Male Infertility: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Male Infertility?
A urologist, a doctor who treats the male reproductive organs and the urinary tract, usually leads care for male infertility. A reproductive endocrinologist, a doctor who treats hormone and fertility problems, may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is male infertility?
Male infertility means a man has not been able to get a woman pregnant after at least one year of trying.
To have a child, a male's sperm must combine with a female's egg. The testicles make and store sperm.
In about 40% of couples with infertility problems, the man is the only cause or a contributing cause. Sometimes no cause can be found.
Symptoms
The main sign is not getting a woman pregnant after a year of trying.
- Some men have trouble getting an erection, which makes sex difficult.
- Signs of low hormones, such as more body fat, less muscle, and less facial and body hair.
Causes and who gets it
The most common causes are problems with how the testicles work. Other causes are hormone imbalances and blockages in the tubes that carry sperm. Lifestyle and age can also play a role.
Some men make no sperm at all. This is called azoospermia. A hormone imbalance or a blockage can cause it. A complete lack of sperm is the cause in about 15% of infertile men.
Some men make less sperm than normal. This is called a low sperm count. The most common cause is a varicocele, an enlarged vein in the testicle.
Other problems that can affect sperm include:
- Diabetes.
- Injury to a testicle.
- Swelling of the testicles from infections such as mumps, gonorrhea, or chlamydia.
- Klinefelter syndrome, a chromosome disorder.
- Thyroid problems.
- Undescended testicles.
Sperm may also be blocked from leaving the body. A vasectomy, a surgery that cuts and seals the sperm tubes, can also block sperm. Many men with cystic fibrosis lack the tubes that carry sperm out of the testicles.
In retrograde ejaculation, sperm move into the bladder instead of out of the penis. Some medicines make this more likely.
A history of high fevers or mumps can also cause male infertility.
How doctors diagnose it
A doctor asks about health history, such as past injury to the testicles or penis, recent high fevers, and childhood diseases like mumps. The doctor also asks about low sexual desire.
Next comes a physical exam of the testes and penis. It can find a mass in the testicles or abnormal veins in the scrotum.
The doctor may ask for a semen sample to check the health and quality of the sperm. A man may need to give a sample more than once, because sperm production can vary over time.
Other tests may include:
- Blood tests for hormones, including testosterone and follicle-stimulating hormone, thyroid hormones, and prolactin.
- A testicle biopsy, where a needle is used to take sperm from the testicle.
- Genetic testing when no sperm or very few sperm are found.
Treatment
Treatment depends on the cause. When doctors can find the cause, treatment may include medicines, surgery, or assisted reproductive technology. Many couples treated for infertility are able to have babies.
When to see a doctor
If you think you may be infertile, see your doctor. There are tests that may show whether you have fertility problems.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can take your health history, do a first exam, and order basic tests. They can refer you to a urologist or a fertility specialist when needed.
Common questions
Do men cause infertility in couples?
Yes, in many couples the man plays a part. In about 40% of couples with infertility problems, the man is the only cause or a contributing cause.
What is a varicocele?
A varicocele is an enlarged vein in the testicle. It is the most common cause of a low sperm count.
How do doctors check a man's fertility?
Doctors start with health history questions and a physical exam. They may also test a semen sample.
Can male infertility be treated?
It depends on the cause. When doctors can find the cause, treatment may include medicines, surgery, or assisted reproductive technology. Many couples treated for infertility are able to have babies.
What is azoospermia?
Azoospermia means a man does not produce sperm. A hormone imbalance or a blockage of sperm movement can cause it.
Sources
- MedlinePlus - Male Infertility
- NICHD - What are some possible causes of male infertility?
- NICHD - How is infertility diagnosed?
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
