Male infertility
A male factor contributes to around half of couples' fertility problems. Assessing the man is a core step, not an afterthought.
Overview
Assessment is advised after a year of trying without pregnancy, or after six months if the female partner is 35 or older. Assessing both partners together saves time.
Some causes of reduced male fertility can be treated, such as a varicocele or hormonal imbalance. Others call for assisted reproduction.
Common symptoms
- No pregnancy after a year or more of trying
- Swelling or heaviness in the scrotum, especially after standing for long
- A history of undescended testis or surgery in the area
- An abnormal result on a previous semen analysis
How we diagnose it
- Semen analysis
- At least twice, after two to seven days of abstinence, since results vary between samples.
- Hormone tests
- Such as testosterone and the hormones that regulate sperm production.
- Scrotal ultrasound
- To assess the testes and any varicocele.
- Genetic testing
- In selected cases with absent or very low sperm counts.
Treatment options
Listed from least invasive. Treatment is chosen after assessment and agreed with you.
Frequently asked questions
Does one poor result mean infertility?
No. Results vary between samples, so we repeat the test before drawing conclusions.
Does a varicocele always affect fertility?
Not always. We treat it when it is linked to abnormal results or symptoms, not just because it is there.
Do fertility supplements help?
Some may help in specific cases, but they don't fix a structural cause. We discuss them after assessment.
Related conditions
Erectile dysfunction & men's health
Confidential assessment of erectile problems and low testosterone, with stepwise treatment up to penile implants.
Read about this ChildrenChildren's urology
Undescended testis, hypospadias, bedwetting, childhood urinary infections, and circumcision.
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