It’s a growing concern for many couples trying to start a family.
About one in 10 couples faces challenges conceiving within a year, meeting the clinical definition of infertility.
Factors such as delayed parenthood, rising obesity rates, exposure to environmental toxins, and conditions like endometriosis or sexually transmitted infections are making infertility more common.
Roughly one-third of cases stem from male factors, one-third from female factors, and the remaining one-third from combined issues or unexplained causes.
Encouragingly, options to address male infertility have expanded significantly.
Common causes of male infertility
While women’s fertility often declines noticeably after age 35, men experience gradual changes without a strict age cutoff.
As men age, semen volume may decrease, sperm motility can weaken, ejaculation force lessens, and sperm DNA damage rises sharply, potentially complicating egg fertilisation and embryo implantation.
The most frequent cause of male infertility is a varicocele — swollen veins in the scrotum, akin to varicose veins in the legs.
Around one in five men has a varicocele, often identified during adolescence.
Among couples struggling to conceive, about two in five men are found to have this condition.
These enlarged veins can impair sperm production and movement, so sharing this history early with a fertility specialist is advisable.
How male infertility is diagnosed
The initial step is usually a semen analysis.
Even if pregnancy is not planned soon, undergoing this test early can identify potential issues without harm.
A primary care doctor, urologist, or infertility specialist can arrange it, or it may be available online.
The test measures sperm count, motility, and shape, while also checking hormones such as testosterone and follicle-stimulating hormone, which prompts sperm production in the testes.
Normal benchmarks include at least 15 million sperm per millilitre, 40 percent or more motile sperm, and 4 percent or more with ideal shape.
Being within normal ranges does not guarantee conception, just as slightly below-threshold counts do not always prevent it.
If the semen analysis or hormone results show abnormalities, consulting a male infertility specialist is recommended.
Treatment options available
Many cases of male infertility respond to surgery, medications, or lifestyle adjustments.
Obesity often disrupts reproductive hormones in men by converting testosterone to oestrogen in excess fat tissue, suppressing fertility.
Adopting a balanced diet, doing cardio exercise at least three times weekly, and strength training twice a week can help.
Additional steps include avoiding prolonged sauna use, not placing a hot laptop on the lap, and reducing contact with microplastics, forever chemicals, and other environmental toxins, as sperm production is highly temperature-sensitive.
Certain medications can boost natural testosterone or block its conversion to oestrogen, thereby increasing sperm counts.
Evidence for fertility supplements remains limited; a healthy diet usually provides necessary nutrients.
When needed, surgery can repair varicoceles by removing problematic veins, clear reproductive tract blockages, or retrieve sperm directly from the testes for banking and use in procedures like in vitro fertilisation.
Considerations for sperm banking and support
No specific age mandates sperm freezing, but after around 45, risks rise for children developing neurocognitive conditions such as autism spectrum disorder or schizophrenia.
Older paternal age generally correlates with higher such risks.
Infertility often brings substantial stress to couples.
Discussing concerns openly with a partner early on helps manage expectations and reduce strain.
Infertility is a shared challenge — not solely a female issue — and affects many.
Seeking testing promptly is worthwhile.
Centres like NYU Langone Fertility Center offer comprehensive evaluations, fertility-enhancing treatments, and mental health support throughout the process.
