When it comes to symptoms of male infertility, there are no symptoms aside from the inability to conceive in a year of trying. Although there are no signs or symptoms, there are some conditions associated with male infertility. These symptoms include:

• Issues with normal sexual function – like difficulty with ejaculation, small volumes of fluid ejaculated, reduced sexual desire, or erectile dysfunction (difficulty maintaining an erection)
• Feeling pain, seeing swelling or a lump in the testicle area
• Frequent respiratory infections
• Inability to smell
• Abnormal breast growth (gynecomastia)
• Signs of a chromosomal or hormonal abnormality like decreased facial or body hair
• A sperm count lower than normal

Male infertility can be caused by various things such as medical issues or environmental factors. In most cases, male infertility is caused by negatively affecting these important factors that are associated with male fertility:

• Sperm production: Your body needs to produce enough testosterone and other hormones to maintain the production of healthy sperm. In addition, you need to have at least one functioning testicle.
• The proper mixing of sperm with semen: Once the sperm is produced in the testicles, they move through special tubes to eventually be mixed with semen. Afterward, they will eventually be ejaculated out of the penis.
• A normal amount of sperm: A lower than normal sperm count / concentration will decrease the chance of fertilization of your partner’s egg. Note: A low sperm count is considered to be fewer than 15 million sperm per milliliter of semen or fewer than 39 million per ejaculate.
• Good sperm mobility: The sperm motility or function allows the sperm to be able to reach and penetrate your partner’s egg and lead to fertilization.

Medical Causes Of Male Infertility

Male infertility can be caused by medical or health issues. Medical or health issues that affect male fertility include:

• Varicocele (the most common cause of male infertility)
• Infections (inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections (STD) like gonorrhea or HIV
• Ejaculation issues (Retrograde ejaculation)
• Antibodies that attack sperm
• Tumors and in some cases, surgery, radiation, or chemotherapy can affect male fertility.
• Undescended testicles
• Hormone imbalances (male hypogonadism)
• Defects of tubules that transport sperm
• Chromosome defects (Klinefelter’s syndrome, cystic fibrosis, Kallmann’s syndrome, and Kartagener’s syndrome)
• Problems during sexual intercourse like difficulty maintaining an erection (erectile dysfunction), premature ejaculation, painful intercourse, urethral opening beneath the penis (hypospadias), or psychological or relationship issues
• Celiac disease
• Certain medications
• Prior surgeries (vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, etc.)

Environmental Causes Of Male Infertility

In addition to medical conditions, there are some environmental causes of male infertility. These conditions include:

• Industrial chemicals (benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials, etc.)
• Heavy metal exposure (lead, cadmium, or mercury)
• Radiation or X-rays
• Overheating the testicles or around the scrotum

Other Causes Of Male Infertility

In some cases, male infertility could be from other causes. These could even include life choices. Here are other causes that can negatively affect male fertility:

• Drugs (anabolic steroids, cocaine, marijuana, etc.)
• Alcohol
• Tobacco smoking
• Emotional stress.
• Depression
• Weight

There are some things that can increase the risk of male infertility. Some of them were already listed above like smoking and drugs. But, there is one thing that naturally causes male infertility. It’s age. Similar to a woman’s natural process of being unable to conceive (menopause) as she gets older, men will experience a reduction in fertility as they age. It was reported that around 40 years old and older will experience difficulty conceiving.

If you are facing difficulties conceiving, there are some things you can try to do to increase your chance of getting your partner pregnant. These tips include:

• Increasing the frequency of sex: Having sexual intercourse frequently around at least four days before and during ovulation increases your chances of fertilization of the egg.
• Have sex when fertilization is possible: The highest chance of fertilization is during ovulation which occurs in the middle of the menstrual cycle, between periods.
• Avoid the use of lubricants: Lubricants like lotions and saliva might impair sperm mobility and function.

A semen analysis, also called seminogram or spermiogram, can help you see the health of your sperm and semen through various semen parameters. Although semen analysis can not fully tell you, it can be good to know. Here are some terminologies that you’ll need:

• Semen volume: The amount of liquid in one ejaculation. (Normal: 1.5 to 5 milliliters (mL) of semen)
• Sperm count / Concentration: This is the number of sperm per ejaculation in millions per milliliter (M/mL) of semen. (Optimal: 55 to 300 M/mL, Moderate: 15 and 55 M/mL, Poor: below 15 M/mL)
• Total count: It is just the total amount of sperm found in one ejaculation.
• Sperm motility / mobility: The sperm’s ability to swim forward, on a 0-4 scale. (Optimal: 3-4, Moderate: 1-2, No movement: 0)
• Sperm Morphology: Sperm with normal form (shape, size, and appearance) in percentage. Immature or having defective heads or tails are signs of sperm with abnormal morphology. (Optimal: more than 14%, Moderate: 4%-14%, Poor: less than 4%, according to the Kruger (strict) guidelines)

[1] Agarwal, Ashok et al. “A unique view on male infertility around the globe.” Reproductive biology and endocrinology: RB&E vol. 13 37. 26 Apr. 2015, doi:10.1186/s12958-015-0032-1

[2]Siterman S, Eltes F, Wolfson V, Zabludovsky N, Bartoov B. Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality. Arch Androl. 1997;39(2):155-161. doi:10.3109/01485019708987914