Common Causes of Male Infertility

Common Causes of Male Infertility

If you have been trying to have a baby without success for a period of 12 months and you have been having sex at least twice a week, both you and your partner should see a Doctor for infertility.  If you know or suspect of factors that could have an impact on your chances of conceiving a baby, you should seek help earlier on.

For infertility, 30% are caused by male factor only.  Another 30% are mixed male and female factors.  Therefore, male factors account for about 60% of infertility couples and play a major role.

After ejaculation, sperms can survive about 3 days in the genital tract but the eggs need to be fertilized within 24 hours after ovulation.  After ovulation, the cervical mucous also undergoes changes blocking further sperm entrance.  As such, the couple needs to have sex within 3 days and before ovulation.

Most common causes of male infertility are:

  • Abnormality in sperm production
  • Obstruction or absence of sperm ducts leading from the testes
  • Hormonal problems
  • Genetic abnormality


Abnormality in Sperm Production

The three most important elements in semen analysis are:

  • Sperm count more than or equal to 15 x 106/mL. Low or total absence of sperms significantly affect fertility. Common causes are:
    • Testicular injury
    • Undescended testicles
    • Twisted testes (torsion)
    • Cancer treatment like Radiotherapy or Chemotherapy
    • Genetic effect
    • eg Micro-deletion of Y genes; Klinefelter Syndrome; Downs Syndrome
    • Medication, especially anabolic steroid
    • Sexually transmitted disease (STD)
    • Varicocele
    • Sperm duct agenesis or obstruction
    • Vasectomy
  • Sperm motility: progressive forward motility more than or equal to 32%. Good sperms have tails that propel them through the woman’s reproductive tract.
  •  Sperm morphology: normal morphology of equal or more than 4%. Abnormal morphology affects sperm motility and the ability to penetrate the surface of the ovarian eggs.

Tips on the collection of a good semen sample

  •  2 to 3 days abstinence, not the longer the better
  • The fresh semen sample should be processed within 2 hours of ejaculation
  • Every drop is important to be collected inside a sterile container
  • Do not use regular condoms to collect semen (there are special condoms that will not affect sperms)
  • Keep the sample in a warm environment during transport

Other male fertility problems

  •  Functional:
    • impotence
    • ejaculation problems
      • failure to ejaculate
      • premature ejaculation
      • retrograde ejaculation into the bladder
    • side effect from prostate surgery
    • medical conditions
      • diabetes
      • multiple sclerosis etc
    • spinal cord injury
  • Hormonal problems (less common)
    • Thyroid disease
    • Pituitary gland disease
    • Haemochromatosis etc


Most male factor infertility will need assistance and treatment from Specialist Doctors. 

A large number will require IVF treatment.


Lifestyle changes that may improve male fertility include:

  •  Stop smoking
  •  Limit alcohol intake
  • No illicit drugs eg. Cocaine, heroin, marijuana
  • Keep testicles cool eg. avoid hot baths, tight underwears, hot spas, sauna and avoid putting laptops/computers on the lap
  • Weight control:  overweight causes reduction in sperm count
  • Well balanced diet
  • Avoid lubricant with sex:  lubricants can damage or kill sperms
  • Avoid contact sports that are likely to cause testicular injury
  • Avoid regular cycling exercises because of pressure and impact of bicycle seats on the testicles.  The same concerns would include horse riding, bull riding etc.
  • Avoid toxins and certain chemicals: lead, mercury, pesticides and certain paints etc.
  • Avoid certain medication and drugs especially anabolic steroids

You may need to discuss your medication with your Doctor

Infertility is a couple’s problem and so both partners should get their investigations done at the same time.  Infertility can be a sign that you have other undiagnosed health concerns and this would be important to get it checked out as well.