Understanding male infertility: Causes, myths and facts
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Male infertility: The Basics1

  • Male infertility means a man is unable to make his female partner pregnant, even after having regular, unprotected sex for at least one year, despite the woman being fertile.
  • Male-related factors account for nearly 50% of all infertility cases.

Common Causes

Lifestyle

Lifestyle2,3

  • Drug use: Steroids, marijuana and cocaine can lower sperm count and quality
  • Alcohol: Heavy or regular alcohol intake can reduce testosterone and sperm production
  • Smoking: Men who smoke often have fewer and less healthy sperm
  • Stress: Having emotional stress can affect hormones and semen quality
  • Obesity: Extra weight can cause hormonal changes that reduce fertility
Environmental causes

Environmental causes2

  • Long term exposure to chemicals, toxins, radiation, X-rays and excess heat around the scrotum can affect sperm quality and sperm production
Genetic conditions

Genetic conditions2

  • Certain inherited conditions can affect development of testis and sperm production
Sexually transmitted infections

Sexually transmitted infections2

  • Certain infections such as gonorrhoea or HIV can damage sperm or block their passage
Other causes

Other causes2

  • Hormonal problems: Imbalances in thyroid or adrenal hormones can reduce sperm count
  • Medicines and surgeries: Medicines used to treat conditions such as cancer, depression or arthritis can affect sperm production, and certain surgeries may also impact fertility
  • Testicular issues: Conditions such as varicocele (enlarged veins in the scrotum) can lower sperm count and sperm quality, making conception more difficult

Terms you must know!4

Oligozoospermia

Oligozoospermia:
Low sperm count

Asthenozoospermia

Asthenozoospermia:
Poor movement of sperm

Asthenozoospermia

Teratozoospermia:
Abnormal sperm shape

Busting common myths5

  • Myth Stress affects fertility only in women
  • Fact Stress impacts fertility in both men and women; in men, it can lower sperm count and quality
  • Myth Age affects only women’s fertility
  • Fact Male fertility decreases with age, as semen volume, movement and shape worsen, reducing the chances of pregnancy and increasing the risk of miscarriage.
  • Myth Infertility is only a woman's problem
  • Fact Infertility can affect both men and women, and male factors contribute to 50% of all infertility cases worldwide

Key Takeaways

  • Infertility is not just a 'woman’s issue.' Lifestyle, age, stress and health matter for both partners.
  • With appropriate medical guidance, healthy habits and timely interventions, most couples can overcome infertility and achieve parenthood.

Understanding infertility is the first step, taking action together is the next.

Abbreviation

HIV: Human immunodeficiency virus; ART: Assisted reproductive techniques; IUI: Intrauterine insemination; IVF: In-vitro fertilisation; ICSI: Intracytoplasmic sperm injection

References

1. Leslie SW, Soon-Suton TL, Khan MAB. Male Infertility. Treasure Island (FL): StatPearls Publishing. Available from: htps://www.ncbi.nlm.nih.gov/books/NBK562258/. Accessed on: 23 September 2025.

2. Low sperm count. Mayoclinic.org. Available from: htps://www.mayoclinic.org/diseases-conditions/lowsperm-count/symptoms-causes/syc-20374585. Accessed on: 24 September 2025.

3. Durairajanayagam D. Lifestyle causes of male infertility. Arab J Urol. 2018;16(1):10–20.

4. Kumar N, Singh AK. Trends of male factor infertility, an important cause of infertility: A review of literature. J Hum Reprod Sci. 2015;8(4):191–6.

5. Abishek A, Jayendiran K, Jose C. Review on myths about infertility-an atempt to clear the air. Int J Res Med Sci. 2023;11:2756–64.