Male Infertility Causes and Symptoms

by Benjamin Bunting BA(Hons) PGCert

Ben Bunting BA(Hons) PGCert Sports and Exercise Nutrition Level 2 Strength and Conditioning CoachWritten by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.


Male infertility is a topic that has long been surrounded by myths and misconceptions.

However, understanding the root causes and symptoms is crucial in order to address this issue effectively.

In this comprehensive article, we delve into the depths of male infertility, decoding its mysteries and shedding light on the underlying factors that contribute to it.

From hormonal imbalances to genetic disorders, we uncover the various reasons that can lead to infertility in men.

Moreover, we explore the symptoms that men should be aware of, including changes in sexual function, pain or swelling in the testicles, and abnormal sperm count.

Through this article, we aim to raise awareness and provide valuable insights to both individuals and couples who may be grappling with fertility challenges.

By demystifying male infertility, we hope to empower individuals to seek proper diagnosis and treatment options, enabling them to take proactive steps towards building their desired family.

So join us as we unravel the intricacies of male infertility and embark on a journey towards understanding and overcoming this often overlooked issue.

What is male infertility?

Infertility does not mean that conception is impossible. Infertility in men can be caused by a variety of factors. You can improve the situation or treat it. 

Infertility can be defined medically as the inability of a couple or individual to fall pregnant following a year-long active attempt to conceive. 

Infertility is not necessarily a sign of irreversible damage, or long-term dysfunction. 

There are some medical conditions which will prevent couples from conceiving. However, for most people there are ways to improve the situation. 

The nature of infertility can make it difficult to pinpoint the cause. 

  • Can the problem be with one of the partners? 
  • Which one? 
  • Could it be both at the same time? 
  • Do you have any hormonal or chemical imbalances? 
  • Is it more of a physical or structural problem? 

Fertility can be complicated. Fertility is complicated. Any number of factors can disrupt the conception process. 

What causes male infertility?

One in seven couples are infertile. This means that they can't conceive even after having frequent sexual relations without protection for at least a year.

Up to 50% of couples with infertility issues are male.

Infertility in men can be due to low sperm counts, abnormal sperm functions or obstructions that block the sperm from reaching its destination. 

Male infertility can be caused by a variety of factors, including illnesses, injuries, chronic problems with health, and lifestyle choices.

Let's take a look, in closer detail:

Sperm and Semen

Semen of poor quality, which contains sperm and is ejaculated by men during sexual activity, can cause infertility.

The following are possible causes of abnormal semen:

  • Lack of sperm - You may be suffering from a low sperm count, or even no sperms at all
  • Sperm that do not move properly will have a harder time swimming to the egg
  • The shape of sperm is sometimes abnormal, which makes it difficult for the sperm to fertilise eggs and move.

Unknown causes of many abnormal cases of semen.

It's not known if wearing underwear that is too loose will improve fertility.


Testicles are the organs that produce sperm and store it. Damage to the testicles can have a serious impact on your semen.

It can be caused by:

  • Testicular infection
  • Testicular Cancer
  • Testicular surgery
  • A problem that you have with your testicles (a congenital deformity)
  • When 1 or both of your testicles have not fallen into the scrotum, known as undecended testiucles. (This is the loose pouch that holds your testicles).
  • Testicular injury


If they don't want to have children, or more than one child, some men opt for a vasectomies.

The vas deferens (the tubes carrying sperm from your testicles) is cut and sealed off so that your semen no longer contains any sperm.

The vasectomy procedure can be reversed but it is not always successful.

Ejaculation disorders

Some men have problems with ejaculation, which can affect their ability to release the semen (ejaculate) during sexual activity.

Drugs and medicines

Some types of medicine can cause problems with infertility. Some of these include:

  • Sulfasalazine is an anti-inflammatory medication used for conditions like Crohn’s disease or Rheumatoid Arthritis. It can reduce sperm counts, but the effects should be temporary. Your sperm count will return to normal once you stop using it.
  • Anabolic steroids are used to improve athletic performance and build muscles.
  • Chemotherapy: - Medicines used for chemotherapy may cause sperm to be severely reduced
  • Some herbal remedies can reduce your testicles' size or affect the production sperm.

Semen can be affected by illegal drugs such as cocaine and marijuana.

