In about 4 out of 10 couples, a condition which might reduce fertility is found in the male.
The most common cause of male infertility is a problem with sperm.
- be low in number
- not be as mobile (as good at swimming) as they should be
- look abnormal when viewed under a microscope. Unusual heads or tails might mean they are not as good at getting inside the egg
Low sperm count or poor-quality sperm
Problems with sperm count are quite common. Your sperm count is considered low if you have less than 15 million sperm in a millilitre (ml) of semen.
There are many things that can cause your sperm count to be low, or for the quality of your sperm to be less than ideal.
- undescended testes (testicles that haven't 'dropped' properly) as a baby
- infections of the testes
- surgery on your testes
- enlarged veins in your testes (varicocele)
- tumours of the testes
- STIs like gonorrhoea and chlamydia
- past infections (mumps can cause a drop in sperm count but this is rarely bad enough to cause infertility)
- excessive alcohol use
- being overweight
- taking drugs like cocaine or cannabis
- performance enhancing drugs like anabolic steroids
- certain prescribed medications
- genetic disorders
- problems with the tubes that carry sperm - for example, scarring from previous operations like hernia surgeries
- hormonal problems such as hypogonadism
- reduced male hormone production
No sperm present
Very rarely, there may not be any sperm in your semen. This may happen if you have had certain medical treatments in the past such as chemotherapy. This can also happen if you have had radiation therapy on your testes.
Treating male infertility
Making some lifestyle changes can greatly improve your fertility in many cases.
This could include:
- achieving a healthy body mass index (BMI)
- stopping smoking
- reducing the amount of alcohol you drink
- stopping any illegal or performance drugs you are taking
Talk to your GP about any prescription medication you are taking, as this could be affecting your fertility.
Make sure you are having regular sex every 2 to 3 days.
Speak to your GP if you are experiencing any sexual problems.
You might be prescribed medication by:
- a specialist in hormones (endocrinologist)
- a specialist in the urinary tract (urologist), or
- your GP
Medication can be prescribed for men with an underlying hormonal problem that affects sperm count.
Medication may also be prescribed if you are having difficulty getting or maintaining (keeping) an erection.
Surgery might be recommended if you have:
- a blocked sperm duct (vas deferens)
- a varicocoele (enlarged veins in your testes)
Treatments like IVF (in vitro fertilisation) and intracytoplasmic sperm injection (ICSI) can be successful if you have:
- low sperm count
- sperm that is less mobile or abnormal in shape or form
Conceiving with donor sperm may be recommended if:
- you are not producing any sperm
- your sperm are very abnormal