Every November, Movember brings men’s health into focus, creating space for conversations about prostate cancer, testicular cancer, and mental health. Male fertility deserves a place in that conversation, too.
Sperm quality, hormone levels, medical history, and everyday habits can all influence fertility. Understanding these factors before trying to conceive can help men make informed decisions about their reproductive health and know when to seek support.
At Piedmont Reproductive Endocrinology Group (PREG), we believe fertility care starts with understanding the whole picture, including male reproductive health. This Movember, we’re breaking down what affects sperm quality, signs that may warrant further evaluation, and what men can expect during a fertility assessment.
How Does Male Infertility Affect Your Chances of Conceiving?
Fertility conversations often focus on women’s reproductive health, but conception involves both partners. In fact, male factors contribute to approximately half of infertility cases, whether that be independently or in combination with female factors.
Male infertility doesn’t necessarily mean you cannot have children. It means that problems with sperm production, sperm function, or delivery are making conception more difficult. You might feel completely healthy and have no noticeable symptoms, and difficulty getting a partner pregnant is often the first indication of a fertility problem.
Other signs that warrant medical attention include testicular pain or swelling, erectile dysfunction, ejaculation difficulties, or changes in sexual desire. These symptoms don’t always indicate infertility, but are worth getting checked.
When pregnancy isn’t occurring as expected, understanding fertility begins with considering both partners’ reproductive health rather than assuming where the problem lies.
What Affects Male Fertility and Sperm Health?
Healthy sperm production depends on several processes working together. The testicles produce sperm, while hormones from the brain regulate their development. The pituitary gland releases hormones that support testosterone production and sperm development. Several medical, hormonal, and environmental factors can disrupt these processes.
Common Causes of Male Infertility
- Low sperm count: Having fewer sperm reduces the likelihood that sperm will reach and fertilize an egg.
- Poor sperm motility: Sperm need sufficient movement to travel through the reproductive tract. Reduced motility affects a sperm’s ability to reach an egg.
- Abnormal sperm shape: Changes in sperm morphology sometimes accompany other abnormalities that affect fertility.
- Hormonal imbalances: Conditions affecting testosterone or other reproductive hormones can interfere with sperm production.
- Varicoceles: Enlarged veins around the testicles can affect sperm count and quality. Some men benefit from surgical treatment.
- Infections and blockages: Certain infections, including sexually transmitted infections, can cause inflammation or scarring that interferes with sperm transport.
Chronic illnesses, previous testicular injuries, genetic conditions, and certain medications also contribute to male infertility. Age is another consideration. Although men continue producing sperm throughout much of their lives, sperm quality changes with age, particularly in later adulthood.
These factors don’t affect everyone in the same way though and identifying the cause of male factor infertility requires an evaluation of your medical history and reproductive health.
How Does Male Fertility Testing Work?
For many men, the first step in fertility testing is a semen analysis, which examines sperm count, movement, shape, and other characteristics that influence fertilization. It’s a relatively straightforward way to begin investigating male infertility, although no sperm test can establish every aspect of male fertility.
What Does a Semen Analysis Measure?
A semen analysis typically evaluates:
- Sperm count and concentration: The number of sperm in your sample (a lower count can reduce the chances of fertilization).
- Sperm motility: How many sperm move and how effectively they travel.
- Sperm morphology: The proportion of sperm with a normal shape.
- Semen volume and pH: The amount of fluid in the sample and its acidity or alkalinity.
Semen analysis results can vary between samples, so your PREG fertility specialist may recommend repeating the sperm test to confirm the findings. An abnormal result doesn’t necessarily mean you cannot conceive, just as normal results don’t guarantee pregnancy.
When Is Additional Testing Necessary?
When a semen analysis identifies potential concerns, your PREG fertility specialist may recommend additional testing to investigate the cause. Your medical history and symptoms also influence which tests are appropriate.
For example, blood tests measure reproductive hormones, including testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), to identify possible hormonal imbalances. A scrotal ultrasound examines the testicles for physical abnormalities, while genetic testing may be appropriate when findings suggest an underlying condition affecting sperm production. Your PREG fertility specialist will review these results together to determine whether further evaluation or treatment is appropriate.
What Happens When Male Fertility Testing Identifies a Problem?
An abnormal test result doesn’t mean everyone needs the same fertility treatment. Some men benefit from medical treatment for hormonal disorders or surgery to address certain varicoceles and reproductive tract blockages. Others need assisted reproductive treatment, depending on sperm quality and additional fertility factors. At PREG, we offer intrauterine insemination (IUI) and in vitro fertilization (IVF) as part of our fertility care.
