Male Infertility: Causes, Symptoms, Tests & Treatment
Male infertility is more common than many people realise. When a couple has difficulty conceiving, fertility problems can involve the male partner, the female partner, or both partners. Therefore, evaluating male fertility is an important part of an infertility assessment.
Male fertility is closely related to sperm count, sperm motility and sperm morphology. Changes in any of these semen parameters can make it more difficult to achieve a pregnancy.
If you and your partner have been trying to conceive without success, understanding the causes, symptoms, diagnosis and treatment of male infertility can help you take the next step.
What Is Male Infertility?
Male infertility refers to difficulty achieving a pregnancy because of factors affecting the male reproductive system. A couple is generally evaluated for infertility when pregnancy has not occurred after 12 months of regular, unprotected sexual intercourse.
Male infertility may be related to problems with sperm production, sperm quality, sperm transport, ejaculation, hormones, genetics or the reproductive organs.
In some men, there are no obvious symptoms. A fertility evaluation may therefore be the first time an underlying problem is identified.
How Common Is Male Infertility?
Infertility affects couples across different age groups and populations, and male factors contribute to a substantial proportion of infertility cases.
Importantly, infertility should not automatically be considered a woman’s problem. Both partners should be evaluated when a couple is experiencing difficulty conceiving.
Male fertility can be affected by several factors, including age, medical conditions, lifestyle habits, hormonal disorders, infections, genetic conditions and problems affecting the testicles or reproductive tract.
What Causes Male Infertility?
The causes of male infertility can be broadly related to sperm production, sperm quality, hormonal function, reproductive anatomy, ejaculation and lifestyle factors.
Some of the most common male infertility causes include:
1. Low Sperm Count
Low sperm count, also called oligozoospermia, means the concentration of sperm in semen is below the laboratory’s reference range.
A low sperm count may reduce the chances of sperm reaching and fertilising an egg naturally. The severity and underlying cause are important when deciding on treatment.
Read more about low sperm count treatment in Srinagar.
2. Poor Sperm Motility
Sperm motility refers to the ability of sperm to move effectively.
Sperm need to move appropriately to travel through the female reproductive tract and reach the egg. Reduced sperm motility is known as asthenozoospermia and may make natural conception more difficult.
3. Abnormal Sperm Morphology
Sperm morphology describes the size and shape of sperm cells.
Abnormalities can involve the sperm head, midpiece or tail. A semen analysis evaluates sperm morphology along with other semen parameters.
Learn more about sperm morphology.
4. Hormonal Imbalance
Hormones play an important role in sperm production and male reproductive function.
Problems involving hormones produced by the hypothalamus, pituitary gland, thyroid or testes may affect sperm production and fertility. Hormone testing may be recommended when a doctor suspects an endocrine cause.
Read more about the role of hormones in fertility.
5. Varicocele
A varicocele is an enlargement of veins within the scrotum. It is relatively common and can sometimes be associated with impaired sperm production or semen quality.
Because sperm production is sensitive to temperature, changes in blood flow and testicular temperature may affect sperm function in some men.
6. Genetic Conditions
Certain genetic conditions can affect sperm production or the development of the male reproductive system.
Examples include Klinefelter syndrome, Kallmann syndrome, Kartagener syndrome and some genetic forms of cystic fibrosis-related infertility.
Genetic testing may be recommended in selected men, particularly when sperm counts are very low or sperm are absent from the semen.
7. Infections
Some infections, including sexually transmitted infections and infections affecting the reproductive tract, can interfere with sperm production or cause scarring and blockage of the reproductive tract.
Appropriate diagnosis and treatment are important when an infection is suspected.
8. Previous Surgery
Previous surgery involving the testicles, scrotum, prostate, bladder, abdomen or reproductive tract may sometimes affect sperm production, sperm transport or ejaculation.
A detailed medical and surgical history can help identify these factors.
9. Smoking and Alcohol
Lifestyle factors can influence male reproductive health.
Smoking and tobacco exposure may adversely affect sperm quality. Heavy alcohol consumption may also affect reproductive hormones and semen quality.
Men trying to improve their fertility should discuss alcohol, tobacco and other lifestyle factors with their healthcare professional.
10. Testicular Injury or Trauma
Previous injury or trauma to the testicles may affect sperm production or testicular function.
A history of significant testicular injury should be discussed during a fertility evaluation.
11. Retrograde Ejaculation
Normally, semen leaves the body through the penis during ejaculation. In retrograde ejaculation, semen enters the bladder instead.
This can result in little or no semen being ejaculated and may affect the ability to conceive naturally.
12. Testicular Tumours and Other Testicular Conditions
Some testicular tumours and other conditions affecting the testicles can interfere with normal sperm production.
Previous treatment for testicular cancer, including surgery, chemotherapy or radiation, can also affect fertility.
13. Medications, Drugs and Anabolic Steroids
Certain medications and recreational drugs can affect male reproductive function.
Of particular importance are anabolic steroids and testosterone supplementation, which can suppress the body’s natural sperm production.
Men using testosterone or other hormonal medicines should discuss fertility plans with their doctor before making changes to treatment.
