< Back to the Blog
Science

What You Need To Know About Male Factor Infertility

Clara Siegmund
Clara Siegmund

Male infertility is just as common as female infertility. If you and your partner are having trouble conceiving, you should both get tested for infertility.

Modified On:
Published:
Apr 16, 2023
Est. Read Time:
0
Published:
Sep 27, 2025
Est. Read Time:
0

Male infertility is just as common as female infertility. If you and your partner are having trouble conceiving, you should both get tested for infertility.

Science
Share to:
No items found.

Male infertility is just as common as female infertility. If you and your partner are having trouble conceiving, you should both get tested for infertility.

You and your partner have decided you want to have a baby. Congratulations! But it’s been a while, and you’re having some trouble. You may find yourself starting to wonder what is going on. Did you know that male factor infertility could be to blame?

Infertility is usually defined as the inability to get pregnant after one year of unprotected sex. Male factor infertility is when that inability is caused by infertility in a male partner. Infertility can feel isolating but it's more common than you may think: 15-20% of heterosexual couples trying to conceive deal with infertility. And either individual (or both) may have something to do with it.

If you suspect you might be having issues with male factor infertility, there are lots of treatment options available to you. With teamwork, and the help of your doctor, you and your partner can increase your chances of a successful pregnancy.

What It Is     Causes     Risk factors     Symptoms     Diagnosing     Treatment

What is male factor infertility?

Male factor infertility is when the male partner is infertile, either from low or abnormal sperm production, or troubles with the delivery of sperm.

Male factor infertility is more common than we might think. In fact, men and women experience infertility at comparable rates: in infertility among heterosexual couples, around 33% of cases are related to male factor infertility, 33% to female infertility, and 33% to infertility issues with both partners or to unknown factors.

Causes of male factor infertility

Male factor infertility can have several different causes, including genetic conditions, hormonal imbalances, and problems with testicular or ejaculatory functions.

Genetic conditions

Is male factor infertility genetic? Certain genetic conditions may lead to problems with male fertility. They include klinefelter syndrome, chromosomal microdeletion, and myotonic dystrophy.

These conditions can cause abnormal development of male reproductive organs. This can affect reproductive function, including testosterone levels, sperm production, and sperm count. If you have a diagnosis of a genetic condition and you’re dealing with male factor infertility, there may be a connection.

Hormonal imbalances

When your hormones are out of balance, your ability to conceive may be affected.

Fertility hormones, and the glands that produce them, influence reproductive function. For example, low sperm production, which can lead to fertility issues, can be caused by:

  • Low testosterone levels
  • High prolactin levels
  • Abnormal levels of follicle stimulating hormone (FSH)

Hormonal imbalances can also cause other health issues, and should be monitored by a doctor.

Problems with testicular or ejaculatory functions

Certain issues can disrupt testicular function or ejaculatory function, such as:

  • Retrograde ejaculation
  • Varicocele
  • Antibodies that attack sperm
  • Undescended testicles
  • Blockages in the tubes that transport sperm

Retrograde ejaculation occurs when semen enters the bladder instead of being ejaculated out of the penis, resulting in very little to no ejaculate (meaning very little to no sperm). Varicocele refers to enlarged veins in the testicles, and can affect the number and shape of sperm. Tubal blockages can occur due to infections, trauma from injury, or abnormal development.

When testicular and/or ejaculatory functions are blocked, your fertility can be impacted.

Other causes

Other possible causes of male infertility include:

  • Cancer treatments like chemotherapy, radiation, or surgery to remove a testicle
  • Certain medications, such as antibiotics, antifungal medicines, and some blood pressure medication
  • Long-term anabolic steroid use
  • Injury trauma to the testicles
  • Groin, testicle, penis, or scrotum surgery
  • Exposure to certain environmental toxins

Risk factors of male infertility

Some factors, such as lifestyle habits or health conditions, may increase your risk for infertility. These include:

  • High alcohol consumption
  • Tobacco intake
  • Use of certain illicit substances
  • Frequent exposure of the testicles to high temperatures
  • Severe stress
  • Depression
  • Obesity

>>MORE: Alcohol and Fertility: What's the Link?

Your age can also have an effect on fertility. Though age is a bigger factor for women and fertility, men over 40 are more likely to report difficulty conceiving.

Symptoms of male factor infertility

You may not have any obvious signs or symptoms of infertility, other than the infertility itself. Some people, however, can exhibit symptoms that could indicate fertility issues. These might be:

  • Pain, lumps, or swelling in your testicles
  • Small, firm testicles
  • Issues with ejaculation or inability to ejaculate
  • Difficulty maintaining an erection
  • Reduced sex drive and desire

Diagnosing male factor infertility

In general, if a couple hasn’t conceived after one year of trying, infertility issues may be at the root of the problem. In this case, both individuals should consider seeing fertility specialists.

