21 causes of infertility in males


April 22, 2018

21 causes of infertility in males |

Up to 15% of sexually active couples struggle with infertility and in many African settings, the woman often gets the full blame. It is however estimated that it is a roughly even distribution: the woman is responsible in a third of the cases, the man is at fault in another third and both are contributory in the remaining third. In short for any childless couple, the problem is from the man’s side in about half of the time. 

Here are reasons a man may be infertile:

1. Low sperm count (oligospermia)

Most men have between 20-150 million sperm per millilitre of semen. But men who have low sperm count (less than 15 million sperm per millilitre of semen) or poor quality sperm often find it had to get a woman pregnant. There are many causes of this condition and there are a number of solutions that can treat low sperm count.

2. Varicoceles

These enlarged veins on the testicles that are present in over a third of men who are infertile.  

3. STDs

Some sexually transmitted diseases can cause damage to parts of the reproductive system, like the testes, prostate, urethra or epididymis. These can affect the production and transportation processes of sperm. This is a good reason to prevent yourself from getting STDs.

Treating STDs may lead to recovery, with resumed production of healthy sperm again. However, if considerable destruction has already occured, then the condition may be permanent.

4. Mumps

Mumps is a fairly common childhood disease. If a male gets it after attaining puberty, there is a higher chance that the viral infection can affect one or more testes, leading to permanent damage.

5. Sexual frustration

Problems with the sex act itself may be responsible for infertility. Some men just do not enjoy having sexual intercourse with their partner. This may be due to psychological, emotional, or relationship problems; or even out of personal choice. This may be difficult for their spouse to understand. 

6. Erectile dysfunction

Popularly referred to as ED or not being able to get it up occurs when a man finds it difficult to have or sustain an erection long enough. There are several options for handling ED.

7. Ejaculation issues

Problems with ejaculation can be the reason for infertility in males: Premature ejaculation, when a man cannot stop himself from ejaculating too early and retrograde ejaculation, where produced sperm find their way into the urine.

8. Blockage

Some males have had blockages along their reproductive system from birth while for others it is due to injury, surgery or infections. This would reduce the amount of sperm that gets out of the penis and may result in dry orgasms.

9. Undescended testes

For most male babies, testicles ‘drop’ into the scrotum late in pregnancy, or at most, by 3 months. If any or both of the testes fail to descend, then surgery may need to be done quickly so that the affected testis does not get permanently damaged by the relatively hot condition inside.

Unfortunately, if an adult (or any male older than 2 years) still has one or both testes undescended, then permanent damage is most likely to have occurred, due to the higher temperature inside the body. Surgery may be recommended to avoid testicular cancer.

10. Genetic abnormalities

One such is Klinefelter’s syndrome is a condition in which a boy is born with an XXY sex chromosome type, instead of XY. Infertility and gynaecomastia (male boobs) are common features of Klinefelter’s syndrome. The good news is that genetic abnormalities are rare.

11. Hormonal imbalance

Deficiency of some hormones produced in the pituitary gland can affect both the production of sperm as well as libido.

12. Nerve dysfunction

Spinal cord injury or surgery, autoimmune disorders like Multiple Sclerosis (MS) and can affect the pelvic floor and affect fertility. However, Diabetes Mellitus (DM), a fairly common disease can result in nerve problems that result in erectile dysfunction, reduced sperm count, lower semen level and retrograde ejaculation when poorly controlled. 

13. Medications

Some types of hormonal replacement therapy, cancer treatment and some drugs for treating mental illnesses may lead to infertility in men.

14. Surgery/radiotherapy

Infertility may be a complication of surgical procedures carried out in a man’s reproductive system. Also, cancer radiotherapy can seriously damage the cells of the testes.

15. Drug abuse

Abuse of anabolic steroids (commonly used by bodybuilders), marijuana (weed), cocaine and other illicit drugs can shrink the testes.

16. Smoking/alcoholism

Smoking cigarettes or excessive drinking can significantly lower sperm count and reduce the quality of sperm.

17. Obesity

Numerous studies show that men who are overweight are more likely to produce little or no sperm than those at their ideal weight and for obese men, that chance is exponentially increased.


18. Stress

Chronic stress has been linked to low sperm count and infertility. Here are some ways to combat stress, raise your happiness levels and of course, make a baby too!

19. Occupational hazards

If you are exposed to radiation or X-rays at your workplace, then make sure that you get the appropriate protective gear, which are tested regularly. Handling toluene, benzene and other volatile chemicals, as well as pesticides, can also deplete your sperm count and exposure to heavy metals like mercury can similarly be harmful. Many of these substances can

20. Overheated testicles

Regular exposure of the testes to heat can lead to low sperm count, decreased motility. Right now, you might even be practising some things that can cause overheated testicles.

21. Unknown

In a good number of cases, a thorough evaluation is done, including proper history taking, various tests, done repeatedly, yet there is no apparent cause. 

Final word

There are so many causes of infertility in males. While, you have no control over some causes, by making some health, occupational and lifestyle changes, you may be able to drastically improve your chances of having a healthy baby.

Do you know anyone who may need some health advice in any aspect, do let them know that they can have an online consultation with any of our doctors via audio/video call or chat on the DoctorDial platform.


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