Understanding Male Fertility: Common Issues & When to Seek Help - Samad Hospital

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November 22, 2025
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When we talk about infertility, most people immediately think of women’s reproductive health. But in reality, male fertility plays an equally important role, contributing to nearly 50% of infertility cases globally. Understanding how male fertility works, what affects it, and when to seek medical guidance can make a significant difference for couples trying to conceive.

This article breaks down male fertility in a simple, practical way — including common issues, symptoms, risk factors, diagnostic tests, treatments, and professional help available.

What Is Male Fertility?

Male fertility depends on the body’s ability to produce healthy sperm and deliver it effectively during intercourse. For a successful conception to happen, three key factors must work together:

  1. Healthy sperm production

  2. Proper sperm movement (motility)

  3. Normal sperm shape (morphology)

  4. Efficient delivery through the reproductive tract

Any disruption in these processes can reduce a man’s chances of fathering a child.

Common Causes of Male Fertility Problems

Male infertility can result from medical conditions, lifestyle habits, environmental factors, or genetic issues. Here are the most common causes:

1. Low Sperm Count (Oligospermia)

This is one of the primary issues men face. Low sperm count means fewer sperm are available to fertilize an egg.
Causes include:

  • Hormonal imbalance

  • Testicular infections

  • Varicocele (enlarged veins around the testicle)

  • Genetic conditions

  • Lifestyle habits like smoking, alcohol, or drug use

2. Poor Sperm Motility (Asthenospermia)

Motility refers to how well sperm move. Slow or weak sperm may not reach the egg.
Possible causes:

  • Infections

  • Prolonged sitting or heat exposure

  • Nutritional deficiencies

  • Oxidative stress

3. Abnormal Sperm Morphology (Teratospermia)

Even if the sperm count is normal, irregular shape or structure can affect fertilization ability.
This may be caused by genetic issues, toxins, smoking, or testicular stress.

4. Varicocele

A varicocele is a swelling of veins in the scrotum. It affects testicular temperature and can lower sperm quantity and quality.
It is one of the most treatable causes of male infertility.

5. Hormonal Imbalance

The hormones FSH, LH, and testosterone regulate sperm production.
Hormonal disorders can result from:

  • Thyroid problems

  • Pituitary gland issues

  • Steroid abuse

  • Chronic illnesses

6. Ejaculation Disorders

Some men experience difficulties with ejaculation, including:

  • Premature ejaculation

  • Retrograde ejaculation (where semen enters the bladder)

  • Erectile dysfunction (ED)

These conditions may be caused by nerve damage, injuries, diabetes, or psychological stress.

7. Infections

Sexually transmitted infections (STIs) or urinary tract infections (UTIs) can damage sperm ducts or cause inflammation in reproductive organs.

8. Genetic Conditions

Genetic factors like Y-chromosome microdeletions or Klinefelter syndrome can impact sperm production or function.

Lifestyle Factors Affecting Male Fertility

Certain habits and environmental exposures can significantly reduce fertility, including:

  • Smoking and alcohol use

  • Obesity and lack of exercise

  • Chronic stress

  • Sleep deprivation

  • Long-term laptop use on the lap

  • Exposure to pesticides, chemicals, or heavy metals

  • Use of anabolic steroids or bodybuilding drugs

Adopting a healthier lifestyle leads to noticeable improvements for many men.

Symptoms of Male Fertility Issues

Most men have no obvious symptoms, making infertility difficult to detect early.
However, certain signs may indicate a problem:

  • Difficulty achieving pregnancy after 1 year of regular unprotected intercourse

  • Low sexual desire

  • Erectile dysfunction

  • Pain or swelling in the scrotum

  • Reduced body or facial hair

  • Very small or unusually shaped testicles

  • Abnormal semen color or consistency

If any of these symptoms appear, it’s advisable to undergo a fertility evaluation.

How Male Fertility Is Diagnosed

A fertility specialist (andrologist or urologist) conducts several tests to assess reproductive health:

1. Semen Analysis

This is the primary test for evaluating:

  • Sperm count

  • Motility

  • Morphology

  • Semen volume

2. Hormonal Testing

Blood tests evaluate testosterone, FSH, LH, and prolactin levels.

3. Ultrasound Scrotum

Helps detect varicocele, blockages, or abnormalities.

4. Genetic Testing

Recommended for extremely low sperm count or azoospermia.

5. Advanced Tests

Some labs also perform:

  • Sperm DNA fragmentation test

  • MAR test for sperm antibodies

Treatment Options for Male Infertility

The good news is that most male fertility issues are treatable. Treatment depends on the underlying cause:

Lifestyle Changes

  • Maintain ideal weight

  • Avoid smoking, alcohol, and drugs

  • Regular exercise

  • Stress reduction techniques

  • Healthy diet rich in antioxidants

Medications & Hormone Treatments

Doctors may prescribe:

  • Hormonal therapy

  • Antibiotics for infections

  • Antioxidants & supplements

  • Medicines to improve sperm count and motility

Surgical Options

  • Varicocele repair

  • Vasectomy reversal

  • Removal of blockages in the reproductive tract

Assisted Reproductive Techniques (ART)

If sperm parameters remain low, ART options can help achieve pregnancy:

  • IUI (Intrauterine Insemination) – placing sperm directly into the uterus

  • IVF (In Vitro Fertilization) – fertilizing the egg in a lab

  • ICSI (Intracytoplasmic Sperm Injection) – injecting a single sperm into the egg

  • Testicular sperm retrieval for azoospermia cases

When Should Men Seek Medical Help?

You should consult a fertility specialist if:

  • You and your partner are unable to conceive after 12 months (or 6 months if the female partner is older than 35)

  • You have erectile dysfunction or ejaculation issues

  • You have a history of testicular injury, surgery, or infections

  • There is swelling, lumps, or pain in the scrotum

  • You experience hormonal symptoms like low libido or hair loss

  • You previously had cancer treatment

  • You work in high-heat or chemical environments

Early evaluation increases the chances of successful treatment and natural conception.

Takeaway

Male fertility is often overlooked, but it is just as important as female reproductive health. Many factors — from hormonal imbalances to lifestyle habits — can impact sperm quality and sexual function. The good news is that with proper diagnosis, timely treatment, and lifestyle modifications, most men can significantly improve their fertility.

If you notice changes in your sexual health, have concerns, or have been trying to conceive without success, don’t delay consulting a fertility specialist. Early intervention leads to better outcomes and a smoother journey toward parenthood.

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