.

2. Age

It’s always considered an infertility risk in women, but age poses a risk to male infertility too.

Turns out, male semen quality peaks between the ages of 30 and 35 years, with overall semen quantity found to be the lowest after 55 years—decreased by 54%!

And men over the age of 40 are much more likely to have genetic defects in the sperm, which can increase a woman’s chance of miscarriages, birth defects, and stillborn births—it also decreases overall fertility.

Yes, age affects us all.

3. Sexually Transmitted Infections (STIs)

Men who have had a history of STIs are more likely to experience fertility problems.

STDs like gonorrhea, chlamydia, and herpes can cause significant inflammation and impair sperm quality if left untreated.

4. Medical history

Certain medical conditions, such as diabetes, can lead to fertility issues.

But there’s also the case for autoimmune disorders and hormonal imbalances or pituitary gland problems.

Men who have undergone prior surgeries, such as a vasectomy or testicular surgery, may also experience infertility.

5. Environmental factors

Exposure to certain industrial chemicals or heavy metals can all play havoc with sperm count as can X-rays or radiation.

Even adverse enviromental conditions like heat exposure and noise pollution can have an impact.

See?

Complicated.

What are the signs of infertility in males?

Male infertility usually does not have any visible symptoms.

But there are some signs to watch out for if TTC is becoming a struggle:

• A decrease in sex drive
  
• Difficulty achieving an erection
  
• Pain or swelling in the testicles
  
• An abnormally large volume of semen during ejaculation
  
• A decrease in the size of the testicles

It is important to speak to a doctor if you are experiencing any of the male infertility symptoms mentioned above, as they can help diagnose the underlying cause.

How does a man get checked for fertility?

Diagnosing male infertility typically begins with a physical examination and a medical history review.

Your GP may also order tests to assess the quality of sperm and semen.

These can include semen analysis, which is used to evaluate sperm count, sperm motility, and shape.

Hormone tests can also be conducted to measure hormones that are essential for sperm production.

In some cases, a doctor may recommend a scrotal ultrasound to examine the testicles and surrounding structures to help identify any abnormalities that may be causing infertility.

Lastly, genetic testing may also be ordered to diagnose potential congenital or inherited syndromes.

How do you fix male infertility?

Treatment options for male infertility largely depend on the underlying cause, with lifestyle changes, fertility medications, and surgery all providing promising avenues.

Some of the most common treatments you could expect to be offered include:

• Fertility drugs: These are used to increase sperm production and are typically taken orally.
  
• Surgical treatment: This may involve correcting a physical blockage or varicocele (an enlargement of the veins in the scrotum).
  
• Assisted Reproductive Technologies: The most common treatment course for male infertility. ART involves collecting sperm from the male and combining it with an egg in a laboratory setting.

Alternative treatments are also on the table, whether it’s reducing stress, improving diet, or increasing physical activity.

The route you and your partner take could look very different to another couple but is no less ripe for success.

It all depends on the results of the medical tests.

Do fertility drugs for men work?

Fertility drugs for men work by increasing testosterone levels and stimulating sperm production.

Human chorionic gonadotropin (HCG) and clomiphene are the most common medications, but there are others.

Gonadotropin-releasing hormone (GnRH) agonists and antagonists, as well as aromatase inhibitors, can all be used to reduce the production of estrogen.

This can help to increase testosterone levels and improve sperm production.

What type of infertility needs surgery?

Surgical treatments for male infertility may be recommended if a physical abnormality or obstruction is preventing the sperm from being released.

These procedures can help to remove a blockage or repair any damage that is causing infertility.

A name fit for an action blockbuster, testicular sperm extraction (TESE) is used to treat men with azoospermia, a condition in which there is no sperm in the ejaculate.

It involves surgically removing sperm from the testicles and is (thankfully) done under general anesthesia.

Which ART technique is used in male infertility?

ART involves the retrieval of sperm from the testicles and the use of a laboratory technique called in vitro fertilization (IVF).

During IVF, the retrieved sperm is combined with an egg in a petri dish and the resulting embryo is then transferred into the woman’s uterus.

Other ART treatments include intracytoplasmic sperm injection (ICSI), which involves injecting a single sperm directly into an egg, and assisted hatching, which involves creating a small opening in the outer layer of the embryo to help it implant in the uterus.

Can male infertility be treated naturally?

When it comes to overcoming male infertility naturally, quitting smoking, reducing alcohol consumption, and exercising regularly are all solid places to start.

Herbal supplements such as ginseng and maca root may also be used to increase sperm production and motility.

And yes, there is suggestions that acupuncture might improve fertility in men by increasing blood flow to the reproductive organs.

But as for improving sperm quality?

That’s still yet to be sufficiently studied.

Men may also benefit from taking zinc supplements since zinc is essential for sperm production and motility.

And let us not overlook folic acid when jumping on the supplement train

But while folic acid and zinc has been shown to be important for sperm health and development, studies suggest they’re limited in the infertility reversing stakes.

The truth is, though there are some causes of male infertility that can be reversed, often the most recommended treatment is ART.

How do you help someone cope with infertility?

Dealing with male infertility can be difficult for both partners in a couple.

It’s important to remember that infertility is a (sometimes mysterious) medical condition and not a reflection on either partner.

Communicating openly with one another about any feelings that may surface is the best step you can take as you move through your options.

Because there are many treatment options available.

And while male infertility is complicated, a doctor or fertility specialist can be your greatest ally.

They can provide individualized advice on treatment options and help you find the best path forward objectively.

Finally, take time for self-care.

It doesn’t matter if it’s yoga, meditation, or spending time in nature, taking time to focus on yourself can help reduce stress and provide a sense of peace and balance.

You’ve got this.

You both do.

And remember, a supporting voice or reassurance from someone who has been where you are is only a tap away on Peanut.