When couples face difficulty conceiving, there is often an unspoken assumption that the problem lies with the woman. This is a damaging myth. Male factor infertility contributes to approximately 40–50% of all infertility cases. In another 20%, both partners have contributing factors. Understanding male fertility — and knowing that effective treatments exist — is a vital first step for any couple on this journey.
What Is Male Infertility?
Male infertility refers to any condition in a man that reduces the chances of his female partner becoming pregnant. It most commonly involves problems with the quantity, quality, or movement of sperm.
Common Causes of Male Infertility
Azoospermia (No Sperm)
In some men, there are no sperm present in the ejaculate. This can be obstructive (a blockage preventing sperm from leaving the body) or non-obstructive (the testes are not producing sperm). Both types can often be treated.
Low Sperm Count (Oligospermia)
A sperm count below 15 million per millilitre is considered low. Lower counts reduce the chances of fertilisation, though pregnancy is still possible with treatment.
Poor Motility (Asthenospermia)
Sperm must be able to swim effectively to reach and fertilise an egg. If fewer than 32% of sperm are moving progressively, this is considered poor motility.
Abnormal Morphology (Teratospermia)
Sperm shape affects fertilisation ability. Abnormal-shaped sperm struggle to penetrate an egg. We look for at least 4% normal forms (Kruger strict criteria).
Other Causes
- Varicocele — enlarged veins in the scrotum that overheat the testes
- Hormonal imbalances (low testosterone, high FSH/LH)
- Infections — such as chlamydia or orchitis
- Genetic conditions — such as Klinefelter syndrome or Y-chromosome microdeletions
- Lifestyle factors — smoking, excessive alcohol, obesity, heat exposure
- Previous surgeries or injuries to the reproductive tract
The Semen Analysis — What We Look For
A semen analysis is the essential first test for any couple trying to conceive. It is simple, non-invasive, and gives us enormous amounts of information. We assess:
- Volume — at least 1.5ml per ejaculate
- Sperm count — at least 16 million per ml
- Motility — percentage of moving sperm and quality of movement
- Morphology — percentage of normally shaped sperm
- pH and white blood cells — to rule out infection
Important: One abnormal semen analysis does not confirm infertility. Sperm quality fluctuates significantly. We always recommend a repeat test 2–3 months after the first, as sperm take about 72 days to develop.
Treatment Options
IUI (Intrauterine Insemination)
For mild male factor, we wash and concentrate the sperm in the laboratory and place them directly into the uterus. This reduces the distance sperm need to travel and increases the chances of fertilisation.
ICSI (Intracytoplasmic Sperm Injection)
For severe male factor, ICSI is the gold standard. A single healthy sperm is selected and injected directly into each egg. Success rates with ICSI are excellent even with very low sperm counts.
Surgical Sperm Retrieval
For men with azoospermia, sperm can often be retrieved directly from the testis or epididymis using minimally invasive procedures — PESA, TESA, or Micro-TESE. These sperm are then used with ICSI.
Lifestyle Changes
In many cases, sperm quality can be significantly improved with lifestyle changes: stopping smoking, reducing alcohol, maintaining a healthy weight, avoiding heat to the scrotum (laptops, hot baths, tight clothing), and taking prescribed antioxidant supplements.
Get a Complete Male Fertility Assessment
Our team provides expert, confidential evaluation for male fertility concerns. Book today and take the first step together.