Male infertility is often overlooked, but it is a thing. In fact, between 20% and 30% of infertility cases can be traced solely to the male partner. And the man is a contributing factor in 50% of infertility issues overall. Fortunately for men, a semen sample is all that is needed for an initial evaluation.

Despite these statistics, the vast majority of research, information, and support for infertility caters primarily to women. This can make the prospect of infertility even more difficult for a man when he is the one with the diagnosis.  

If your partner is dealing with male-factor infertility, it’s good to have some key facts. Here, we’ll share the treatments, lifestyle tips, and strategies for supporting him through this time—while also giving you a better chance of conceiving. 

What Causes Male Infertility?

A man’s ability to reproduce depends on three main factors: 

• Making healthy sperm that can fertilize an egg
• Having an erection
• Ejaculating so sperm can reach the egg

Genetic, hormonal, or anatomical abnormalities can cause male infertility. Health and lifestyle issues can also play a part. Here’s a look at the potential reasons a man may be experiencing infertility:

• Sperm disorders: Poor semen quality is the most common cause of male infertility. A number of things can trigger sperm disorders, from genetic and environmental factors (like heat, industrial chemicals, heavy metals, and radiation) to chromosomal or hormonal problems, to using nicotine, alcohol, or drugs. There are different types of sperm disorders:
  • Inability to produce sperm (azoospermia)
  • Low sperm count (oligospermia)
  • Reduced sperm motility (asthenozoospermia), which makes it harder for the sperm to travel through the female reproductive tract to fertilize the egg
  • Abnormalities in sperm size and shape (morphology), which may affect the sperm’s ability to reach and penetrate the egg
• Medications: Certain prescription medications can cause male infertility. But most are reversed when the medication is discontinued.
• Lifestyle factors: Smoking and heavy drinking have been linked to abnormal-sized and -shaped sperm. Recreational drug usage has been shown to affect sperm production.
• Variococles: In this condition, the veins in the scrotum are enlarged and may make them overheat, resulting in low sperm numbers. Variococles occurs in about 40% of infertile men but does not always cause a man to be infertile. 
• Blockages in the reproductive tract: Ejaculatory duct obstruction occurs when one or both sperm ducts are blocked, and sperm cannot exit with ejaculation. 
• Hormonal disorders: Improper function of the hypothalamus or pituitary glands—which maintain normal testicular function—may result in low or no sperm production.
• Genetic diseases: Certain diseases affect sperm counts. These include cystic fibrosis, Klinefelter syndrome (when men are born with an extra X chromosome), and Y-chromosome microdeletion of genes. 
• Health conditions: Diabetes, certain autoimmune disorders, and some infections (like mumps) can lead to testicular failure. This means the testes cannot produce sperm or male hormones (like testosterone).
• Cancer treatments: By impacting reproductive organs, glands, and sperm, many cancer treatments can lower fertility or cause permanent infertility.  
• Trauma to the testes: This may result in lower sperm counts.

As you can see, there could be a lot of things going on. To assess what’s happening, a clinician will do a semen analysis. This looks at the number (concentration), motility (movement), and morphology (shape) of the sperm. 

A doctor will also do a physical examination. They may order blood tests to check hormone levels, or do an ultrasound to see if there are any structural abnormalities in the testes and scrotum. Depending on the results of the semen analysis, the man may also get a testicular biopsy.

What Increases the Risk for Male Infertility?

Age is the biggest factor in female infertility. With men, semen and sperm quality do decrease with age. According to the Centers for Disease Control and Prevention, couples where the male partner is 40 years or older are more likely to report difficulty conceiving. 

Of course, age isn’t the only risk factor for infertility. Other things can contribute. Some may be avoidable, and some not:

• Weight: Being obese or overweight is linked to low sperm counts and sperm motility issues; being underweight may lead to decreased sperm counts and low testosterone levels 
• Smoking, heavy drinking, and the use of recreational drugs
• Testosterone prescribed medically to treat low testosterone, or when used recreationally to increase muscle mass 
• Frequent use of a wheelchair, sauna, or hot tub, which expose the testes to high temperatures
• Exposure to radiation or environmental toxins such as pesticides, flame retardants, lead, mercury, or cadmium
• Having a history of undescended testes or varicoceles

Help for Male Infertility

Every case of male infertility is unique. Treatments will vary, but may include medications, surgery, or lifestyle modifications. What’s important to know is that there are a number of things a guy can try.