Klinefelter Syndrome

It is a mutation in which the male has the XXY chromosomes instead of the normal XY. Hypogonadism is usually infertile. 

The symptoms can be varied, but include bilateral hypertrophic or atrophic tests, reduced muscle mass and facial and body hair, as well as gynecomastia. 

Infertility, accompanied by azoospermia and severe oligozoospermia, is often the first symptom. Klinefelter Syndrome is the most commonly diagnosed cause of hypogonadism in men, although the majority (50-75% of them) never receive a diagnosis.

Viral Orchitis Mumps

The most common cause of acquired failure is mumps, but there are other viruses that can be a close second. Their incidence is on the rise. 

The decrease in MMR vaccinations in children in the early 1990s is likely to be responsible for this. Orchitis affects about one quarter of adults with mumps. One-third of these will have bilateral disease. 

The infection can cause direct damage to the seminiferous tubes or indirect damage from compressive ischaemia caused by severe intraesticular swelling when being restricted by the extremely tough tunica albuginea. 

Testicular atrophy can occur between 1 and 6 months following infection. The extent of testicular loss is not related to the severity or potential infertility of the infection. 

Two-thirds of adult patients with bilateral mumps orchitis and one-quarter with unilateral disease will experience infertility.


Normal levels of prolactin in men are quite low. If they are elevated, it may be a sign of a prolactin-secreting tumor in the pituitary.

These tumors can cause infertility, low testosterone, galactorrhea and gynecomastia.

They may also compress the optic chiasm, resulting in a decrease of peripheral vision. The presence of prolactin above 150 mcg/L may be indicative, whereas a level over 300 mcg/L can be considered diagnostic. 


A hypogonadism occurs when testosterone levels are abnormally low. This is the hormone that controls male sexual function and helps to make sperm.

This could be due to a tumor, illegal drug use, or Klinefelter Syndrome, a rare syndrome that involves an extra female gene.

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Unexplained infertility

Unexplained infertility is a common problem in the UK. When neither partner can identify the cause, this is called unexplained infertility.

Talk to your doctor if you have not found the cause of your infertility problems.

NICE recommends that women who are unable to conceive after two years of regular sex without protection should receive treatment.

Is low testosterone a cause of infertility?

Up to 40% of men with couple infertility may have hypogonadism.

Testosterone is the major androgen regulating-spermatogenesis in men; as a result, men with either primary or secondary hypogonadism may be subfertile because of impaired spermatogenesis.

In males with primary hypogonadism, the damage to seminiferous tubes prevents sperm production.

In contrast, males with secondary hypogonadism (i.e., disorders of the hypothalamus or pituitary) can have their sperm produced to the level necessary to restore or achieve fertility.

Males who have pituitary disease can be treated with gonadotropins, while those with hypothalamic disease can be treated with gonadotropins or pulsatile gonadotropin-releasing hormone (GnRH).  

Hypogonadism, the medical term for when testes do not produce enough testosterone, can directly impact fertility by reducing the quality and quantity of sperm. This condition can have an indirect impact on fertility by reducing sexual drive, causing erectile problems or ejaculation issues. 

You can still produce sperm if your testosterone levels are below normal. However, there could be issues with the quality of semen or total sperm count. 

Semen and sperm are not the same: sperm, as well as other fluids from your prostate, seminal glands, and bulbourethrals, is a component of semen. The sperm in your seminal liquid is what fertilises the egg of a woman after ejaculation. 

What is a normal count of sperm? There's a lot of variation in this. Normal range is a millilitre of semen containing anywhere from 15 million to 200 million sperm. It only takes one sperm to cause conception. 

A number of factors, including aging, can lead to a drop in testosterone levels. Your testosterone levels naturally begin to decline from around 30 to 40 years old. This is called andropause and is also known as male menopause. 

The comparison to female menopause may not be helpful or accurate, but it is a useful one. While the drop in the oestrogen level in women during menopause is quite abrupt and steep, the fall in testosterone in men is more gradual. 

It's important to note that a drop in testosterone is not necessarily a cause for concern. For some, it may even be barely noticeable. There are some key signs that could indicate that your testosterone levels are decreasing, including: 

  • Increased body fat
  • Loss of muscle mass
  • Low energy levels
  • Irritability and moodiness
  • Hair loss
  • Reduced sex drives
  • Erectile problems
  • Orgasm trouble (e.g. premature ejaculation)

You and those around you are likely to recognize these symptoms. The male fertility issues related to testosterone are not as obvious. 