14. Obesity and Excess Weight
Maintaining a healthy weight, eating a balanced diet and staying physically active can support overall reproductive health.
15. Excessive Physical or Training Load
Regular physical activity is generally beneficial. However, extreme training, inadequate nutrition and overtraining may affect hormonal balance and reproductive function in some individuals.
16. Chronic Stress and Poor Sleep
Long-term stress and inadequate sleep can affect overall health and may influence hormonal and reproductive function.
Managing stress, maintaining adequate sleep and following a healthy lifestyle can form part of a broader approach to improving fertility.
Male Infertility Symptoms
One of the challenges with male infertility is that many men have no obvious symptoms.
In other cases, symptoms may provide clues to an underlying condition.
Possible signs and symptoms include:
- Difficulty achieving or maintaining an erection
- Reduced sexual desire
- Problems with ejaculation
- Little or no semen during ejaculation
- Pain, swelling or a lump in the testicle or scrotum
- Recurrent genital or urinary infections
- Reduced facial or body hair
- Enlarged breast tissue
- A history of testicular problems or surgery
- Difficulty conceiving despite regular unprotected intercourse
Experiencing one of these symptoms does not necessarily mean that a man is infertile. A proper medical evaluation is needed to identify the cause.
How Is Male Infertility Diagnosed?
The diagnosis of male infertility usually begins with a detailed medical and reproductive history followed by appropriate tests.
A fertility specialist may ask about:
- Previous pregnancies
- Duration of infertility
- Sexual and ejaculation history
- Previous surgeries
- Testicular injuries
- Medications and supplements
- Lifestyle factors
- Previous infections
- Family history
- Previous fertility treatments
The results help determine which additional investigations may be appropriate.
Male Infertility Tests
Semen Analysis
Semen analysis is one of the most important initial tests for evaluating male fertility.
It assesses factors such as:
- Sperm concentration
- Total sperm number
- Sperm motility
- Sperm morphology
- Semen volume
- Other semen characteristics
A single semen analysis may not provide the complete picture because semen parameters can vary between samples. Your doctor may therefore recommend repeat testing.
You can also explore infertility tests in Srinagar.
Hormone Testing
Blood tests may be used to evaluate reproductive hormones such as testosterone, FSH and LH, depending on the clinical situation.
Hormonal testing can help identify conditions affecting sperm production.
Scrotal Ultrasound and Doppler
A scrotal ultrasound or Doppler study may help evaluate the testicles, epididymis, blood flow and conditions such as varicocele.
Transrectal Ultrasound
A transrectal ultrasound, or TRUS, may be recommended in selected cases when a doctor suspects a blockage involving the ejaculatory ducts or other structures.
Genetic Testing
Genetic tests may be recommended for certain men with severe sperm-production problems, particularly very low sperm counts or azoospermia.
Testicular Biopsy
In selected cases, a testicular biopsy may help determine whether sperm production is occurring within the testicular tissue.
Can Male Infertility Be Treated?
Yes. Male infertility treatment depends on the underlying cause.
Some men may benefit from lifestyle changes or medicines, while others may require surgery or assisted reproductive techniques such as IVF and ICSI.
Treatment should be based on a proper diagnosis rather than simply treating the semen report.
Male Infertility Treatment Options
Lifestyle Changes
Depending on the cause, a doctor may recommend:
- Stopping tobacco use
- Limiting excessive alcohol consumption
- Maintaining a healthy weight
- Following a balanced diet
- Regular moderate physical activity
- Managing stress
- Getting adequate sleep
- Avoiding unnecessary exposure to excessive heat
- Reviewing medicines that may affect fertility with a doctor
Medicines and Hormonal Treatment
When hormonal abnormalities or specific medical conditions are identified, appropriate medicines may help improve reproductive function.
Hormonal treatment should only be taken under medical supervision.
Varicocele Treatment
When a clinically significant varicocele is associated with infertility, a specialist may consider varicocele repair in selected patients.
Vasovasostomy
A vasovasostomy is a surgical procedure used to reconnect the vas deferens, commonly after a previous vasectomy.
Vasoepididymostomy
A vasoepididymostomy connects the vas deferens to the epididymis and may be considered when there is an obstruction that prevents sperm from entering the semen.
Transurethral Resection of the Ejaculatory Duct
In selected cases involving ejaculatory duct obstruction, a transurethral procedure may be considered to improve sperm passage.
IVF for Male Infertility
In vitro fertilisation (IVF) may be considered when male-factor infertility is significant or when other fertility treatments have not been successful.
During IVF, eggs are retrieved from the ovaries and fertilisation takes place in a laboratory. The resulting embryo can then be transferred into the uterus.
Learn more about IVF treatment in Srinagar.
ICSI for Male Infertility
Intracytoplasmic sperm injection (ICSI) is an advanced fertilisation technique commonly used when sperm-related factors make conventional fertilisation difficult.
During ICSI, a single selected sperm is injected directly into a mature egg in the laboratory.
