Causes of Infertility in Men2019-12-09T17:18:09-07:00

Causes of Infertility in Men

Couple Holding Sonography

Infertility in Men

For pregnancy to occur, the sperm must fertilize the woman’s egg to form an embryo. The sperm are made and stored by the testicles, which are ejaculated by the penis and travel to the fallopian tube during sexual intercourse.

One of the main causes of male infertility are problems related to the testicles. There are numerous additional factors that may affect male infertility, including hormone imbalances, blockages in the male reproductive organs, medications, surgeries and genetic disorders.

To help identify the cause of infertility, you and your partner should undergo a comprehensive fertility work-up. Through this detailed diagnostic process, your CCRM physician will look at a variety of factors that could impact your ability to conceive. Since sperm health is vital to conception, it is important to have your sperm evaluated if you are struggling with infertility.

Examples of Causes of Infertility in Men


A varicocele is a swelling of the veins that drain the testicle, which can impact sperm quality. Varicocele can affect one or both testes. The majority of men with varicocele present no symptoms.

Ejaculation disorders

Ejaculation disorders include premature ejaculation, anejaculation (the failure to ejaculate), and retrograde ejaculation, which is when semen enters the bladder during orgasm instead of coming out the tip of the penis.

Antibodies that attack sperm

Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.


Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. Additionally, surgery, radiation or chemotherapy to treat tumors can affect male fertility.

Undescended testicles

During fetal development one or both testicles may fail to descend from the abdomen into the sac that normally contains the testicles. Infertility is more likely in men who have had this condition.

Hormone imbalances

Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes.

Sperm Transport Issues

There are many different tubes that carry sperm. They can be blocked due to numerous causes, including infections, trauma or abnormal development, leading to sperm transport issues.

Genetic disorders

Hereditary disorders, such as Klinefelter’s syndrome (when a male is born with two X chromosomes and one Y chromosome instead of one X and one Y) impacts the normal development of the male reproductive organs.

Problems with sexual intercourse

These can include trouble keeping or maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex.


Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medications can impair sperm production and decrease male fertility.

Prior surgeries

Certain surgeries may prevent you from having sperm in your ejaculate, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others. In most cases, surgery can be performed to either reverse these blockage or to retrieve sperm directly from the epididymis and testicles.

Celiac disease

A digestive disorder caused by sensitivity to gluten, celiac disease can cause male infertility. Fertility may improve after adopting a gluten-free diet.


Some infections, such as gonorrhea or inflammation of the testicles, can affect sperm production or sperm health or can cause scarring that blocks the passage of sperm.