Causes of Male Infertility: An overview

Last Updated on 10/13/2026 by DrHelal, MD
Medical Doctor with 50+ Years of Clinical Practice • [Read Full Author Bio & Credentials →]

Infertility affects many couples worldwide. Understanding causes of Male infertility is crucial for men to take proactive steps. They can improve their reproductive health. Addressing male infertility causes is key to conception.

Many causes can lead to male infertility. But many of these causes are treatable. Knowledge and action can significantly improve your chances of conceiving. Keep reading to discover the key factors behind male infertility.

In this article, we will explore medical and lifestyle causes, genetic conditions, varicocele, infections, hormonal and others. The goal is to help understand infertility. Read more in our cornerstone article Semen Analysis Guide, and Men’s Health.

Male Infertility

Infertility is defined as the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse.

According to various sources: between 48 million and 186 million individuals globally are affected by infertility. Male factors contribute to 50% of fertility issues.

Key Factors in Male Fertility

• Sperm Count which is the number of sperm per milliliter of semen.
• Sperm Motility. the ability to move effectively.
• Sperm Morphology: The shape and structure.
• Semen Volume.

Male Infertility Causes and Risk Factors

It is essential to understand the various causes that can impact male reproductive health. Male infertility causes include problems in the ejection of semen, the absence or low levels of sperm. Additionally, the abnormal shape and movement of sperm can cause infertility.

“In about 50% of cases, the causes of male infertility cannot be determined. 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.”

Sources: https://www.nichd.nih.gov/health/topics/menshealth/conditioninfo/infertility

Genetic Conditions

Some genetic conditions can have a significant impact on male fertility. For example, Klinefelter syndrome, Y chromosome deletions, and cystic fibrosis can cause abnormalities in the testes. These abnormalities lead to a decrease in sperm production and quality.

These conditions can be diagnosed through genetic testing, which involves analyzing a person’s DNA to look for any genetic abnormalities.

Varicocele

The veins in the scrotum become enlarged in this condition. This leads to decreased blood flow and increased temperature in the testicles. This can lead to a decrease in sperm production and quality.

The good news is that varicocele is treatable and can be corrected with surgery or other minimally invasive procedures.

Infections

Such as sexually transmitted infections (STIs) and other bacterial infections can cause male fertility. These infections can cause inflammation and scarring in the reproductive tract, leading to a decrease in sperm production and quality.

Hormonal Imbalances

Hormonal imbalances, such as hypogonadism and thyroid disorders, can cause a decrease in testosterone levels. This leads to a decrease in sperm production and quality. They can be treated with hormone replacement therapy or other medications.

Medications

Certain medical treatments, such as chemotherapy and radiation therapy, can damage sperm-producing cells in the testes. This damage leads to a decrease in sperm production and quality.

Lifestyle Factors

These factors include smoking, excessive alcohol consumption, poor diet, Stress and exposure to environmental toxins. Smoking can lead to a decrease in sperm count and motility. Excessive alcohol consumption can reduce testosterone levels and sperm quality.

Stress also can negatively impact male fertility, and exposure to environmental toxins can cause sperm damage. Making simple lifestyle changes can improve overall reproductive health.

Azoospermia

It is a complete lack of sperm that is the cause of infertility in about 15% of male’s infertility. Azoospermia can be caused by a hormone imbalance or a blockage of sperm movement. In some cases of infertility, a man produces less sperm than normal, which is called oligospermia. (SOURCE)

The Link Between ED and Infertility

ED and infertility often coexist; both are linked to lifestyle and medical issues. Addressing Erectile Dysfunction improves overall health and can improve fertility.

Addressing Erectile Dysfunction

• Identify the underlying cause of ED.
• Manage stress and anxiety effectively.
• Consider medical treatments if needed.

The Importance of Mental Health

It is crucial for fertility. Mental health including Stress and anxiety can affect sperm production. Therapy and support groups help. Mindfulness and relaxation reduce stress.

SOURCES:

• “Specific causes include Industrial chemicals. Extended exposure to certain chemicals, pesticides, herbicides, organic solvents, and painting materials may contribute to low sperm counts. Heavy metal exposure. Exposure to lead or other heavy metals also may cause infertility. Radiation or X-rays.” URL: https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773
• “What causes male infertility? Many biological and environmental factors can impact your fertility. Possibilities include: Azoospermia: Your infertility can be related to your inability to produce sperm cells. Oligospermia: The production of low or poor quality sperm.” URL: https://my.clevelandclinic.org/health/diseases/17201-male-infertility
• “Idiopathic male infertility can be attributed to endocrine disruption due to environmental pollution, reactive oxygen species, or genetic abnormalities. 3 Medications and Lifestyle Factors Numerous substances have been implicated as causes of infertility.” URL: https://www.uspharmacist.com/article/male-infertility-an-overview-of-the-causes-and-treatments
• “Causes of male infertility include Abnormal sperm production or function due to undescended testicles, genetic defects, health problems such as diabetes, or infections such as chlamydia, gonorrhea, mumps or HIV. Enlarged veins in the testes (varicocele) also can affect the quality of sperm.” URL: https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317

SUMMARY

In conclusion, various factors can cause male infertility including genetic conditions, varicocele, infections, and hormonal imbalances. Medical treatments and lifestyle factors can also play a role. It is essential to identify any underlying medical conditions and genetic factors that may impact fertility.

Simple lifestyle changes can significantly improve overall reproductive health. Quitting smoking, limiting alcohol consumption, and following a healthy diet are beneficial steps. Managing stress levels and reducing exposure to environmental toxins can also increase the chances of conceiving.

