Male Infertility

Approximately 15 percent of couples are infertile. This means they aren't able to conceive a child even though they've had frequent, unprotected sexual intercourse for a year or longer. In about half of these couples, male infertility plays a role.

Male infertility is due to low sperm production, misshapen or immobile sperm, or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices and other factors can play a role in causing male infertility.

Not being able to conceive a child can be stressful and frustrating, but a number of male infertility treatments are available.

Symptoms

The main sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms. In some cases, however, an underlying problem such as an inherited disorder, hormonal imbalance or a condition that blocks the passage of sperm may cause signs and symptoms. Male infertility signs and symptoms may include:

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The inability to conceive a child
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Problems with sexual function — for example, difficulty with ejaculation or difficulty maintaining an erection (erectile dysfunction)
Pain, swelling or a lump in the testicle area
Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality
Having a lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate)

Causes

Some other causes of male infertility include:

Illegal drug use. Anabolic steroids taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. Use of cocaine or marijuana may temporarily reduce the number and quality of your sperm as well.
Alcohol use. Drinking alcohol can lower testosterone levels, cause erectile dysfunction and decrease sperm production. Liver disease caused by excessive drinking also may lead to fertility problems.
Occupation. Certain occupations can increase your risk of infertility, including those associated with extended use of computers or video display monitors, shift work, and work-related stress.
Tobacco smoking. Men who smoke may have a lower sperm count than do those who don't smoke. Secondhand smoke also may affect male fertility.
Emotional stress. Stress can interfere with certain hormones needed to produce sperm. Severe or prolonged emotional stress, including problems with fertility, can affect your sperm count.
Weight. Obesity can cause hormone changes that reduce male fertility.
Prolonged bicycling. Prolonged bicycling is another possible cause of reduced fertility due to overheating the testicles. In some cases, bicycle seat pressure on the area behind the testicles (perineum) can cause numbness in the penis and erectile dysfunction.

When to see a doctor

See a doctor if you:

Are unable to conceive a child after a year of regular, unprotected sexual intercourse
Have erection or ejaculation problems, low sex drive, or other problems with sexual function
Have pain, discomfort, a lump or swelling in the testicle area
Have a history of testicle, prostate or sexual problems
Have had groin, testicle, penis or scrotum surgery