Male infertility is far more common than people think. In fact, male factors contribute to about 40–50% of infertility cases. Yet, it often goes undiscussed, leaving many men feeling isolated or ashamed. The good news is that most causes of male infertility are identifiable—and many are treatable.
Here are the five most common causes, explained simply.
1. Low Sperm Count (Oligospermia)
What it means: A man’s ejaculate contains fewer sperm than normal.
- A healthy sperm count is usually above 15 million sperm per milliliter.
- Low sperm count reduces the chances of sperm reaching and fertilising the egg.
Causes may include: hormonal imbalances, genetic conditions, lifestyle factors (smoking, alcohol, obesity).
Treatment options:
- Lifestyle changes (nutrition, exercise, quitting smoking).
- Medications or hormone treatments.
- Assisted reproduction like IUI or IVF, sometimes with ICSI.
2. Poor Sperm Motility (Asthenozoospermia)
What it means: Sperm are present but don’t swim well enough to reach the egg.
Causes may include: infections, varicocele (enlarged veins in the scrotum), exposure to toxins, or genetic factors.
Treatment options:
- Correcting underlying issues (treating infection, repairing varicocele).
- Using ART techniques where sperm are directly placed in the egg (ICSI).
3. Abnormal Sperm Shape(Morphology Issues)
What it means: Sperm may have misshapen heads or tails, making it harder to penetrate and fertilize an egg.
Causes may include: genetic defects, heat exposure, toxins, or infections.
Treatment options:
- IVF with ICSI is often recommended, since embryologists can select the healthiest sperm under a microscope.
4. Blockages or Structural Problems
What it means: Sperm production may be normal, but blockages in the reproductive tract prevent sperm from being ejaculated.
Causes may include: vasectomy, congenital absence of the vas deferens, scarring from infections or surgery.
Treatment options:
- Surgery to remove the blockage.
- Sperm retrieval techniques (TESA, PESA, micro-TESE) combined with IVF/ICSI.
5. Hormonal Imbalances
What it means: Hormones like testosterone, LH, and FSH regulate sperm production. If these are out of balance, sperm may not develop normally.
Causes may include: pituitary gland disorders, thyroid problems, or anabolic steroid use.
Treatment options:
- Hormone replacement or medication to correct imbalances.
- Treating underlying conditions.
Other Contributing Factors
- Lifestyle: smoking, heavy alcohol use, obesity, drug use.
- Age: Sperm quality declines gradually with age, though men remain fertile longer than women.
- Environmental exposures: heat (saunas, hot tubs), toxins, radiation.
Emotional Considerations
A diagnosis of male infertility can feel like a heavy blow. Many men struggle with feelings of shame or inadequacy. But infertility is a medical condition—not a reflection of masculinity.
Support from partners, counseling, and open communication can help men cope and move forward with treatment confidently.
Questions to Ask Your Doctor
- What did my semen analysis results show?
- Which of the five main factors is affecting me?
- Can lifestyle changes improve my fertility?
- What medical or surgical treatments are available?
- What assisted reproductive technologies (like ICSI) could help us conceive?
Important Disclaimer
Treatment options and availability vary depending on country and clinic regulations. This article is for educational purposes only and does not replace medical advice. Always consult a licensed fertility specialist for personalised recommendations.
Final Thoughts
When Alex first learned he had low sperm motility, he felt crushed. But with treatment and IVF with ICSI, he and his partner welcomed a healthy baby boy.