ICSI may be considered in situations such as:
- Very low sperm count
- Poor sperm motility
- Severe sperm morphology abnormalities
- Previous fertilisation failure
- Surgically retrieved sperm
- Certain cases of severe male-factor infertility
Read more about ICSI treatment in Srinagar.
Sperm Retrieval Procedures for Male Infertility
Some men produce sperm inside the testicles but have little or no sperm in the ejaculated semen. In such cases, sperm retrieval may be considered for use with IVF-ICSI.
Common sperm retrieval procedures include:
TESA
Testicular Sperm Aspiration (TESA) uses a needle to obtain sperm-containing tissue from the testicle.
PESA
Percutaneous Epididymal Sperm Aspiration (PESA) retrieves sperm from the epididymis using a needle.
TESE
Testicular Sperm Extraction (TESE) involves obtaining a small amount of testicular tissue to look for sperm.
Learn more about TESE and its success rate.
MESA
Microsurgical Epididymal Sperm Aspiration (MESA) uses microsurgical techniques to retrieve sperm from the epididymis.
MicroTESE
Microdissection TESE (microTESE) uses an operating microscope to identify areas of the testicle that may contain sperm.
The most appropriate sperm retrieval technique depends on the individual’s diagnosis and whether sperm production is present.
Donor Sperm Treatment
When sperm cannot be obtained or when other treatment options are not appropriate, donor sperm treatment may be considered in accordance with applicable medical and legal requirements.
Your fertility specialist can explain the available options, eligibility requirements and treatment process.
When Should a Man Get a Fertility Test?
A male fertility evaluation may be appropriate when:
- The couple has been trying to conceive for 12 months without pregnancy
- There is a known history of low sperm count
- There is a history of testicular injury or surgery
- There are ejaculation or erectile problems
- There is a history of reproductive or urinary infection
- The man has used testosterone or anabolic steroids
- There is a known hormonal or genetic condition
- The female partner’s age or fertility history makes earlier evaluation advisable
Both partners may need evaluation because infertility can involve male factors, female factors, or a combination of both.
Can Male Infertility Be Prevented?
Not every cause of male infertility can be prevented, particularly genetic or congenital conditions. However, maintaining overall health may help protect reproductive health.
Helpful measures may include:
- Avoiding tobacco and recreational drugs
- Limiting excessive alcohol consumption
- Maintaining a healthy body weight
- Exercising regularly without excessive training
- Managing chronic medical conditions
- Avoiding unnecessary testosterone or anabolic steroid use
- Seeking treatment for reproductive or urinary infections
- Protecting the testicles from significant injury
- Discussing fertility preservation before treatments that may affect sperm production
Frequently Asked Questions About Male Infertility
What is the main cause of male infertility?
There is no single cause. Male infertility may result from low sperm count, poor sperm motility, abnormal sperm morphology, hormonal problems, varicocele, genetic conditions, reproductive tract obstruction, infections, medications, lifestyle factors or problems with sperm production.
What are the signs of male infertility?
Many men have no noticeable symptoms. When symptoms occur, they may include ejaculation problems, erectile dysfunction, reduced libido, testicular pain or swelling, or changes in semen volume.
Which test is used for male infertility?
A semen analysis is usually one of the first investigations used to assess male fertility. Additional tests, such as hormone testing, ultrasound, Doppler studies, or genetic testing, may be recommended depending on the findings.
Can low sperm count be treated?
Treatment depends on the cause and severity. Depending on the diagnosis, options may include lifestyle changes, medicines, treatment of an underlying condition, surgery, sperm retrieval or assisted reproductive techniques such as IVF-ICSI.
Can a man with zero sperm count have a baby?
In some cases, yes. Men with azoospermia may still produce sperm in the testicles. Depending on the cause, sperm retrieval techniques such as TESE or microTESE may be considered, often together with ICSI.
Is IVF required for every case of male infertility?
No. Treatment depends on the underlying cause. Some men may improve with lifestyle changes, medicines or surgery. Assisted reproductive techniques may be considered when other approaches are not suitable or have not worked.
Is ICSI better than IVF for male infertility?
IVF and ICSI are different fertilisation approaches. ICSI may be particularly useful when there is significant male-factor infertility or when sperm-related problems make conventional fertilisation difficult. The appropriate technique should be decided based on the couple’s clinical circumstances.
Take the Next Step for Male Infertility
Male infertility can have several possible causes, and a semen report alone does not always explain the complete picture. A proper evaluation can help identify whether the issue involves sperm production, sperm quality, hormones, anatomy, ejaculation or another factor.
If you or your partner are having difficulty conceiving, consider consulting a fertility specialist for an individual assessment. At Imprimis IVF & Fertility Centre, fertility evaluation and treatment options are discussed based on your medical history, test results, and reproductive goals.
Explore male fertility and infertility care or consult a fertility specialist to understand the next appropriate step.
Medical Reviewer: Imprimis IVF & Fertility Centre
Last Updated: September 2026
Clinic: Imprimis IVF & Fertility Centre, Srinagar
Address: Second Floor, S R Plaza, Hyderpora Flyover, Hyderpora, Srinagar, Jammu and Kashmir – 190014
Phone: 7678556881, 9650777084