IUI places prepared sperm into the uterus around ovulation and sometimes suits patients with mild male factor infertility, while IVF involves fertilizing eggs in a laboratory and may be appropriate for more significant fertility concerns.
In some IVF cases, intracytoplasmic sperm injection (ICSI) involves injecting a single sperm directly into an egg. The appropriate approach depends on your diagnosis, sperm parameters, and other individual factors.
Our fertility specialists discuss these findings with you so that your treatment recommendations reflect your specific circumstances.
How to Improve Male Fertility Through Everyday Habits
Not every cause of male infertility responds to lifestyle changes, but certain habits affect sperm health and reproductive function.
Maintain a Healthy Weight
Body weight influences hormone regulation and sperm production. Men with obesity often have lower testosterone levels and poorer semen quality, while being underweight can also contribute to hormonal imbalances.
Regular physical activity and a balanced diet support a healthy weight. For men carrying excess weight, weight loss can improve sperm concentration and other semen parameters, although improvements in pregnancy outcomes are less certain.
Consider Smoking, Alcohol, and Medication Use
Smoking is associated with lower sperm count, reduced sperm motility, and changes in sperm shape. Quitting smoking supports your general health and removes a known reproductive risk factor.
Heavy alcohol intake can interfere with testosterone production and semen quality and recreational drugs and anabolic steroids can also impair sperm production.
Testosterone medications should also be taken with caution and discussed with your PREG fertility specialist because external testosterone can suppress sperm production.
Be Mindful of Heat and Environmental Exposure
The testicles function at a temperature slightly below normal body temperature, which means that frequent exposure to excessive heat, including prolonged hot tub use, can temporarily affect sperm production. Environmental toxins, metals and chemicals have also been associated with reduced sperm quality.
Sperm development takes approximately two to three months, so changes in semen parameters following lifestyle adjustments generally take time to appear. Healthy habits support reproductive health, but they don’t replace an evaluation when an underlying medical condition is present.
When Should You Seek a Male Fertility Evaluation?
For couples having regular, unprotected sexual intercourse, fertility evaluation is generally recommended after 12 months without pregnancy, however when the female partner is 35 or older, evaluation should be within six months.
Some circumstances call for earlier fertility testing, including:
- A history of testicular injury, surgery, or known reproductive conditions
- Previous cancer treatment or medications that affect sperm production
- Persistent sexual function concerns or an existing abnormal semen analysis
Cancer treatment also deserves particular attention, because chemotherapy can damage sperm-producing cells and sometimes cause lasting infertility. Discussing fertility preservation before treatment begins gives men an opportunity to understand their options when medically appropriate.
At PREG, we approach fertility evaluations with your individual medical history and family-building goals in mind. For couples trying to conceive, evaluating both partners supports a more informed discussion about treatment.
Make Male Fertility Part of the Conversation This Movember
Movember is a reminder that male reproductive health deserves a place in the conversation about fertility. Understanding your sperm health and knowing when to seek an evaluation can help you make informed decisions about family-building.
At PREG, we take a personalized approach to fertility care, considering both partners’ reproductive health and individual circumstances. Our fertility clinic works with individuals and couples across South Carolina and North Carolina to help them understand their options and make decisions with confidence.
Have questions about male fertility or sperm testing? Schedule a consultation with PREG to talk with our fertility specialists about your concerns, available testing, and treatment options that may fit your needs.
Frequently Asked Questions About Male Fertility
Can you have a normal sex drive and still experience male infertility?
Yes. Sexual function and fertility are different. You can have a normal sex drive and no noticeable symptoms while still having a low sperm count or other sperm abnormalities.
Does having a child before mean your fertility is still normal?
Not necessarily. Male fertility can change with age, medical conditions, medications, or lifestyle factors. Secondary infertility can affect men who have previously fathered a child.
Can you tell whether your sperm is healthy by looking at semen?
No. Semen appearance doesn’t reliably indicate sperm count, movement, or quality. A semen analysis is needed to evaluate these characteristics.
Does taking testosterone affect your chances of having a baby?
Yes. Testosterone therapy and anabolic steroids can suppress sperm production. Discuss your fertility goals with your healthcare provider before starting or changing testosterone treatment.
Can male infertility be treated without IVF?
Yes. Depending on the cause, options may include medication, lifestyle changes, surgery, or intrauterine insemination (IUI). Your fertility specialist will recommend treatment based on your evaluation.
