Around one in six couples experience infertility, with a male factor involved around one-third of the time. Male infertility is more common than you might think, so it’s natural to consider whether you (or your boyfriend or husband) might have issues with conceiving, but there’s no way to tell if a man is infertile just by looking at him.
Signs of infertility in men
Infertility is defined as the inability to conceive a child after 12 months of regular unprotected sex. If this is the case for you and your partner, you should both book an appointment with a doctor to get your fertility investigated. You should both be investigated at the same time to reduce delays in knowing what’s going on and starting treatment if you want it.
Fertility test for men
The way to begin testing a man’s fertility is with a semen analysis, which is done at a pathology laboratory. Your doctor will give you a referral to have it done. Semen analysis involves examination of freshly ejaculated semen under a microscope to determine the number of sperm, their size and shape and their movement. Semen collection can be done at the testing laboratory, which has a private room with lockable doors and suitable inspiration for getting the job done. You may be able to produce a sample at home and bring it to a laboratory.
Plenty of men feel stressed, nervous and awkward about collecting semen, and some performance anxiety is normal.
Fertility assessment for males involves a detailed physical examination and questions about your health. Your doctor will ask about your medical and surgical history, family history, and behaviours that influence your health (like diet and exercise, sleep, smoking and alcohol consumption and your work life). These health assessments are necessary because fertility is affected by your overall health.
You might also have a blood test to measure your hormone levels and other things in your blood, or an ultrasound scan to look at your testicles.
Causes of infertility in men
Your fertility may be affected by the quantity and quality of your sperm. If the number of sperm you ejaculate is low, or if the sperm are of a poor quality, it will be difficult, and in some cases impossible, to get pregnant.
Male infertility usually results from problems with sperm production, which can be caused by a range of things, including genetic conditions, infections, hormonal imbalances and behaviours you can change like smoking and alcohol use. Sometimes there is no explanation for infertility – this is called idiopathic infertility or unexplained infertility.
Other possible signs and symptoms
While many men with infertility have no obvious symptoms, certain signs can suggest an underlying problem.
Pain, swelling or a lump in the genitals
These could indicate trauma, infection or a varicocele.
Small testicles (the size of a grape), reduced facial or body hair, gynaecomastia
Or other signs of a chromosomal condition like Klinefelter syndrome.
Fatigue, low libido, erectile dysfunction, mood swings, irritability, reduced muscle mass and difficulty concentrating
These could be signs of a hormonal imbalance.
Reduced semen volume
These could be a sign of a blockage or obstruction within the reproductive tract
Problems with sexual function, such as low sex drive, erectile dysfunction and ejaculation problems, can also make it harder to conceive.
Want more on male fertility?
You can learn more about how your preconception health can affect your fertility, your partner’s pregnancy and the wellbeing of your future child here.
How to improve male fertility
Many health issues are associated with damage to your sperm, including being overweight, smoking, and exposure to harmful chemicals. But improving your preconception health can help you avoid this damage, boost your sperm quality and improve your fertility.
Sperm take about three months to develop, so the changes you make today will impact your fertility in around 90 days. So, at a minimum, prioritise your health for at least three months before trying to conceive.
