Male infertility — clear steps to find out why and what to do

Male infertility is a common reason couples don’t conceive. If you’ve been trying for months with no luck, the good news is that many causes are treatable or manageable. This page gives straight, practical advice: what typically causes problems, which tests matter, and easy things you can try right away.

First, know the common causes. Problems fall into a few groups: low sperm production (from hormones, testicular damage, or genetics), poor sperm movement or shape, blockages that stop sperm from leaving the body, and lifestyle or medication effects. Varicoceles (enlarged veins in the scrotum), past infections, high body heat (frequent hot tubs or tight underwear), anabolic steroids, and some prescription drugs can all lower fertility. Certain genetic conditions—like Klinefelter syndrome or Y-chromosome microdeletions—also matter, especially when sperm counts are very low.

How to find out: start with a semen analysis. This is the key test. Labs look at sperm count, how many move (motility), and shape (morphology). Most doctors ask for two samples taken a week apart after 2–7 days without ejaculating. Normal reference numbers: sperm concentration of 15 million per mL or more, and reasonable motility and shape. If results are low, follow-up tests may include hormone blood tests (FSH, LH, testosterone), scrotal ultrasound to check for varicocele or blockages, and sometimes genetic testing.

Simple lifestyle steps that help sperm now

Before jumping to medical procedures, try these changes — they’re low cost and often helpful. Stop smoking and cut back on alcohol. Avoid recreational drugs and anabolic steroids; they can suppress sperm production. Lose excess weight, eat more whole foods, and get regular moderate exercise. Keep testicles cool: skip hot baths and tight underwear, avoid laptops on the lap for long periods. Review medications with your doctor — some common drugs affect sperm.

Some men try supplements. Evidence is mixed, but antioxidants like vitamin C, vitamin E, zinc, folate, and coenzyme Q10 have shown modest benefit in studies for some men. Talk to your doctor before starting anything, especially if you take other meds.

Treatment options and next steps

If tests point to a fixable problem, options include varicocele repair, treating infections, or changing medications. For hormonal issues, doctors may use medications to boost sperm production. When sperm production is very low or absent, assisted reproduction helps: IUI (intrauterine insemination) works when sperm numbers are ok; IVF with ICSI (injecting a single sperm into an egg) can use low-count samples. If no sperm in ejaculate, surgical sperm retrieval (TESE) may find sperm for IVF/ICSI. In some cases donor sperm is discussed.

See a urologist who specializes in male fertility if semen tests are abnormal or if you have risk factors (past cancer treatment, undescended testicle, or years of infertility). Keep records of tests, treatments, and any meds. Dealing with infertility is stressful — reach out for emotional support and consider counseling or support groups while you explore options.

Want next steps? Book a semen analysis and a consult with a specialist. Small changes can help, and medical treatments have helped many men become fathers.