It’s important to recognize that infertility is often emotionally draining. Both people in the couple may be dealing with feelings of anger, sadness, confusion, and inadequacy. Talking about your emotions, both with each other and with mental health professionals, can help. It’s completely possible, and beneficial, to address your physical and emotional well-being while on your journey to pregnancy.

>>MORE: Oova 101: How Support Systems Can Help You Navigate Infertility

Talk to your doctor

For the physical side of things, you can start by making an appointment with your general practitioner.

During your visit, you’ll undergo a physical examination, including an examination of your genitals. Be prepared for a thorough review of your medical history, including questions about:

  • Your sexual history
  • Any history of infertility with previous partners
  • Chronic health conditions
  • Medication you take
  • Previous surgeries

The next step in diagnosing male infertility is a semen analysis. A semen sample will be sent to a lab to measure:

  • Semen volume
  • Sperm concentration
  • Total sperm count
  • Sperm morphology (shape)
  • Sperm motility (movement)

You’ll likely give multiple semen samples for analysis over a period of time. This ensures accurate results, as sperm count can vary significantly from sample to sample. The results of these analyses will determine next steps.

Visit a male fertility specialist

If your semen analyses come back with abnormal results, your doctor will likely recommend that you see a fertility specialist. For male infertility, you’ll see a reproductive urologist.

Your reproductive urologist will run more tests to determine the cause of your fertility issues. Some examples of tests this doctor might perform are:

  • Scrotal ultrasounds
  • Transrectal ultrasounds
  • Post-ejaculation urinalysis
  • Hormone testing
  • Genetic tests

Scrotal ultrasounds check for conditions like varicocele. Transrectal ultrasounds look for tube blockages. Post-ejaculation urinalyses determine whether retrograde ejaculation is occurring.

The results of these tests will help you and your doctor decide what treatment path you’ll take.

How do you treat male factor infertility?

There are several treatment options available to people dealing with male factor infertility. Your reproductive urologist will make recommendations and help you through your treatment.

Surgery

Depending on your case, one option may be surgery. Surgical procedures can:

  • Correct varicocele
  • Reverse a prior vasectomy
  • Retrieve sperm directly from the testicles using various sperm retrieval techniques

Hormone treatments

If the problem is hormonal, you might undergo hormone treatments. Hormone therapy or hormone medications can correct imbalances by restoring hormones to normal levels, which can improve fertility.

Assisted reproductive technologies (ART)

If other treatment options aren’t working, your doctor might recommend that you and your partner try assisted reproductive technologies (ART). In this case, your reproductive urologist will coordinate closely with a reproductive endocrinologist (REI), a female infertility specialist. ART treatments include:

  • Intrauterine insemination (IUI): sperm are injected directly into the uterus
  • In vitro fertilization (IVF): sperm are combined with eggs, and an embryo is then transferred to the uterus
  • Intracytoplasmic sperm injection (ICSI): a single sperm is injected directly into an egg, and the embryo is then transferred to the uterus

Assisted reproductive technology can be highly successful in treating male factor infertility, with some sources saying 90% of all infertile males have the potential to conceive their own child.

The bottom line

Our society tends to think that women’s bodies are always to blame for infertility, but this is not the case. Anyone can experience infertility — men, women, trans men, trans women, and non-binary people alike. This is why it’s so important that you and your partner get tested for infertility if you’re having trouble getting pregnant. You’re in this together.

Thinking more largely, blame and guilt have no place in the conversation around infertility. Infertility is no one’s “fault,” it’s just something that can happen to people, and it’s often out of our control.

If you’re having trouble trying to conceive, the first step for anyone, men included, is to see a doctor. With treatment, you and your partner can increase your chances for a successful pregnancy.

About the author

Clara Siegmund
Clara Siegmund is a writer, editor, and translator (French to English) from Brooklyn, New York. She has a BA in English and French Studies from Wesleyan University and an MA in Translation from the Sorbonne. She is passionate about literature, reproductive justice, and using language to make information accessible.‍

