About 1 in 5 couples experience infertility, and male factors are involved in roughly half of those cases. In men, infertility is most often linked to problems with sperm production, function, or delivery. Hormonal imbalances, blockages, genetic conditions, lifestyle choices, and chronic health issues can all contribute to male factor infertility.

Unlike many health conditions, male infertility often does not cause noticeable symptoms. In many cases, one of the first clues that something may be wrong is when a couple has not conceived after 12 months of regular, unprotected intercourse (or after 6 months if the female partner is over 35).

So how can you tell when male factor infertility is involved, especially when there are no clear symptoms?

In this article, we break down the most common causes of male infertility, how to know if it may be affecting you, and what testing can reveal.

What Is Male Infertility?

The World Health Organization (WHO) defines male infertility as the inability of a man to cause pregnancy in a fertile female partner after 12 months or more of regular, unprotected intercourse. According to the WHO, male factor infertility is solely responsible for about 20% of infertility cases and is a contributing factor in another 30-40% cases of infertility.

Unlike many health conditions, male infertility often comes without obvious symptoms. Many men feel perfectly healthy and yet still receive abnormal semen test results. That is why semen analysis is often the first and most important step in the diagnostic process.

Notably, male infertility is not a disease but a clinical finding typically identified through semen analysis and followed by further evaluation such as hormone testing, physical examination, or imaging when appropriate. The good news is that many causes are identifiable and treatable with lifestyle changes, medical care, or fertility treatments.

Common Causes of Male Infertility

Several conditions can impair sperm production, delivery, or function. Some of the most common causes include:

  • Varicocele: Enlarged veins in the scrotum that raise testicular temperature and reduce sperm quality.
  • Low testosterone or hormonal imbalance: Can affect sperm production, sex drive, and overall fertility.
  • Obstructions: Blockages in the vas deferens or ejaculatory ducts can prevent sperm from being released.
  • Genetic abnormalities: Issues like Klinefelter syndrome or Y chromosome deletions can disrupt sperm development.
  • Infections: Past STIs, mumps, or prostatitis may damage reproductive structures.
  • Lifestyle factors: Smoking, heavy alcohol, cannabis use, anabolic steroid use, obesity, heat exposure (hot tubs, laptops), and environmental toxins can impact sperm quality.

In some cases, no clear cause is identified, a condition known as idiopathic male infertility, which accounts for an estimated 10% to 20% of cases. These men may have normal semen parameters but are still unable to achieve pregnancy with a fertile partner, underscoring the complexity of male reproductive health.

How to Know If You Might Be Infertile

While the only way to confirm male infertility is through testing, certain signs and symptoms may suggest something is wrong. These clues don’t always point to a specific diagnosis, but they can indicate when it’s time to get evaluated.

Common Clues to Watch For:

  • You have been trying to conceive for 6-12 months with no success. This is the single most important sign, especially if your partner is under 35.
  • Low semen volume or dry ejaculation. This could suggest a blockage, retrograde ejaculation, or a congenital issue.
  • Erectile dysfunction or low libido. Sexual performance issues can signal underlying hormonal imbalance or vascular problems.
  • Testicle swelling, pain, or lumps. These could indicate a varicocele, past injury, or infection affecting sperm quality.
  • Visible signs of hormonal imbalance. Reduced facial or body hair, fatigue, breast tissue development (gynecomastia), or mood changes may suggest low testosterone.
  • Abnormal semen analysis results. This is the most definitive indicator. Low sperm count, poor motility, or abnormal morphology are strong predictors of male infertility.

If you are experiencing any of these symptoms or have been trying to conceive without success, contact our fertility specialists or book a fertility assessment to better understand your reproductive health and explore your options.

How Male Infertility Is Diagnosed

Semen analysis is the standard starting point for evaluating male infertility. It measures sperm count, movement (motility), shape (morphology), and overall semen quality. In many cases, this test provides enough information to guide next steps. However, depending on your results and medical history, additional testing may be needed:

  • Hormone testing: blood work to assess testosterone, FSH, LH, and other hormones that regulate sperm production.
  • Scrotal ultrasound: imaging to check for varicoceles, blockages, or other structural issues.
  • Genetic testing: used in cases of very low or absent sperm count to identify potential chromosomal abnormalities.
  • Urinalysis: may be used to screen for infections, diabetes, or retrograde ejaculation.
  • Testicular biopsy: in select cases, a small tissue sample is taken to determine if sperm are being produced inside the testicles.

Our fertility doctors can recommend further testing based on your specific results and situation.

Can Male Infertility Be Treated?

In many cases, yes. Treatment depends on the underlying cause, but even when a specific cause is not identified, there may still be options to improve fertility.

Common approaches include:

  • Lifestyle changes: quit smoking, limit alcohol or cannabis use, manage your weight, avoid or reduce heat exposure to the testicles, and stop testosterone or anabolic steroid use.
  • Medical or hormonal treatment: for men with low testosterone, pituitary disorders, infections, or other hormonal imbalances, medications may improve hormone levels, stimulate sperm production, or address underlying conditions that affect fertility.
  • Surgical options: procedures like varicocele repair or vasectomy reversal may improve sperm quality or restore sperm flow.
  • Fertility treatments: in some cases, IUI, IVF, IVF with ICSI, or other Assisted Reproductive Technologies (ART) may be recommended to help achieve pregnancy.

Our team can help determine the most appropriate next steps based on your test results, your goals, and your partner’s fertility status. Contact us to schedule a consultation and explore your options.

Learn About Solutions to Low Sperm Quality From Dr. Zhang

FAQs: Signs of Male Infertility 

What are the most common signs of male infertility?

In many cases, there are no obvious symptoms. However, some men may notice low semen volume, erectile dysfunction, testicular pain or swelling, or signs of low testosterone such as fatigue or reduced body hair. For most, the first sign is simply not being able to conceive after 6–12 months of trying.

The main test is a semen analysis, which evaluates sperm count, motility (movement), shape, and other parameters. Additional testing may include hormone panels, imaging, and genetic tests.

Yes. Ejaculation is not the same as fertility. Some men produce semen that contains little or no sperm (a condition called azoospermia), which can only be diagnosed through semen analysis.

Low sperm count does not always mean treatment is necessary. If your partner has no fertility issues and your sperm motility and shape are normal, natural conception may still be possible. Our fertility specialists can help assess whether treatment is necessary.

No. Male and female factors often co-exist. That is why both partners should be evaluated if conception has not occurred after 6–12 months.

In many cases, yes. Treatment options depend on the cause and may include lifestyle changes, medication, surgery, or fertility treatments like IVF or IUI.

It can, especially if caused by lifestyle factors or temporary conditions. Because sperm regenerate every 2-3 months, positive lifestyle changes may lead to improved semen results over time.

Moving Forward With Confidence

If you suspect something may be wrong – or simply want answers – testing is the first step. Male infertility is more common than most people realize, and many cases are treatable with the right diagnosis and care.  Call us at (347) 970-8479 or schedule your initial consultation with New Hope Fertility Center today.

New Hope Editorial Team

Written by the New Hope Editorial Team

As experts in IVF and Assisted Reproductive Technologies, we are committed to educating and empowering people on their fertility journey with accurate information and compassionate care.