Doctor explains causes of male infertility

What Are the Causes of Male Infertility?

10 min read


05 Oct 2023

Grab your cheat sheet

  1. What Is Male Infertility?
  2. What Causes Male Infertility?
  3. Does Low Testosterone Cause Infertility?
  4. How Is Male Infertility Diagnosed?
  5. What Can You Do (if Anything) To Improve Fertility?
  6. Natural Ways To Boost Testosterone

As men, we can be a little reluctant to open up about issues like fertility. But, we really shouldn’t shy away from it.

There’s no reason to keep problems to yourself, especially if you’re looking into something that’s worrying. Opening up will set your mind at ease or put you on the path to a solution.

The first step to doing that is to find out more about a topic. So, with that in mind, let’s take a look at male infertility, testosterone, and the link between them—as well as what you can do to boost your testosterone levels.

What Is Male Infertility?

The first thing to say here is that infertility doesn’t automatically mean conception is impossible. Male infertility covers a range of issues, it can be caused by any number of reasons, and you can often improve or treat the situation.

From a medical perspective, infertility is typically defined as a couple’s or person’s inability to fall pregnant after a year of actively trying to conceive a child. 

This opens things up a bit from a treatment perspective, as we now see that infertility doesn’t necessarily suggest irreversible damage or long-term improper functioning.

Of course, there are medical conditions that will, unfortunately, prevent couples from ever being able to conceive, but for the majority of people, there are steps they can take to remedy the situation and improve their chances of conception.

Man and woman who have conceived

But, the nature of fertility itself can make it hard to determine the root cause. Could the issue lie with just one member of the couple? If so, which one? Could it be both? Are there any chemical or hormonal imbalances? Or is it a more physical or structural issue?

Fertility is complicated. It requires lots of conditions to be just right and fall into place at the appropriate time. So, any number of things can cause disruption to the process of conception.

What Causes Male Infertility?

There are many reasons why a couple might be unable to fall pregnant despite months of frequent and unprotected sexual intercourse, including:

  • Problems with sperm (e.g. quantity, production, delivery, shape, motility)

  • Physical issues (e.g. swollen veins in the scrotum, blockages or obstructions somewhere along the male reproductive tract)
  • Interaction effects to medications (e.g. for some cancer treatments, depression, or high blood pressure)

  • Genetic diseases or medical conditions (e.g. cystic fibrosis, diabetes)

  • Unhealthy lifestyle or habits (e.g. smoking, drug use, drinking, poor diet)

  • Immunity issues (e.g. infection, anti-sperm antibodies)

  • Hormonal problems (e.g. pituitary gland issues, low testosterone levels)

  • As you can clearly see, there are a whole host of things that can impair fertility. But one of the most prevalent issues, and one of the most treatable, concerns testosterone levels.

    Does Low Testosterone Cause Infertility?

    You may not have considered your testosterone levels to be linked to fertility, but they can play a role—particularly when it comes to low sperm count.

    Testosterone is a primary male sex hormone, so it makes sense that it can affect fertility in a man if his levels are too low.

    Hypogonadism (the medical term for when the testes don’t produce enough testosterone) can have a direct impact on fertility by decreasing the quantity and quality of sperm. It can also have a more indirect effect on fertility efforts by potentially reducing sex drive and causing erectile dysfunction or ejaculation problems.

    Man has erectile dysfunction

    If your testosterone levels are lower than normal, then you are still able to produce sperm, but there may be some issues with semen quality or total sperm count.

    It’s worth mentioning here as well that sperm and semen aren’t the same thing: sperm is one of the components of semen, along with other fluids from the prostate, seminal vesicles, and the bulbourethral glands. It’s the sperm contained in your seminal fluid that fertilises a woman’s egg after ejaculation.

    So, what constitutes a normal sperm count? Well, actually, there’s quite a wide scope here. A millilitre (ml) of semen that contains anywhere between 15 million and 200 million sperm is considered to be within the normal range—and it only takes a single sperm for conception to happen.

    Lots of factors can cause your testosterone levels to drop, not least of all aging. From around the ages of 30 to 40, your testosterone levels begin to naturally decline by around 1-3% per year—this is known as andropause, and is often referred to as the male menopause.

    This comparison with female menopause isn’t particularly helpful, though and isn’t an accurate one, either. Whereas the decline in oestrogen levels in women is fairly sudden and steep during menopause, the drop in a man’s testosterone levels is much more gradual.

    Reduced testosterone doesn’t have to be a cause for alarm, and may not even be that noticeable for some. But, there are a few key things to look out for that may suggest your T-levels are dropping, such as:

    Man losing his hair

  • Increased body fat
  • Loss of muscle mass
  • Low energy levels
  • Irritability or moodiness
  • Hair loss
  • Reduced sex drive
  • Erectile problems
  • Orgasm trouble (e.g. premature ejaculation)

  • These symptoms are all fairly easy to spot, so between yourself and the people in your life you will likely recognize if and when any of these changes happen. Male fertility problems related to testosterone, on the other hand, aren’t quite so obvious.

    The way that low testosterone levels impact fertility is mostly through sperm production.