Medical Interventions 

• Hormone therapy medications can help improve sperm count in some men. 
• If a man has had a vasectomy and wants to reverse it, surgery can be performed. Surgery can also repair damage to the vas deferens, the tube that carries mature sperm to the urethra before ejaculation.
• When semen quality and sperm count are an issue, intracytoplasmic sperm injection (ICSI) is an excellent option. It’s a non-invasive procedure, where sperm is collected through masturbation. Afterward, the scientist hand-picks a single sperm. Using a microscopic needle, a sperm is then injected into each egg, which will have been collected from the woman through IVF. This technique has been shown to raise the chance of conception to 90% among infertile males. 

Lifestyle Strategies 

• Try the Mediterranean diet. This eating plan is often recommended by doctors for its overall health benefits. It limits consumption of dairy and meat, and focuses on legumes, whole grains, fruits, vegetables, fish, and healthy fats like avocado and olive oil. How’s this relate to, well, sperm? Fruits and veggies are rich in antioxidants, and antioxidants may help improve sperm count and quality. Plus, studies have shown that the Mediterranean diet aids in the production of quality semen. 
• Manage stress. Stress: It does a body bad. For men, chronic stress can cause changes in testosterone and decrease semen quality. Finding ways to relax may help protect against this. This is where some tried-and-true calming techniques can help. We’re talking deep breathing exercises, mindful meditation, guided imagery, and progressive muscle relaxation. A doctor can share more info or recommend a therapist who can teach these skills.
• Keep the testicles cool. Hot tub fans, we hate to be the bearer of bad news, but it’s best to steer clear of excess heat when trying to boost fertility. That means avoiding hot tubs and saunas, and even making sure to keep your laptop on a desk or pad (not directly on your lap). 
• Stay active. Moderate exercise can help elevate levels of powerful antioxidant enzymes. And these can help boost sperm health. 

How to Support Your Partner With an Infertility Diagnosis

It’s so rare to hear about male infertility, because it’s widely considered a woman’s issue. So, as with most “taboo” health issues, when a man gets an infertility diagnosis, it can come with some pretty heaving emotions. 

He might be shocked or angry or wracked with fear or insecurity. He might feel like a failure. Male infertility is common, the reproductive journey is a journey taken together as a unit, supporting each other through the ups and downs.  

What can you do to help him through this? Be kind and supportive, but don’t pander or try to over-correct like it’s no big deal. Try these six tips.

• Be patient. Your partner may cope with stressful events very differently than you do. Give him time to come to terms with his infertility, and don’t try to immediately fix the situation for him. 
• Ask him how you can help. Does he want you to join him for his medical appointments, or would he prefer to go alone? When he shares his upset, is he looking for empathy or does he want you to pipe up with your latest treatment finding? 
• Make a plan together. When the time is right, discuss what’s next. Whether it’s additional testing, fertility treatments, or getting therapy for emotional wellness, you’ll have a course of action you both are comfortable with. 
• Tune up your listening skills. Now is the time to actively listen to your partner. It will allow him to feel heard and valued and encourage more open communication.  
• Let him know it’s ok. Think about what you’d want to hear if the situation were reversed. Be clear that you don’t blame him for what’s going on, and that he hasn’t let you down. Make sure he knows he doesn’t have to go through this alone.
• Nurture each other. There are things you can do together to support both of you—physically and mentally. Plan healthy meals, or take walks after dinner. Be as compassionate as you can with each other.

What’s Lube Got to Do With It? 

Many lubricants can damage sperm, making it difficult for them to travel to an egg. If you need extra lube when you’re trying to get pregnant, here’s what to know.

• Check lube packaging for “FDA-certified fertility lubricant” or “fertility-friendly.” Try Pre-seed or Conceive Plus.
• Look for a hydroxyethylcellulose base, which has a similar consistency to natural vaginal mucus. Silicone- and water-based lubes affect sperm motility. 
• Be sure ingredients panels don’t list fragrance, glycerol, or parabens.
• Avoid using an oil, such as coconut oil, or a lube marked “natural” or “organic.”