Sources

‍

https://www.oova.life/blog/progesterone-supplementation-guide
Can I take progesterone if I'm breastfeeding?
Yes, progesterone is generally safe while breastfeeding and doesn't significantly affect milk supply. However, always discuss with your healthcare provider before starting any hormone supplementation while nursing.
https://www.oova.life/blog/progesterone-supplementation-guide
Is it safe to take progesterone throughout pregnancy?
Yes, when prescribed by your healthcare provider. Progesterone supplementation in early pregnancy is safe and can reduce miscarriage risk in women with low progesterone or a history of pregnancy loss. Most providers continue supplementation through the first trimester (weeks 10-12) when the placenta takes over.
https://www.oova.life/blog/progesterone-supplementation-guide
Can progesterone supplementation cause weight gain?
Progesterone can cause temporary water retention and bloating, which may show up as a few pounds on the scale, but it doesn't cause true fat weight gain. Most women don't experience significant weight changes from progesterone supplementation.
https://www.oova.life/blog/progesterone-supplementation-guide
Can I switch from pills to suppositories or vice versa?
Yes, but only under your doctor's guidance. The dosing and timing may need adjustment when switching between forms since they're absorbed differently. Never switch on your own, especially if you're pregnant or undergoing fertility treatment.
https://www.oova.life/blog/progesterone-supplementation-guide
Will progesterone supplementation delay my period?
Yes, progesterone keeps the uterine lining intact, so if you're not pregnant and continue taking progesterone, your period will be delayed. Once you stop taking it, your period should start within 2-10 days. If you are pregnant, progesterone helps maintain the pregnancy and you won't get a period.
https://www.oova.life/blog/progesterone-supplementation-guide
Should I take progesterone pills orally or vaginally?
For fertility and pregnancy support, vaginal progesterone is usually preferred because it delivers higher concentrations directly to the uterus. For perimenopause or general hormone balance, oral progesterone often works well and is more convenient. Your doctor will recommend the best route based on your specific needs.
https://www.oova.life/blog/progesterone-supplementation-guide
When should I start taking progesterone after ovulation?
Typically, progesterone supplementation for luteal phase support starts 2-3 days after ovulation (confirmed by LH surge or temperature rise). Your doctor will give you specific timing based on your protocol. Some women start immediately after a positive ovulation test.
https://www.oova.life/blog/progesterone-supplementation-guide
What's better: progesterone cream or pills?
Pills (oral micronized progesterone) are generally more effective and reliable than creams because absorption from creams is inconsistent. For medical conditions like fertility issues, low progesterone, or HRT, prescription pills or suppositories are strongly recommended over over-the-counter creams.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
How can I tell if I have low or high progesterone?
The only definitive way to know is through hormone testing via blood tests or at-home urine tests that measure progesterone metabolites. However, symptom patterns can provide clues: anxiety and irregular periods suggest low progesterone, while bloating and extreme fatigue suggest high progesterone.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
When during my cycle should I test progesterone levels?
Test progesterone levels during the luteal phase, typically 7 days after ovulation or around day 21 of a 28-day cycle. This is when progesterone should be at its peak, making it easier to identify if levels are too low or too high.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
What are the main differences between low and high progesterone symptoms?
Low progesterone typically causes irregular or heavy periods, anxiety, hot flashes, and sleep issues. High progesterone causes bloating, fatigue, intense breast tenderness, and depression-like mood changes. Low progesterone symptoms persist throughout your cycle, while high progesterone symptoms are most intense during the luteal phase.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
Can you have symptoms of both low and high progesterone?
Some symptoms like breast tenderness and mood changes can occur with both low and high progesterone, making it confusing. However, the timing, intensity, and accompanying symptoms differ. Hormone testing is the best way to determine which imbalance you're experiencing.
https://www.oova.life/blog/10-dpo
Can stress affect 10 DPO symptoms?
Yes, stress can worsen or mimic 10 DPO symptoms. Stress increases cortisol, which can cause cramping, fatigue, and mood changes similar to both PMS and early pregnancy. During the two-week wait, try stress-reduction techniques like gentle exercise, meditation, or spending time with loved ones.
https://www.oova.life/blog/10-dpo
Is it better to test at 10 DPO or wait?
It's better to wait until 12–14 DPO for more accurate results. Testing at 10 DPO often leads to false negatives because hCG levels may still be too low. If you absolutely can't wait, use a sensitive early detection test with first morning urine, and be prepared to retest in 2–3 days if negative.
https://www.oova.life/blog/10-dpo
What does implantation bleeding look like at 10 DPO?
Implantation bleeding at 10 DPO is typically light pink or brown, much lighter than a period, and lasts 1–2 days. It's often just spotting when you wipe or a few drops on a panty liner. However, only 15–20% of pregnant women experience implantation bleeding—most don't have any bleeding at all.
https://www.oova.life/blog/10-dpo
Why am I cramping at 10 DPO?
Cramping at 10 DPO can be caused by elevated progesterone (whether you're pregnant or not), implantation (if you're pregnant), or premenstrual cramping. Unfortunately, cramping alone can't tell you if you're pregnant since progesterone causes similar symptoms in both scenarios.
https://www.oova.life/blog/10-dpo
What are the chances of a BFP at 10 DPO?
If you're pregnant, you have about a 50–60% chance of getting a positive test at 10 DPO. This means there's a 40–50% chance of a false negative even if you conceived. Chances improve significantly by 12–14 DPO.
https://www.oova.life/blog/10-dpo
What DPO is most accurate for pregnancy testing?
14 DPO (the day of your missed period) is the most accurate time to test, with 99% accuracy. 12 DPO offers 80–90% accuracy. 10 DPO has only 50–60% accuracy. For best results, wait as long as you can—ideally until 12–14 DPO.
https://www.oova.life/blog/10-dpo
Is 10 DPO too early to test?
10 DPO is considered early for pregnancy testing. While some women get positives at 10 DPO, accuracy is only 50–60% if you're pregnant. For best results, wait until 12 DPO (80–90% accuracy) or 14 DPO/missed period (99% accuracy).
https://www.oova.life/blog/10-dpo
Can you have implantation at 10 DPO?
Yes, implantation can still occur at 10 DPO, though 84% of women have already implanted by this point. Late implantation at 10–12 DPO is normal. If implantation happens at 10 DPO, you won't get a positive pregnancy test for another 2–3 days.
https://www.oova.life/blog/10-dpo
What does a negative test at 10 DPO mean?
