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What causes male infertility - and how to improve your chances of conception

If you've been trying to conceive for more than a year without success (or for six months if you're over 35) it may be time to get a few his 'n' hers fertility tests done. Finding out the cause of male infertility, and treating it accordingly, may improve your chances of getting pregnant.

By Mumsnet HQ | Last updated Jul 1, 2021

man and woman holding pregnancy test

What is male infertility?

Male infertility essentially means that the male partner has difficulty fertilising an egg. Usually this is due to sperm being in some way abnormal but there can be other issues.

In around a third of cases of infertility, the problem will lie solely with the male partner, and in half the cases the difficulty conceiving is in part down to the man. The good news is that infertility in men is in many ways less complex than female infertility – and can often be treated, or at least improved.

Do you know when you're ovulating?

Male fertility is significantly impaired through smoking, heavy drinking, obesity and poor diet. I would suggest trying to improve those aspects if you're having trouble conceiving.

Some experts have suggested that male infertility is on the increase. This may be to do with the age at which people are choosing to start a family, or environmental factors (or both). There are some lifestyle changes which can help to improve male fertility.

Male fertility begins to decline when men hit their 40s, but it doesn't shut down as sharply as it does with women and age.

What are the main causes of male infertility?

The following issues are common reasons for infertility in men:

  • Damage to the testicles because of disease, trauma or a congenital defect
  • A blockage, so that sperm cannot be released from the body during ejaculation
  • Ejaculation problems, such as retrograde ejaculation, where semen is ejaculated into the bladder
  • Low levels of the hormone testosterone, which inhibits sperm production.

These can result in:

  • Low or non-existent sperm count
  • Decreased motility, meaning sperm can't effectively swim to meet the egg
  • 'Abnormal' sperm (shaped differently to normal sperm – for example with wonky tails, two heads, no tail, tiny heads etc).

Other potential factors in male infertility

Less commonly, one of these could be the cause of infertility:

  • Sperm allergy, where the body treats its own sperm as a foreign invader and produces antibodies
  • A chromosomal disorder
  • Having recently had chemotherapy, which is known to severely reduce sperm count
  • Taking anabolic steroids, and also illegal drugs such as cocaine, as these can have an affect of numbers and quality of sperm
  • Taking certain medicines, particularly the anti-inflammatory Sulfasalazine, which reduces sperm count. Some herbal remedies can have an effect, too, so it's worth checking.

Male fertility testing

Male fertility is tested by analysing a sample of sperm, and sometimes blood, to look at hormone levels, and to assess sperm count and the health and motility of the sperm. The results show whether there are actual functional sperm present and whether they are of sufficient quantity and quality.

There are a number of different treatments for the causes of male infertility, all with varying success rates. Your GP will be able to talk through the options, depending on what the issue is found to be.

For some, minor surgery or drug treatment may solve the problem. Others may be offered assisted conception. In many cases, the best option will be to just keep trying, since conception can be a bit of a numbers game. There are also plenty of things you can do to improve your chances yourself.

Things that may help to improve male fertility

Lifestyle changes

  • Cut down on alcohol, as there's a link between booze and infertility. Current guidelines recommend men drink no more than 14 units a week – the same as for women.
  • Stop smoking, which can affect your sperm count.
  • Swap long, hot baths for showers, and tight-fitting Y-fronts for loose-fitting boxers, as heat can lower sperm production.
  • Get off your bike (and your horse) – cycling and riding can both reduce sperm production, too.
  • Certain chemicals, such as pesticides, can affect fertility, so avoid handling them if possible. This is not an excuse to stop doing the gardening – there are plenty of natural pesticides available.
  • Don't take recreational drugs and check whether any medication you are taking can interfere with fertility.
  • Get checked for sexually transmitted infections and get them treated if necessary.
  • Try to maintain a healthy weight, as excess weight can have an impact on your fertility. Do plenty of exercise and eat sensibly (see below).
My husband had 3% morphology (ie normally formed sperm) and cut down booze, caffeine and took Wellman supplements, pine bark and extra vitamin C. Eight weeks later it was 7%. It does change.

Look at your diet

  • Cut down your caffeine intake.
  • Get enough folic acid. Foods rich in folates include orange juice, broccoli and other leafy green vegetables and fortified cereals.
  • Try to eat foods rich in zinc, such as lamb, nuts, seeds, oysters, beef and baked beans, or take a supplement.
  • Eat plenty of foods rich in vitamin C, such as fresh citrus fruit.
  • Calcium and vitamin D are also important for fertility, so don't scrimp on dairy products.
  • Get enough selenium by taking supplements or eating Brazil nuts, tuna, sunflower seeds, eggs and mushrooms.
  • Drink plenty of water – a must for healthy sperm production.