Healthy sperm

Healthy sperm can be defined in many ways. 

  • Volume - the amount sperm in an ejaculate
  • Concentration - number sperms per ml
  • Velocity is the speed at which your sperm move
  • Motility - How well they move e.g. Straight line or not?
  • Viability - What percentage of sperm is alive and mobile?
  • Viscosity is the speed at which your semen will liquify
  • Shape
  • Size
  • If they are too acidic, the pH level will be high. If they are too acidic

If you have low testosterone, this can affect sperm parameters. This is why increasing your testosterone can play a role in improving fertility. 

Does exogenous testosterone affect fertility?

Exogenous testosterone could be the administration of testosterone replacement therapy (TRT), or the use of anabolic steroids.

A growing number of men in their twenties and thirties are seeking help for the symptoms of hypogonadism (low androgen levels), including fatigue, depression, lack of libido and erectile problems.

In younger athletes, the prevalence of anabolic steroids-induced hypogonadism and testosterone supplements in general is increasing.

This creates a group of men that are particularly affected by negative effects of using exogenous steroids on testicular organs.

Exogenous testosterone therapy can alter the natural regulation of the hypothalamic-pituitary-gonadal axis leading to impaired spermatogenesis with azoospermia being a serious possible result, thus rendering the individual infertile.

It has been demonstrated that human chorionic gonadotropin (hCG), when used in conjunction with testosterone, can not only reverse the effects of testosterone therapy on azoospermia but also help to maintain high intratesticular levels.

Selective estrogen receptor modulators are often used in conjunction with hCG to both elevate testosterone total levels and maintain spermatogenesis.

Symptoms of male infertility

Male infertility does not have any particular symptoms. You may experience symptoms if the cause is a surgical or medical condition or low levels of hormones.

The condition of your testicles can cause:

  • Testicular swelling and pain
  • Testicular veins with prominent veins
A problem with your prostate gland or the tube that carries sperm from the testicles ( epididymis), may cause:
  • Blood in your semen
  • Pain when ejaculating
  • Trouble ejaculating when you have sex

Low hormone levels can cause:

  • Problems obtaining or maintaining an erection
  • Changes in your mood
  • tiredness
  • Problems Concentrating
  • Weight gain
  • Lower sex desire (libido), than normal
  • You can shave your face less frequently if you have less facial hair.

You may find that you cannot ejaculate or your urine is cloudy when you have had sex. 

How is male infertility diagnosed?

Infertility can be a strange symptom. Most men discover they are having fertility problems when they cannot impregnate their female partners. Only after you've reached this stage can you get tested and assessed. 

Infertility can be caused by a variety of factors. Other symptoms may accompany the infertility, which will help to diagnose the cause. 

Semen analysis can identify any problems with your sperm (such as a low sperm number, mobility issues or misshaped sperm). Other tests, such as an ultrasound of the testicles, will reveal if you have any structural problems or blockages. 

If you find that there are few or no sperm in your testes, a biopsy of the testicle may be necessary for further assessment. 

Your doctor may suggest that you take a blood sample first. A blood test will reveal any issues with your hormone levels and rule out other causes for male infertility. 

Initial tests

Your doctor may ask to examine you and do some tests.

A sample of semen can show whether you're producing enough healthy sperm. 

You may be able to take the sample at home or in a clinic. You'll need to collect the sample (through masturbation) at least two days after, but no more than five days, since you last ejaculated. 

Your semen will be tested for a number of things, including:

  • How many sperm there are
  • How fast the sperm move
  • The size and shape of your sperm

If this shows up any problems, you'll need to repeat the test around a month later. If the second test confirms a problem with your sperm, your GP may refer you to a fertility specialist.

If you're unable to get an erection or keep one for long enough to have sex, your GP may arrange blood tests. These will look for low hormone levels or evidence of diabetes, as erectile dysfunction can be a sign of diabetes.

