Male infertility affects thousands of couples across the UK each year. If you and your partner have tried to conceive for over a year without success, you may feel confused, frustrated, or even embarrassed. I want to reassure you that male infertility is common, treatable in many cases, and nothing to feel ashamed about.
As a medical professional working in reproductive health, I regularly see men who assume fertility problems always stem from women. In reality, male factors contribute to around 40–50% of infertility cases. In this article, I will explain the lesser-known causes of male infertility, what signs to watch for, and what you can do next.
What Is Male Infertility?
Male infertility occurs when you struggle to achieve pregnancy because of issues with sperm production, sperm function, or sperm delivery. Healthy sperm need:
- Adequate numbers (sperm count)
- Good movement (motility)
- Normal shape (morphology)
- Clear pathways for ejaculation
Any disruption in these areas can reduce your chances of conception.
1. Varicocele: Enlarged Veins in the Scrotum
A varicocele refers to enlarged veins inside the scrotum. You can think of it as similar to varicose veins in the legs. It affects about 15% of men and is one of the most common reversible causes of infertility.
Why it affects fertility:
- Raises testicular temperature
- Reduces oxygen supply to the testes
- Impairs sperm production
You may not notice symptoms, although some men report a dull ache or heaviness. A simple physical examination or ultrasound can detect it. Surgery can improve sperm quality in many cases.
2. Hormonal Imbalances
Your brain controls sperm production through hormones. The hypothalamus and pituitary gland signal the testes to produce testosterone and sperm.
If you have low testosterone or abnormal levels of FSH and LH, sperm production can fall.
Possible causes:
- Pituitary disorders
- Obesity
- Long-term stress
- Anabolic steroid use
Many men use testosterone supplements without medical supervision, thinking they improve virility. In fact, external testosterone can shut down natural sperm production.
3. Silent Infections
Infections in the reproductive tract may cause scarring or blockages without obvious symptoms.
Conditions such as:
- Epididymitis
- Prostatitis
- Sexually transmitted infections (STIs)
Chronic inflammation can damage sperm or block sperm transport. If you have had pain, swelling, or urinary symptoms in the past, you should discuss this with your GP.
If you are interested in supportive approaches for inflammation, you may also wish to read about Herbal Remedies for Epididymitis and explore options for a Natural Treatment for Epididymitis alongside medical care.
4. Genetic Conditions
Some men inherit conditions that interfere with sperm production.
Examples include:
- Klinefelter syndrome
- Y chromosome microdeletions
- Cystic fibrosis gene mutations
You may have no visible symptoms apart from infertility. Genetic testing becomes important if your sperm count is extremely low or absent.
5. Undescended Testicles
If one or both testicles failed to descend into the scrotum during infancy, fertility can suffer later in life.
Even if surgery corrected the condition in childhood, sperm production may still be reduced. Early treatment improves outcomes, but adult assessment remains essential.
6. Autoimmune Reactions Against Sperm
In rare cases, your immune system produces antibodies that attack your own sperm. This can happen after:
- Testicular injury
- Surgery
- Infection
These antibodies reduce sperm movement and prevent fertilisation.
7. Lifestyle Factors You Might Overlook
Many men underestimate how daily habits influence fertility.
Smoking
Cigarettes damage sperm DNA and reduce motility.
Excess Alcohol
Heavy drinking lowers testosterone and impairs sperm formation.
Obesity
Excess fat converts testosterone into oestrogen, disrupting hormonal balance.
Poor Diet
Nutrient deficiencies can weaken sperm health. You may consider reviewing top rated vitamins and supplements for adults UK to ensure you meet essential micronutrient needs such as zinc, selenium, and folate.
8. Heat Exposure
Sperm production requires a temperature slightly lower than body temperature.
Regular exposure to heat from:
- Hot tubs
- Saunas
- Laptops placed directly on the lap
- Tight underwear
can temporarily reduce sperm quality.
Switching to loose-fitting clothing and limiting heat exposure can improve sperm parameters within months.
9. Environmental Toxins
You may not realise how chemicals in your environment affect fertility.
Common exposures include:
- Pesticides
- Heavy metals (lead, mercury)
- Industrial solvents
- Plastic chemicals such as BPA
Men working in agriculture, construction, or manufacturing may face higher risks. Protective equipment and workplace safety practices matter greatly.
10. Medications That Affect Fertility
Certain medications interfere with sperm production or ejaculation.
Examples:
- Chemotherapy drugs
- Long-term steroid use
- Some antidepressants
- Blood pressure medications
If you take prescription medication and struggle with infertility, ask your doctor whether an alternative exists.
11. Ejaculation Problems
You may produce healthy sperm but still face difficulty delivering it.
Issues include:
- Erectile dysfunction
- Retrograde ejaculation (semen flows backwards into the bladder)
- Premature ejaculation
Diabetes, nerve damage, and prostate surgery can increase risk.
12. Chronic Illness
Long-term medical conditions often affect reproductive health.
Conditions linked to infertility:
- Diabetes
- Thyroid disorders
- Liver disease
- Kidney disease
Managing these conditions improves general health and may improve fertility.
13. Stress and Mental Health
Chronic stress increases cortisol, which interferes with testosterone production. Anxiety and depression can reduce libido and sexual performance.
I encourage you to address mental wellbeing as part of fertility care. Counselling, exercise, and adequate sleep all support hormone balance.
14. Poor Sperm DNA Quality
Even if sperm count appears normal, DNA fragmentation can reduce pregnancy success.
Contributors include:
- Smoking
- Oxidative stress
- Advanced paternal age
Antioxidants such as vitamin C, vitamin E, zinc, and CoQ10 may help reduce oxidative damage.
Signs You Should Seek Help
Consult your GP if you experience:
- Inability to conceive after 12 months
- Pain or swelling in the testicles
- Sexual dysfunction
- History of testicular injury or infection
Early evaluation improves treatment options.
How Doctors Investigate Male Infertility
Your assessment may include:
- Semen analysis – measures sperm count, motility, and morphology
- Hormone testing – checks testosterone and related hormones
- Ultrasound – detects varicocele or blockages
- Genetic testing – if sperm count is very low
I always recommend that both partners undergo evaluation simultaneously.
What You Can Do Today
While medical treatment depends on the cause, you can take practical steps now:
- Stop smoking
- Limit alcohol
- Maintain a healthy weight
- Exercise moderately
- Sleep 7–8 hours nightly
- Reduce heat exposure
- Eat a balanced diet rich in fruit, vegetables, and lean protein
Small changes can significantly improve sperm health within three to six months.
Treatment Options
Treatment depends on the diagnosis:
- Surgery for varicocele
- Antibiotics for infection
- Hormone therapy
- Assisted reproductive techniques such as IVF or ICSI
Even when sperm count remains low, assisted reproductive technology often offers hope.
Emotional Impact of Male Infertility
Infertility can affect self-esteem and relationships. Many men feel isolated or reluctant to talk about fertility problems.
Open communication with your partner and healthcare provider reduces stress. Support groups and counselling can also help you process emotions constructively.
Final Thoughts
Male infertility has many causes, some obvious and others easily overlooked. Hormonal issues, silent infections, lifestyle habits, heat exposure, genetic factors, and environmental toxins all play a role.
If you suspect fertility problems, act early. Speak to your GP, request a semen analysis, and explore appropriate treatment. In many cases, doctors can improve sperm quality or offer assisted reproductive options.
Most importantly, remember that infertility does not define your masculinity or your worth. With proper evaluation and support, many couples go on to achieve healthy pregnancies.
