Male Infertility

Getting pregnant (conceiving) often takes a while. Some couples take two years or more to conceive. But if your partner hasn’t got pregnant after a year of regular sex and no contraception, this could be a sign of fertility problems.

? What is male infertility?

One in seven couples have difficulty conceiving. A doctor may use the word ‘infertility’ if your partner isn’t pregnant after one year of having regular sex without using contraception. But this still doesn’t mean you can’t have children naturally.

There are two types of infertility. Primary infertility. This means you and your partner have never had children together.

Secondary infertility. This is when you and your partner have had children together, but are now having problems conceiving.

Infertility can be caused by a problem that affects you or your partner. In about four out of 10 couples who can’t conceive, both partners have a condition that affects their ability to have a baby. You may have a problem with your sperm or hormone levels, or may not be ejaculating (releasing semen) properly.

Over eight out of 10 couples will conceive within one year of having regular, unprotected sex. Most couples will get pregnant within two years of trying without having any medical help. If you and your partner have been trying to get pregnant for a year without any success, there may be an underlying reason.

? Diagnosis of male infertility

Many couples don’t get pregnant straight away when they start trying for children. But if you and your partner have been trying for a year and you’re worried about your fertility, see a specialist doctor.

? How can I boost my fertility?

If you and your partner have been trying for a baby for less than a year, a specialist doctor may suggest you keep trying to conceive naturally. Some couples take two or three years to conceive without any medical help.

? Timing

Having sex every two to three days will help to make sure you’re having sex during your partner’s most fertile time of the month. This will maximise the chance of your partner getting pregnant. If you use lubricants, be aware that some of these can affect the quality of your sperm and make them less likely to fertilise your partner’s egg.

? Lifestyle and diet

You may find it helpful if you can make some changes to your lifestyle. Stop smoking or at least cut down, and don’t drink more than 14 units of alcohol a week on a regular basis. Your doctor may also suggest you lose any excess weight, because being overweight can affect your fertility.

? Heat

Some research has found that if your scrotum (which contains your testicles) is too warm, this may reduce the quality of your sperm. Several things can cause your scrotal temperature to rise. Examples include having hot baths, working in hot conditions, driving for extended periods and using laptops. It’s been suggested that wearing loose-fitting underwear may help to lower your scrotal temperature. But it’s not yet clear whether this can improve fertility.

? Medication

Some medicines, such as sulfasalazine (taken for rheumatoid arthritis or other long-term inflammation) can affect your production of sperm. Antidepressants and some medicines for high blood pressure can affect ejaculation.

? Work hazards

Some jobs involve working with certain hazards that can affect your fertility. These include heat, metals, pesticides and X-rays. If you’re worried that your work could be affecting your fertility, speak to your employer or the occupational health advisor at your workplace.

? Causes of male infertility

There are many things that can cause infertility in men. But in about a quarter of couples, doctors can’t find any specific cause.

? Sperm disorders

The most common reason for male infertility is a problem with your sperm. It may be that:

  • you don’t have enough sperm in your semen
  • your sperm don’t move as fast as they need to
  • your sperm are the wrong shape

You may have all three of these problems at the same time.

Some men who have problems with fertility have no sperm at all in their semen. This is usually caused by a condition called obstructive azoospermia. This is when the tubes (called seminal ducts) that carry sperm from your testicles to your penis are blocked. You may be born with this blockage or you may develop it after an infection or surgery, such as a vasectomy.

Hypogonadism

Your infertility may be caused by a condition called hypogonadism. This means you don’t produce enough, or any, of the hormone testosterone. Low testosterone levels may affect your sperm count, can mean you can’t get an erection, and that you have little sex drive (libido). You can have hypogonadism from birth or develop it later on, after an illness or accident. You may also develop it if you’re taking certain medicines, such as spironolactone (a water tablet or diuretic), and cyproterone (used to treat prostate cancer).

Ejaculation disorders

There are several problems that can affect how you ejaculate (release semen).

  • Erectile dysfunction is when you can’t keep an erection for long enough to have sex.
  • Retrograde ejaculation is when your semen is ejaculated backwards into your bladder rather than out of your body when you orgasm.
  • If you have delayed ejaculation, you can’t ejaculate inside your partner’s vagina. This may be a psychological problem.
  • Anorgasmia means you don’t reach an orgasm and ejaculate. This may be because you don’t have enough feeling in your penis (sometimes caused by nerve damage).

? Treatment for male infertility

  • Most treatments for male infertility need to be prescribed by a specialist fertility doctor. Our infertility treatments topic provides more detailed information about treatments available for both male and female infertility.