Understanding male infertility
When a couple has not conceived after a year of trying, a male factor is involved in roughly half of cases. Assessing both partners early saves time, and many male causes can be treated.
Common causes
- Varicocele: enlarged veins in the scrotum that can affect sperm production
- Hormonal imbalance, including low testosterone
- Blockage of the tubes that carry sperm
- Infection or inflammation
- Genetic factors
- Smoking, heavy alcohol use, excess weight and heat exposure
- Some medicines and anabolic steroids
Assessment
The assessment is private and straightforward:
- Medical and sexual history
- Examination, including a check for varicocele
- Semen analysis, usually repeated, to measure sperm count, movement and shape
- Hormone blood tests
- Scrotal ultrasound and, when needed, genetic tests
Treatment options
Treatment is chosen according to the cause found.
Lifestyle changes
Stopping smoking, reducing alcohol, losing excess weight and avoiding heat to the testicles can improve sperm quality.
Medical treatment
Hormonal treatment or antibiotics when tests show a hormonal problem or an infection.
Varicocele repair
A procedure to close the enlarged veins, which can improve sperm quality in suitable men.
Assisted reproduction support
When needed, sperm can be retrieved and used with IVF/ICSI, in coordination with a fertility centre.
Improving fertility day to day
- Stop smoking
- Keep alcohol low
- Reach a healthy weight
- Avoid hot baths, saunas and laptops on the lap
- Avoid anabolic steroids and testosterone unless a specialist prescribes them
Frequently asked questions
This page is general information and does not replace a medical consultation.