A negative test at 10 DPO does not mean you're not pregnant. It's very common to get negatives at 10 DPO even if you conceived. Your hCG levels may still be too low, or implantation may have occurred later. Wait until 12–14 DPO to retest for more accurate results.
https://www.oova.life/blog/10-dpo
Can you get a positive pregnancy test at 10 DPO?
Yes, but only about 50–60% of pregnant women will get a positive at 10 DPO. The other 40–50% have hCG levels that are still too low to detect. If you test negative at 10 DPO, wait 2–3 days and test again.
https://www.oova.life/blog/high-progesterone-symptoms
Can high progesterone cause weight gain?
Yes, elevated progesterone can cause temporary weight gain through water retention and bloating. This is a normal part of the luteal phase and early pregnancy.
https://www.oova.life/blog/how-to-increase-estrogen
Does stress affect estrogen levels?
Yes, chronic stress elevates cortisol, which can suppress estrogen production and disrupt hormonal balance. Stress reduction through meditation, yoga, adequate sleep, and self-care practices helps maintain optimal estrogen levels.
https://www.oova.life/blog/how-to-increase-estrogen
When should I consider medical treatment for low estrogen?
Consider medical intervention if natural methods don't improve symptoms after 3 months, if symptoms severely impact quality of life, if you're experiencing early menopause (before 40), or if you have fertility concerns. Hormone replacement therapy may be appropriate in these cases.
https://www.oova.life/blog/how-to-increase-estrogen
What are the signs that my estrogen is increasing?
Signs of rising estrogen include more regular menstrual cycles, reduced hot flashes, improved vaginal lubrication, better mood stability, increased energy, and improved skin elasticity. You may also notice reduced symptoms that originally indicated low estrogen.
https://www.oova.life/blog/how-to-increase-estrogen
Can exercise increase estrogen levels?
Yes, moderate exercise stimulates estrogen release and helps maintain hormonal balance. Aim for 150 minutes of moderate cardio weekly plus strength training twice per week. However, excessive exercise can actually lower estrogen, so balance is key.
https://www.oova.life/blog/how-to-increase-estrogen
How long does it take to increase estrogen naturally?
With consistent dietary and lifestyle changes, you may notice improvements in symptoms within 4-8 weeks. However, significant hormonal changes typically take 2-3 months. Tracking your cycle and symptoms can help you monitor progress.
https://www.oova.life/blog/how-to-increase-estrogen
What foods increase estrogen levels naturally?
Foods high in phytoestrogens can help increase estrogen naturally. The best options include flax seeds (high in lignans), soy products (tofu, tempeh, edamame), lentils, chickpeas, whole grains (oats, quinoa, brown rice), and garlic. These plant compounds mimic estrogen's effects in the body.
https://www.oova.life/blog/perimenopause
What helps relieve hot flashes quickly?
Cool environments, layered clothing, herbal teas, and medical treatments like gabapentin or HRT may help—depending on severity. Lifestyle changes like reducing caffeine and alcohol can also provide relief.
https://www.oova.life/blog/perimenopause
Are there tests to confirm perimenopause?
Yes. Tests measuring estradiol, LH, and FSH levels can indicate hormonal shifts—but diagnosis is often symptom-based since hormone levels fluctuate widely during perimenopause.
https://www.oova.life/blog/perimenopause
How do I know it's perimenopause and not something else?
A doctor may recommend hormone testing (like LH, E3G, and PdG) and track symptom timing. Diagnosis is often based on symptoms combined with age and menstrual pattern changes.
https://www.oova.life/blog/perimenopause
What's the earliest age perimenopause can start?
Some women begin experiencing symptoms as early as their mid-30s, though perimenopause typically starts between ages 38-45.
https://www.oova.life/blog/perimenopause
Does perimenopause affect mental clarity?
Yes. Brain fog and difficulty concentrating are common during hormone fluctuations in perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What happens after the last sign of perimenopause?
After your final period, you enter postmenopause. You'll need 12 consecutive months without a period to confirm menopause. Many symptoms gradually improve, though some like vaginal dryness may persist without treatment.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
When do perimenopause symptoms finally stop?
Some symptoms like brain fog improve after menopause, while others like hot flashes may continue for up to 10 years post-menopause. Vaginal symptoms often persist or worsen without treatment. Each person's timeline is different.
https://www.oova.life/blog/high-progesterone-symptoms
Is high progesterone a sign of pregnancy?
Yes, high progesterone is one of the earliest indicators of pregnancy. Progesterone levels rise significantly after conception to support the developing embryo and reach their peak during the third trimester.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Can you still get pregnant in late perimenopause?
Yes, you can still get pregnant during perimenopause as long as you're having periods, even if they're infrequent. Continue using birth control until you've gone 12 consecutive months without a period and have officially reached menopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Do symptoms get worse before perimenopause ends?
Yes, most perimenopause symptoms intensify in the final 1-2 years before menopause. Hot flashes peak around your final period, vaginal symptoms worsen, and mood changes increase. However, brain fog typically improves in late perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
How long does late perimenopause last?
Late perimenopause typically lasts 1-3 years before your final period. However, the exact duration varies significantly from person to person. You've reached menopause after 12 consecutive months without a period.
https://www.oova.life/blog/high-progesterone-symptoms
What are the symptoms of high progesterone?
High progesterone symptoms include fatigue, bloating, breast tenderness, weight gain, anxiety, depression, headaches, and food cravings. During pregnancy, you may also experience increased nipple sensitivity and muscle aches.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What are the first signs that perimenopause is ending?
The earliest signs include longer gaps between periods (60+ days), intensifying hot flashes that peak around your final period, and worsening vaginal dryness. These symptoms typically increase in late perimenopause before you reach official menopause.
https://www.oova.life/blog/high-progesterone-symptoms
When should I be concerned about high progesterone?
Consult a healthcare provider if you experience high progesterone symptoms outside your luteal phase when not pregnant, or if symptoms include severe pelvic pain, abnormal vaginal bleeding, or rapid weight gain while on hormone therapy.
https://www.oova.life/blog/high-progesterone-symptoms
How do you test progesterone levels?
Progesterone can be measured through blood tests at your doctor's office or at-home urine tests that measure PdG (a progesterone metabolite). Testing is typically done during the luteal phase, about 7 days after ovulation.

