Male-factor infertility can be defined as any health issue that lowers the probability of his female partner getting pregnant. Difficulties getting pregnant can be upsetting for anyone involved, irrespective of gender. Often, it is female infertility issues that are more widely spoken about, with factors such as age, the cessation of menstrual cycles, ovary syndrome and endometriosis commonly discussed.

Despite this, according The National Institutes of Health, male reproductive issues are just as responsible for cases of infertility, with a further third categorised as "unexplained infertility". Here's an overview to the signs of infertility as a man and what can cause male-factor fertility challenges.

The signs of infertility in a man

As with biological women, the main indication of male infertility is an inability to conceive.  Often, there are no noticeable symptoms of infertility, however there are some warning signs in a man's body that can indicate infertility issues. These include:

Issues with sexual function

‍This can involve finding it hard to ejaculate, erectile dysfunction (inability to get or maintain an erection), or ejaculating small volumes of liquid. Reduced libido or sex drive is also classified as a sexual dysfunction, and so such issues are not limited to the male reproductive system.

Pain or swelling in the testicles

Testicular pain is famously sore. Thankfully, it is usually temporary, however continued soreness in the testicles, swelling and bruising can indicate more serious problems which can lead to male infertility:

• Physical trauma- Testicular damage can cause blood to leak into the scrotum which, without surgical intervention, can cause infertility.
• Testicular torsion – Is a testicle twists inside of the scrotum, it can block flow of blood necessary for them to function. Similarly, surgery may be required to prevent infertility. Boys aged 12-18 have the highest risk of testicular torsion.
• Epididymitis – This is when the epididymis – a narrow tube attached to each testicle – becomes inflamed, and is usually caused by an infection, often an STD. If left untreated, scar tissue can develop around the testicles and prevent healthy sperm from being released. ‍

Inability to smell

‍It may seem unlikely, but a lack of sense of smell (anosmia) is unlikely to be related to issues with fertility. However, it can be an indication of Kallmann Syndrome – a congenital condition which effects the development of sex characteristics during puberty. If the loss of smell is caused by Kallmann Syndrome, you may experience infertility as another symptom of the condition.

Decreased facial hair or body hair

‍A loss facial or bodily (especially pubic) hair can be an indication of the genetic disorder Klinefelter Syndrome (KS). A genetic condition One impact KS can have is preventing sperm production, thus leading to infertility. For more information on Klinefelter syndrome please visit the NIH website.

Inability to conceive

If you have been unable to get pregnant after over a year of unprotected sexual intercourse (primary infertility), it may be an indication of male-factor infertility. In such cases, your GP will be able to guide you towards next steps, treatment plans and hopefully solutions.

What are the causes?

A number of biological and environmental factors can contribute to male-factor infertility. These include:

• Hormonal disorders - Disorders that affect the pituitary gland can affect infertility. Located in the brain, the pituitary gland produces certain hormones which instruct the testicles to produce sperm. Over-production of prolactin, often caused by a tumor in the pituitary gland can lead to imbalanced hormone levels and result in low or no sperm production. A simple blood test can be done to check your hormone levels for any hormonal imbalances.
• Genetic conditions - Klinefelter’s Syndrome, Y-chromosome microdeletion, myotonic dystrophy are examples of genetic diseases that can result in little to no sperm production in the testicles.

Issues relating to sperm

Lower than normal sperm count – A low sperm count (known also as oligozoospermia) is when a man has fewer than 15 million single sperm cells per millilitre of semen and can make it difficult to conceive. Diagnosing a low sperm count can only be done through a semen analysis which you can organise through your GP or your Fertifa Patient Advisor.

Low sperm motility - This is when a significant proportion of sperm cells exhibit reduded mobility. Poor sperm motility contributes to male infertility because it reduces the chance of sperm reaching and fertilising the egg. Different classifications of low sperm motility include:

• Asthenozoospermia: This condition refers to a general reduction in sperm motility, where the majority of sperm cells exhibit sluggish or non-progressive movement.
• Oligoasthenoteratozoospermia (OAT): This condition combines low sperm count (oligospermia), poor motility (asthenozoospermia), and abnormal morphology (teratozoospermia). 

Inflammatory disease - Inflammation of the prostate or past genital infections, contracted from an STD for example, can prevent semen flow through the genital tract.

Preexisting medical conditions - Diabetes, autoimmune disorder and cystic fibrosis are all medical conditions which can put a man at risk of infertility.

Mental health issues - Depression and anxiety can both affect sexual desire in a man. This may reduce the frequency of unprotected sex a couple might have, and therefore the chances of getting pregnant.

Fertifa is a helping hand for people experiencing all kinds of reproductive health concerns. ​If you'd like to book in a call to discuss how we can provide men's health benefits for you and your team at work, get in touch here. We'd love to speak 💜 

Read our guide to male fertility

In our guide, we'll answer the questions our doctors and nurses get asked the most about male fertility:

• What is male infertility and what causes it
• What is male subfertilit
• How do I find a sperm donor?
• How can I become a solo parent as a man

Every person or couple has a different experience when it comes to trying for a baby. Some people get pregnant quickly, and for others it can take much longer. If you’ve been trying for a baby for a year or more and your partner is not pregnant or if you'd like to get your sperm tested, it’s a good idea to speak to your Fertifa Patient Advisor who can help you with the next steps.

If you're not part of Fertifa, but you're interested in putting fertility support and benefits in place at work, get in touch here to book a call with our team. We'd love to chat about how we can help 💜