Additional tests

You may want to consult your doctor if you have been trying to conceive for a long time. If your sperm counts are low, you may need to consult a fertility specialist. You may need:

  • Give a sample of urine to check for retrograde semen ejaculation. This occurs when the semen is ejaculated into your bladder, rather than outside.
  • If you don't produce any sperm, an ultrasound scan your testes is recommended.
  • Tests for genetic conditions which may affect sperm quality
  • Tests to measure your hormone levels

You can still try treatments if your doctor cannot pinpoint the cause of your infertility. 

What can you do to improve fertility?

Most people assume that they will need some type of testosterone or hormone therapy. However, this can have the opposite of what you're looking for.

Injections, patches, creams and other methods of introducing exogenous testosterone to your bloodstream will cause your testes to receive signals that they should stop producing their own testosterone. This can lower your sperm counts or create sperm with poor quality. 

It really depends on what the cause is. If there is a medical problem and fertility treatment is needed, a full health assessment by your healthcare provider will hopefully guide you in the correct direction. 

Lifestyle Tweaks

You can also improve your chances to conceive, particularly if your fertility issues are due to low testosterone levels. 

Why should testosterone production be different? 

First, you should take stock of all your bad habits. Then make healthy changes. Smoking, alcohol, recreational drugs and other substances can all negatively impact testosterone levels. 

You can start by kicking your vices and eating better, exercising more or getting a good night's sleep.  

Your testosterone levels could be affected by a psychological factor. Stress, anxiety and depression can all affect how much testosterone is produced by your body. 

Your mental health is vital. Knowing that there may be a problem in this area will help you to get a better handle on things. 

T-Boosting Supplements

You can also increase your testosterone naturally by taking supplements. 

You can increase your testosterone levels without medical intervention by looking for certain ingredients in supplements. 

D-aspartic (or DAA) is a common amino acid. It plays a vital role in the ability of your pituitary to produce luteinizing hormonal. This can then boost your testosterone levels. 

Ashwagandha and zinc are both naturally occurring ingredients with a lot of scientific backing for their ability to support and increase healthy testosterone levels. 

The compounds in a plant known as fenugreek are also capable of enhancing your sexual function. They can reinvigorate and enhance your sex desire, while improving your sperm quality. 

This is done by increasing the amount of free testosterone present in your blood. It also has a major impact on the total serum testosterone level (which includes free testosterone as well as the testosterone bound to your body's proteins). 

If you have questions or concerns regarding fertility, you should consult your doctor. 

Take the time to do these things to naturally increase your testosterone. Reduced testosterone simply means that you have a reduced chance of reproducing. So, it's a no brainer to take a daily supplement to increase your chances. 


Infertility affects the reproductive system. Infertility is a disease that makes a person incapable of having children. 

It can affect either a man or a woman. Infertility in men is a result of a problem with the male reproductive system. You cannot get pregnant with your partner.

Male fertilityis influenced by various factors.

You must be able:

  • How to make healthy sperm which can fertilise an egg
  • You need to ejaculate and have an erection in order for the sperm to reach the egg

Male infertility is most commonly caused by problems with sperm production. Sperm can be immature or have an abnormal shape.

They may also not be able to swim. You may not have enough of your sperm in some cases. You may not be able to make any sperm.

Semen can be stopped by anything that blocks the genital canal. It could be due to a birth defect or genetic condition. 

Semen can be blocked by infection or inflammation caused by a sexually-transmitted disease. Scar tissue after surgery or twisted and swollen scrotal veins are also possible causes. 

Infertility can also be caused by erectile dysfunction, or premature ejaculation. Infertility can be caused by liver or kidney disease or seizure disorders. 

Use Military Muscle to boost your testosterone levels

One of the great benefits of using a testosterone-boosting supplement is that it raises your testosterone levels naturally and safely. 

The use of high-quality ingredients can help your body produce more testosterone naturally, without the need to inject harmful anabolic steroids or external male hormones into your system. 

Military Muscle contains ingredients that have been studied extensively and have shown to positively impact the amount of testosterone your body can produce. 

Fenugreek, urtica dioica and other ingredients are effective in boosting sperm and revitalising libido. Mucuna pruriens and ashwagandha help create the luteinizing hormonal responsible for the production of testosterone in the testes. 

This can result in healthier sperm and an increase in your sexual drive. 

You should supplement your diet with natural testosterone boosters if low testosterone levels affect your sexual life or fertility.

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