What Is Male Infertility?

What Is Male Infertility?

Male infertility refers to a man’s inability to cause pregnancy in a fertile female. A man’s fertility generally relies on the quantity and quality of his sperm. If the number of sperm a man ejaculates is low or if the sperm are of a poor quality, it will be difficult, and sometimes impossible, for him to cause a pregnancy. It is estimated that one in twenty men has some form of fertility problem with low numbers of sperm in their ejaculate. However, only about one in every hundred men has no sperm in their ejaculate.

What Causes Male Infertility?

Many different medical conditions and other factors can contribute to fertility problems, and an individual case may have a single cause, several causes, or—in some cases—no identifiable cause. Causes of male infertility include:

  • Physical problems with the testicles
  • Blockages in the ducts that carry sperm
  • Hormone problems
  • A history of high fevers or mumps
  • Genetic disorders
  • Lifestyle or environmental factors
  • Sperm production problems

A complete lack of sperm occurs in about 10% to 15% of men who are infertile. A hormone imbalance or blockage of sperm movement can cause a lack of sperm. In some cases of infertility, a man produces less sperm than normal. The most common cause of this condition is varicocele, an enlarged vein in the testicle. Varicocele is present in about 40% of men with infertility problems.


The main sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms. In some cases, however, an underlying problem such as an inherited disorder, hormonal imbalance, dilated veins around the testicle, or a condition that blocks the passage of sperm causes signs and symptoms.Although most men with male infertility don’t t notice any symptoms other than inability to conceive a child, signs and symptoms associated with male infertility include:

  • Changes in hair growth
  • Changes in sexual desire
  • Pain, lump, or swelling in the testicles
  • Problems with erections and ejaculation
  • Small, firm testicles


If a doctor suspects male infertility, he may run some tests to make a definitive diagnosis. Your partner may first undergo a routine physical exam and semen analysis. The semen analysis will analyze the number of available sperm, the shape of the sperm and its movement. If the semen analysis shows a problem, your doctor may recommend further testing. Other tests for male infertility may include:

  • A semen culture to look for infection
  • A vital staining test to determine how many sperm are alive in a sample
  • A blood test that checks for abnormal hormone levels or genetic disorders
  • A sonogram of the scrotum to look for blockages
  • A testicular biopsy to see if sperm production is normal
  • A test for anti-sperm antibodies
  • A contrast dye test of the vas deferens to check for a blockage

Lastly, your doctor may run male infertility tests to see how well the sperm attaches to an egg or is able to penetrate it.


The treatment of male infertility depends upon the underlying cause. If a specific reason for infertility is discovered, it is sometimes possible to treat. A variety of treatment options are available and include hormonal therapy, surgery to correct blocked tubes, and treatment of infections or underlying medical conditions.


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Dr. David Samadi M.D.

Dr. David Samadi is a board certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is Chairman of Urology, and Chief of Robotic Surgery at Lenox Hill Hospital.

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