Understanding Male Infertility

If you and your partner are having trouble getting pregnant, it can be a stressful, frustrating time. It helps to understand your options early.

In about one-third of cases, male infertility is the cause. Another third of the time, female infertility is the reason. The final third is caused by either two infertile partners or an unknown cause. About 15 percent of all couples experience difficulty getting pregnant. If you’ve been actively trying to conceive (including looking at the calendar and choosing the right days) for 12 months with no success, it’s time to talk to a doctor about getting tested. For people over the age of 30, you may want to see a doctor if you’ve had difficulty for 6 months or more, or if you suspect there may be a problem.

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Causes and Signs of Male Infertility

The most obvious sign of possible infertility is your partner not becoming pregnant despite trying. The environment needs to be just right for both sperm production and delivery in order to conceive. When men struggle with infertility, there’s usually a problem with either sperm production or delivery.

The most common causes that contribute to problems with sperm production or delivery are:

  • Sperm disorders. This means that something’s not right with how your body creates sperm. They may be abnormally shaped or move slowly. You may also have a low sperm count, in which case there may not be enough sperm (known as oligospermia) or even none at all (known as azoospermia).
  • Varicocele. This occurs when the veins in the scrotum swell. As the swollen vein blocks blood drainage, that backup can damage sperm production. Varicoceles are fairly common in men with infertility.
  • Retrograde ejaculation. When the bladder muscles don’t close during orgasm, semen flows backward into the bladder instead of out the penis. You’ll notice a dry or low volume ejaculation or cloudy urine after sex if you have this condition.
  • Obstruction. Blockages in the reproductive tract — whether caused by surgery, injury, birth, or developmental defects along the sperm’s path — stop the sperm from traveling out.
  • Cancer treatment. Chemotherapy and radiation can reduce or entirely eliminate sperm production. It’s best to talk to your doctor about fertility preservation with sperm freezing before undergoing cancer treatment.
  • Medication, hormones, and illness. Certain medications or health conditions, such as kidney failure, can cause problems with sperm production.
  • Lifestyle. Smoking, using drugs, and drinking excessive alcohol may damage sperm production and lower sperm count.

Tests and Treatment for Male Infertility

When you first talk to a doctor about infertility, you’ll answer questions about your sex life, past medical history, and lifestyle habits. Your doctor will also perform a physical exam to look for blockages, varicoceles, or other common problems with the urological tract.

A sperm count, or semen analysis, is the next step in finding where the problem lies. Your doctor will analyze a semen sample to determine whether the cause is a sperm disorder. Your doctor may also order other tests, such as an ultrasound, biopsy, or hormone profile.

Medication or surgery can correct many causes of infertility, allowing you and your partner to conceive naturally.


Medications can treat infertility that’s rooted in hormone problems, a lack of semen during ejaculation, retrograde ejaculation, or other medical issues harming sperm development.


Doctors may suggest surgery to correct blockages, a varicocele, or other physical defects that block the sperm’s passage out of the penis.

Assisted Reproductive Techniques

If your doctor can’t find the cause of infertility, or they can’t treat it by other methods, they may recommend assisted therapies such as intrauterine insemination and in vitro fertilization. This includes retrieving sperm from your body, particularly if you have low sperm count or the sperm cells have trouble moving. Doctors may inject the removed sperm directly into her egg, which they then implant into her uterus.

With ongoing advances in infertility treatment, you have many options to conceive, even if you initially have challenges. If you and your partner are having trouble conceiving, and think male infertility is the issue, talk to one of our specialists about infertility treatment by contacting the UPMC Men’s Health Center or calling 1-877-641-4636 (4MEN).

About Men’s Health Center

The UPMC Men’s Health Center evaluates and treats conditions affecting men’s sexual and reproductive health. With years of clinical experience in male sexual medicine and surgery, our team has treated a wide variety of conditions and performed thousands of surgeries. We are dedicated to providing patients the highest level of quality care. Our providers understand the intimate nature of male sexual difficulties, and we will work to help you restore your normal level of sexual function in a comfortable, educational, and discreet environment.