    There are many aspects to what constitutes healthy sperm. The most well-known is sperm count (i.e. the quantity of sperm you are creating), but there are other factors that may lead to a reduced chance of conception and impair your sperm’s ability to fertilise your partner’s eggs, such as:

  • Volume (the amount of sperm per ejaculate)
  • Concentration (number of sperm per ml)
  • Velocity (how fast your sperm travel)
  • Motility (how well they move, e.g. in a straight line or not)
  • Viability (what percentage of sperm are alive and mobile)
  • Viscosity (how quickly your semen liquifies)
  • Shape
  • Size
  • Colour
  • pH level (i.e. if they are too acidic)

  • If your testosterone levels are too low, then sperm parameters like these can be affected—which is why boosting your testosterone can be an important factor in fertility.

    How Is Male Infertility Diagnosed?

    The strange thing about infertility is that infertility is itself the symptom. The way that most men find out they have fertility issues is through being unable to impregnate a female partner—so it is this lack of conception that leads to the diagnosis. It’s only after this point that you can get tests and assessments.

    Depending on the underlying reasons for the inability to conceive, there may also be other symptoms that go hand in hand with the infertility – which can help diagnose the main cause.

    A semen analysis can reveal any issues with your sperm profile (such as low sperm count, mobility issues, or misshapen sperm). Additional tests, including an ultrasound of your testicles, can determine if there are any structural issues or blockages.

    Man visits doctor about male infertility

    If any of these reveal that you have few or no sperm, then a testicular biopsy may be required for further evaluation.

    Before all of that, though, your physician may indicate that a blood test is the best first step. Taking a blood test can show any problems related to your hormone levels, as well as rule out other causes of male infertility.

    What Can You Do (if Anything) To Improve Fertility?

    One of the first things most people think is that they’ll require some form of hormone therapy or testosterone replacement. But, this can actually have the opposite effect of what you want, by limiting your ability to create healthy sperm.

    While things like patches, creams, and injections may introduce exogenous testosterone into your bloodstream, your testes will receive signals to stop making their own testosterone as a result (therefore lowering your sperm count or creating poor-quality sperm). 

    The rest of your body may be flowing with additional testosterone, but levels will be reduced in the testes—which is where it matters for healthy sperm production. So, this is not actually recommended for anybody wishing to impregnate their partner.

    Woman comforts male partner

    So, what can you do to improve fertility?

    This really depends on the underlying cause. A full health assessment with your healthcare provider can hopefully steer you in the right direction if there is a medical issue and fertility treatment is required.

    Lifestyle Tweaks

    There are also things you can do at your end to improve your chances of conception, especially if low testosterone levels are behind your fertility problems in some way.

    Lifestyle factors play a huge role in all aspects of our health, so why should testosterone production be any different?

    The first thing to do is take stock of your bad habits and make some healthy adjustments. Smoking, recreational drugs, and alcohol all have a negative impact on testosterone levels, as do a poor diet and lack of sleep. 

    Start with these areas by quitting your vices, eating healthier, exercising more, and getting some good quality slumber.

    Man sleeps to boost testosterone

    Mental Health Care

    There could also be a psychological component affecting your testosterone levels. Stress, anxiety, depression, and low self-esteem can all be contributing factors to how much testosterone your body is able to produce. 

    It’s easier said than done to overcome these, of course, but your mental health is important. Simply knowing there could be an issue in this area can at least put you on the path to getting a handle on things.

    T-Boosting Supplements

    Finally, you can improve your testosterone levels naturally through supplementation.

    There are several ingredients to look for in supplements that can boost your levels of testosterone without the need for medical intervention.

    D-aspartic acid (or DAA, as it’s commonly known) is an amino acid that plays a crucial role in your pituitary gland being able to create luteinizing hormone. This, in turn, can boost your overall testosterone levels.

    Panax ginseng and ashwagandha are two naturally occurring ingredients that have a huge amount of scientific support behind them regarding their ability to increase and support healthy testosterone levels. 

    Panax ginseng is particularly useful as a libido booster—giving you extra energy and improving your sex drive, should it have dipped at all.

    Likewise, the compounds found in a plant called fenugreek can also enhance your sexual function, reinvigorate your sex drive, and improve your sperm profile. 

    It does this by raising the levels of free testosterone in your blood, as well as having a significant effect on your total serum testosterone (which includes both free testosterone and the testosterone that is bound to proteins in your body).

    Do make sure that you check in with your doctor if you have any questions or concerns about fertility, though. 

    Meanwhile, take some time and make the effort to do the things mentioned above to increase your testosterone levels naturally. Remember: reduced testosterone just means a lower likelihood of reproduction—so it feels like a no-brainer to do whatever you can to improve that likelihood, especially when it can be something as simple as taking a daily supplement.

    Natural Ways To Boost Your Testosterone Levels

    One of the great benefits of using a testosterone-boosting supplement is that it raises your testosterone levels naturally and safely. High-quality ingredients are able to get your body to produce increased levels of its own testosterone without having to introduce external forms of male hormones or dangerous anabolic steroids into your body.

    The ingredients used in TestoPrime have all been thoroughly studied and proven to have a positive impact on the amount of testosterone you can produce. Fenugreek and Panax ginseng are particularly effective at revitalising your libido and enhancing sperm production. DAA helps create the luteinizing hormone that is responsible for testosterone production in the testes, as does ashwagandha.

    All of this can lead to healthier sperm parameters and a boost to your sex drive

    If low testosterone levels are affecting your sex life and fertility,  supplementing your diet with a natural testosterone booster should be your first port of call to get those levels back up where they belong.