About the Oova Blog:
‍Our content is developed with a commitment to high editorial standards and reliability. We prioritize referencing reputable sources and sharing where our insights come from. The Oova Blog is intended for informational purposes only and is never a substitute for professional medical advice. Always consult a healthcare provider before making any health decisions.

Posts

Latest Articles

Progesterone Supplementation: Complete Guide to Pills, Suppositories & Creams
Hormones
Oct 23, 2025

Progesterone Supplementation: Complete Guide to Pills, Suppositories & Creams

Compare progesterone pills, suppositories, and creams. Learn about bioidentical options, effectiveness, side effects, and dosing for fertility and perimenopause. Written by a registered nurse.

Foods to Avoid During Perimenopause (And What to Eat Instead)
Perimenopause
Oct 23, 2025

Foods to Avoid During Perimenopause (And What to Eat Instead)

If you've noticed certain foods make your perimenopause symptoms worse, you're not imagining it. Learn which foods trigger hot flashes, worsen weight gain, disrupt sleep, and increase anxiety plus discover what to eat instead for symptom relief.

Perimenopause Belly Fat: Why It Happens & How to Lose It
Perimenopause
Oct 23, 2025

Perimenopause Belly Fat: Why It Happens & How to Lose It

If you've noticed your weight shifting to your stomach during perimenopause, you're not alone. Learn why perimenopause belly fat happens, how hormones affect fat distribution, and science-backed strategies that actually work to lose menopause belly.