Male Infertility – What Are the Main Issues?

last updated on: 03.06.2025 | Medical review by:

Mayara Belli

Nutritionist

When we think about pregnancy and the difficulties in making it happen, we always tend to take the responsibility onto ourselves, as women. It is always the woman who goes after tests and more tests, and we are always the ones talking about this topic. But when it comes to fertility, both partners need to be investigated, since men are responsible for half of what makes a pregnancy possible.

Male infertility—or even infertility as a couple—can appear after some time spent trying. Usually, doctors ask couples to wait and try for one year. But it’s always important to dig deeper and do tests to find out how the couple’s reproductive health is. There are cases where the man refuses to take tests, but it’s necessary for both to be willing for a pregnancy to happen.

The main test for men is the semen analysis¹. Through it, it is possible to discover if everything is okay with the sperm, and also to point out possible causes of male infertility.

The semen analysis examines the chemical condition of the semen and some characteristics of the sperm. The main sperm characteristics analyzed are their quantity, motility, and shape. All these qualities are essential for successful fertilization.

The semen analysis is performed through masturbation at a clinic or laboratory. After the semen is collected, it is analyzed to check the following characteristics:

Volume and concentration: The amount of semen and sperm per milliliter. The recommended number is over 20 million.
Motility: This is the sperm’s ability to move forward properly. The expected result is that at least 50% move normally.
Morphology: The shape of the sperm, including head, body, and tail. An ideal total number is above 15% of the ejaculated sperm. For the Kruger morphology result, those considered perfect should be above 4%.

Often, infertility in the couple or in the man can be due to low sperm concentration, low motility, and also morphology, which in some cases can be extreme². The problems that can usually be detected include:

Oligospermia: Less than 15 million sperm per milliliter.
Oligoastenospermia: Reduced motility and quantities below ideal.
Teratospermia: Inadequate sperm morphology.
Necrospermia: Inactive or dead sperm.
Leucospermia: Changes in white blood cells in the semen, usually due to some type of infection.
Azoospermia: Absence of sperm in the semen.
Asthenospermia: Sperm that do not move as they should and are slower.

The acidity of the semen can also be a factor that may damage the lifespan of the sperm. That’s why pH needs to be balanced, both in the semen and in the vaginal canal: so that the sperm is in an ideal environment to move toward the egg.

External factors such as smoking, tight clothing (very tight pants and underwear), varicocele, STIs (sexually transmitted infections like syphilis and chlamydia) and common, easily treated infections can affect sperm. Also, the use of drugs and substances like anabolic steroids and steroids can affect male fertility by influencing the main male sex hormone, testosterone.

Sometimes, there are simple solutions like using certain vitamins³. An example of a vitamin that can help is vitamin E. In some cases that are easy to treat, tribulus terrestris has proven very useful in treating male infertility. However, all causes should be analyzed individually and with careful judgment by the doctor accompanying the couple.

Investigating both partners instead of just the woman can shorten a path of suffering and pressure about pregnancy. Suffering without seeking help is not a good idea. If your husband or partner still refuses to get tested to check for any problems, just show him this post and the countless conditions that can affect male fertility. It’s more common than you think.

Reader Silvana Chaves and her husband Talles Chaves went through a tough time when they were trying for their first baby, who is now one year old. Here’s a bit more about Silvana and her husband’s case:

“We had been trying to get pregnant for 2 years when the doctor suggested we go for a deeper investigation.

Their shape was also very different from normal: some had 2 tails, others 2 heads, some were flattened, and many were dead. The doctor then suggested a treatment, which included quitting smoking, alcohol, and taking vitamin E along with another daily medication (I can’t remember the name).

About 3 months later, he repeated the tests and, to our joy, the results were much better and there was no longer a need for in vitro fertilization. Four months after the results and the start of treatment, I became pregnant with my son Renan, who has just turned one. So, ladies, don’t hesitate to seek medical help; a good professional’s opinion can be crucial to ending a couple’s suffering.”

Remember that hormone tests are also very welcome. Besides the urologist, your gynecologist can also request tests for your partner if there is any suspicion of a problem.

I hope I helped!

See also: Methods to get pregnant part 1

Male Infertility – What Are the Main Issues?

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