Overview
Male fertility is part of overall reproductive health. It involves the testicles making sperm, hormones helping that process work normally, and the body being able to release sperm during ejaculation. Problems in any of these steps can reduce the chance of pregnancy.
Key Symptoms
Male fertility problems often do not cause obvious symptoms. Sometimes the first sign is difficulty helping a partner become pregnant after regular unprotected sex over time. Some people may also notice sexual function problems, pain or swelling in the testicles, changes in ejaculation, or signs of hormone problems such as low sex drive or reduced body hair.
Causes and Risk Factors
Male fertility can be affected by low sperm count, poor sperm movement, abnormal sperm shape, or blockage that prevents sperm from leaving the body. Causes can include varicocele, prior infections, undescended testicles, hormone disorders, genetic conditions, injury, and some surgeries. Smoking, heavy alcohol use, drug use, overheating of the testicles, obesity, poor general health, some medicines, chemotherapy, radiation, and exposure to toxins or pollutants may also play a role.
Who Is Affected
Male fertility problems can affect adults of many ages and backgrounds. Risk may be higher in people with certain long-term health conditions, past testicular problems, sexually transmitted infections, or family history of infertility. Fertility can also change with age, although the effect varies from person to person.
Prevention
Not all causes can be prevented, but some steps may support reproductive health. These include avoiding tobacco and recreational drugs, limiting alcohol, protecting the groin from injury, managing long-term health conditions, and reducing exposure to harmful chemicals when possible. Getting prompt care for testicular pain, swelling, infections, or sexual health concerns may also help prevent complications.
Diagnosis and Tests
Evaluation usually starts with a medical history, sexual and reproductive history, and physical exam. Common tests include semen analysis, blood tests for hormone levels, and sometimes imaging such as scrotal ultrasound. Depending on the situation, a clinician may also recommend genetic testing, urine testing after ejaculation, or other tests to look for blockage or underlying disease.
Treatment Categories
Treatment depends on the cause. Options may include treatment of infections, procedures for varicocele or blockage, support for hormone-related conditions, changes to medicines when appropriate, and help for erection or ejaculation problems. Assisted reproductive methods may also be discussed if pregnancy is not happening naturally.
Diet and Lifestyle
General health habits can matter for fertility. A balanced diet, regular physical activity, enough sleep, stress management, and keeping a healthy weight may support hormone function and sperm health. Avoiding smoking, vaping nicotine, anabolic steroids, and recreational drugs is especially important, and it may help to avoid frequent high heat exposure to the testicles, such as hot tubs or prolonged laptop heat on the lap.
When to Seek Medical Care
See a healthcare professional if pregnancy is not happening after trying over time, or sooner if there is testicular pain, swelling, a lump, ejaculation problems, erection problems, or a history of undescended testicles, cancer treatment, or pelvic surgery. Seek care if you have symptoms of infection such as fever, burning with urination, or discharge. Early evaluation can help identify treatable causes and important health conditions.