If you suspect that you may have symptoms, Helal Medical can help, offering quick, private, and convenient testing options. You may contact us here: Facebook page

Read More About Male health:

• Boosting Male Fertility: How to Increase Sperm Count
• Prostate Health
• Semen Quality and Fertility: What Every Man Should Know
• 5 Foods That Increase Your Semen Volume and Your Health!
• What is Normal Sperm Count?

Frequently Asked Questions

Is it true that prevalence of Male infertility increased?

It appears to be. Research suggest that in the last fifty years or so, the number of sperm in the average western male’s semen has went down to about half the count used to be. As a result male infertility rate increased.

Today, about one in seven of couples (in United Kingdom) asks medical assistance to get a baby. Because They have pregnancy difficulties. In half of these cases, the male is the cause of the problem. Usually, most male infertilities cased by low sperm count.

What are the indications for Semen Analysis?

• To detect causes male infertility
• Follow up after Vasectomy
• Hypogonadism
• Storage of semen before radiotherapy

How many times can you do a sperm analysis to evaluate male infertility?

Semen analysis tests are usually repeated at least to times to evaluate man fertility status.. This is because sperm count varies from time to time, due to many reasons. So we repeat the test to get an accurate representation of the sperm count over time. A second sample is usually collected one to two weeks after the first one.

What are the causes of low sperm count?

Causes of low sperm count are also causes of male infertility causes. They include the following:

• Some medications:
  – Anabolic steroids (They affect the count significantly)
  – anti-arthritis drugs
  – Other prescription drugs (like Viagra)
• alcohol and Drugs (cocaine , marijuana )
• chemotherapy
• Diet related causes:
  – low levels of minerals such as zinc
  – low levels of vitamins, like vitamin C
• smoking (reduces the sperm’s life expectancy and sense of direction)
• stress

Does age really affect the sperm count?

Yes, age really affects the sperm count and causes male infertility. So, an older man is less potent than he was young. Once a man crosses 40 years of age the quality of his sperm declines gradually. This does not mean that an older man cannot man make his wife pregnant. He can but his chances are reduced due to the deterioration of his sperm quality. The concentration of abnormally shaped sperm increases with age.

Can smoking have lower sperm count and increase male infertility?

Smoking , reportedly , has negative effects on sperm. It reduces both the count and quality. Smokers who are not able to have children, Tobacco usually found to have a role. Scientists have found that smoking increases your chances of infertility by 30 percent.

Cell phones and laptops affect sperm count and fertility?

The heat and electromagnetic waves emitted by both cell phones and laptops have been found to affect the sperm quality. Many men are inclined to keep their cell phones in their trouser pockets close to the pelvic area and this could be damaging your sperm as your phone is constantly sending out and receiving electromagnetic signals. The heat from keeping your laptop on your lap for long durations has been known to cause DNA damage to the sperm. So, the best way to reduce the damage is by keeping the laptop in a table and not your lap, also avoid keeping cell phones in your trouser pocket.

Stress declines sperm quality. Hot tubs are relaxing and help to reduce stress, don’t they improve sperm quality?

Heat is damaging to the sperm. Soaking in a hot tub means exposing your sperm to high heat conditions and even if it relaxes and calms your body, it might not be doing any good to your sperm.

Are boxers better than briefs to keep your sperms healthy?

As long as your testes have air to breath and remain cool, briefs are fine. Men who wear briefs are not likely to become infertile. Even though boxers are ideal and provide great cooling and air circulation to the testes. There is no compulsion that you have to switch over to boxers to keep your virility. Read to know if your underwear can make you infertile.

Can cycling cause male infertility?

In fact, cycling keeps the testes cool with the movement of the legs fanning the pelvic area. There is not much restriction or pressure caused by the bicycle seat to the testes and hence the sperm are safe on a cycle. Cycling is better than driving an automobile and sitting in a seat which tends to generate heat.

Is alcohol in moderation fine or does it affect the sperms?

Occasionally, drinking alcohol is fine but drinking regularly in moderation can harm your sperm quality. Alcohol, when consumed regularly even in small quantities, begins to affect the shape of the sperms. For pregnancy to take place there is a requirement for a certain minimum percentage of normally formed sperm. So limit your alcohol to occasions.

Can abstinence improve sperm quality?

No, this is a myth. The more sperms you release the better the quality of your sperms. In fact, it has been found that infrequent sex can cause infertility. Ejaculating regularly can keep your sperm healthy and improve sperm motility. Sperm motility is the movement and swimming capability of the sperm. Sperm that can move fast and well are more likely to reach the female egg and fertilise it. So, continue to have sex regularly and ejaculate to keep your sperm quality optimum.

Some studies suggest that body weight doesn’t affect fertility, is it true?

As much as you would like for that to be true but your weight does hamper fertility. Obese people have a hormonal imbalance. When you are carrying around excess weight it produces higher levels of estrogen (the female hormone) and your testosterone (male hormone) levels are reduced. This is probably the reasons why very fat men have some feminine characteristics. The reduced levels of testosterone mean that less sperm is produced by the testes. On the other hand being too thin or underweight is also not good for fertility and could lead to a hormonal imbalance and reduce testosterone production. Men who are excessively thin have a high probability of being infertile too.

Is a vasectomy effective and safe?

Vasectomy operation is done as means of male contraceptive. It is easy and effective. But it may not be reversal. If you opt for Vasectomy, dont expect that you can get your partner pregnant in the future.
Sperm count refers to the number of sperms that should be present in a given sample of ejaculation. A normal sperm count ranges from 15 million sperm to more than 200 million sperm per milliliter (ml) of semen. With a simple semen analysis, one can know their sperm count.

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