The majority of healthy couples will get pregnant within a year of actively trying. However, around one in seven couples may have difficulty conceiving. In terms of male infertility, it is estimated that up to 7% of men are affected, and 50% of fertility problems within a heterosexual couple are due to male factors, with around half of those being unexplained.

In this article, we’ll explore male infertility causes and treatments, as well as the signs of infertility in males.

Male infertility

What are the signs of infertility in males?

If you and your partner have been actively trying to conceive without success for 12 months or more – that means regular unprotected sex every two to three days throughout the month – then one or both of you may be infertile.

Common signs of infertility in males include:

  • Changes in sexual desire, which could indicate issues with hormone health
  • Problems maintaining an erection (erectile dysfunction), which again could be due to hormone levels
  • Pain or swelling in the testicles, which could be down to a range of conditions
  • Inability to ejaculate, or small volumes of fluid ejaculated
  • Abnormal breast growth (gynecomastia)
  • Decreased facial or body hair, or other signs of a hormonal or chromosomal abnormality
  • A lower than normal sperm count

It is important to see a doctor if you are experiencing any of the above, or have a history of testicle, prostate or sexual problems, or have undergone groin, testicle, penis or scrotum surgery.

What are some of the most common male infertility causes?

It is important to consider that male infertility can have many causes, from not making enough sperm or having unhealthy sperm, to genetic conditions such as cystic fibrosis, or genital tract blockages.

Men who have had genital infections or prostate inflammation in the past, who have experienced injury to or twisting of their testicles, or who have been through early or late puberty, may be more likely to have male infertility. Hernia repair, exposure of the genitals to high temperatures, and undescended testicles may also be potential male infertility causes.

Certain prescription medicines may also increase the risk of male infertility, such as medication for ulcers, psoriasis, high blood pressure and depression.  If you are concerned about whether your prescription medication may be affecting your fertility, please speak to your GP about alternatives.  Do not discontinue prescription medication without first consulting the appropriate medical professional.

How is male infertility diagnosed?

When it comes to diagnosing male infertility, you should make your first port of call your GP. After reviewing your health history and carrying out a physical examination, they may go on to suggest further tests. These could include:

Semen analysis

A sample is produced after 2-7 days abstinence and within 1 hour this is analysed in the laboratory where a number of parameters are checked. These could include volume of semen produced and its consistency. The number of sperm will also be counted, as well as looking at their mobility and shape.

Blood tests and other investigations

Blood tests can check hormone levels and the presence of other potential issues. Other tests may be carried out to find the cause of sperm defects, or general problems with the male reproductive system. An ultrasound may be used, for example, to look at the testicles, blood vessels and scrotum.  Genetic testing can be performed if indicated.

Testicular biopsy

If a semen analysis detects a low sperm count, or no sperm at all, then a small piece of tissue may be taken from each testicle to check for sperm.  This can act as a diagnosis as well as for treatment, as if motile sperm are retrieved they may be used for future treatment.

What are my male infertility treatment options?

Male infertility treatment will depend on what is causing the infertility. There are various treatments that may be recommended, some of which will be focused on helping your partner get pregnant. These include artificial insemination, in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), for example.

Other male infertility causes may suggest that medication will be a more suitable treatment. Hormone treatment may help where a hormonal disorder is causing the infertility. Imbalances can affect the development of sperm, and could be caused by problems in how the pituitary gland, the hypothalamus and the testes interact.   Medications such as gonadotropin therapy or antibiotics may be used to treat the cause.

Another recommendation may be surgery. If there are issues with sperm being made, developing or being ejaculated, it may be necessary to correct any swollen or twisted veins in the scrotum, which could improve the quality of the sperm.

Male infertility – what to do next

Male infertility may have many causes, and male infertility treatment will depend on those causes. Do remember though that in 40% of cases, there is an issue with both the male and female partner.

If you have been trying without success to get pregnant for a year, you should seek advice from your GP in the first instance, so that they can refer you both for investigative tests. If your female partner is aged over 35, NICE guidelines recommend that you visit your GP after 6 months of trying without success. If either of you are already aware that you could have fertility problems, you are wise to see your GP sooner.

You may also seek private fertility advice, for which there is no need to arrange a GP referral. But it is worth bearing in mind that all patients, whether self-funding or not, are entitled to NHS funded fertility investigations.

Hull & East Riding Fertility has helped create thousands of babies since it was founded in 1986. Offering a range of services for those seeking fertility assistance, we are East Yorkshire’s only registered clinic providing specialist infertility investigations and personalised treatment, both self-funded and NHS. We also offer a range of investigatory and fertility treatment planning services at our two satellite fertility clinics in York.

We would be delighted to welcome you at any of our clinics to discuss your needs. Please get in touch to let us know how we can help you.