Male Infertility: Causes, Diagnosis, and Treatment

Published: January 2, 2019
couple holding hands with text male infertility

Around 13% of couples have difficulty conceiving. And in approximately 1/3 of those cases, male infertility is the issue. (1) 

If everything is working properly, during sexual intercourse the male’s body mixes healthy sperm with fluid from the prostate and seminal vesicles to produce semen. The semen is ejaculated into a female’s vagina where it travels into the uterus. If an egg is present, the sperm and egg meet, allowing for fertilization to occur. (1) 

In order for this series of events to result in a successful pregnancy, genetics, hormones and environmental factors must align correctly. (1) 

Male infertility is just one of the reasons why couples may struggle to get pregnant, and it can occur for a variety of reasons. (1)


Certain medications, hormonal imbalances, obstruction and chromosomal structure can all inhibit the production and delivery of healthy sperm. In addition, we’ve outlined a few of the more commonly seen male infertility causes.

Sperm Disorders

The most common fertility issue for men lies in making and growing sperm. In some cases sperm count is very low or nonexistent. In other cases the sperm are formed improperly – they’re not shaped correctly, fully grown, or adequately mobile. (1) 

Difficulty producing healthy sperm can result from lifestyle choices, medications, underlying health issues, or a combination thereof. 


Varicoceles are swollen veins in the scrotum that are more common in infertile men. It is thought that these veins keep the scrotum too warm to make sperm. (1) 

Retrograde Ejaculation

This type of ejaculation sends semen backwards into the male’s bladder rather than out of the body. Because of this, sperm does not enter the vagina, making fertilization impossible. “Dry” ejaculations and cloudy urine following ejaculations are both symptoms of this condition. (1) 

Immunologic Infertility

Sometimes as a result of surgery, injury, or infection, a male’s body can attack his own sperm. In these cases, the sperm can have a harder time reaching and fertilizing an egg. 


Your physician will conduct a physical exam and will work with you to learn more about your past medical history. From there, your urologist may take semen or blood samples to run tests that are typically able to uncover hormonal imbalances, low sperm count, or sperm abnormalities. Your particular case may require an ultrasound or testicular biopsy to determine if blockages or other abnormalities are presenting challenges. 


The treatment that your urologist recommends will vary based on the underlying cause of infertility. Medications, steroids, nerve impulse therapy and surgery can all be effective treatments for male infertility. 

At Virginia Urology, we are highly specialized in male urological issues, including infertility. We’ve worked with countless men to diagnose and treat male infertility. Our extensive experience can help pinpoint the cause of your fertility challenges, so that we can discuss your options and pursue a solution. 

Give us a call today.


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