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Male Infertility: Infertility Warning Signs

Medically reviewed by Mary Rani Cadiz, MD · Obstetrics and Gynecology

Written by Honey Buenaventura · Updated Jan 29, 2021

Male Infertility: Infertility Warning Signs

Issues of infertility can affect men and women. In fact, each group is responsible for 30% of infertility cases. The rest is a combination of both male and female factors. Therefore, it is necessary to check both partners’ fertility. More so if they are unable to conceive after more than a year of regular, unprotected intercourse. If it is the male who is the contributing cause of infertility, knowing and understanding the infertility warning signs can help. 

How to Increase Chances of Getting Pregnant Naturally

What are the symptoms of male infertility?

Male infertility can have multiple causes. Some are due to problems with sperm development. In other cases, they might experience difficulty in delivering sperm to the woman’s ovaries. Infertility usually does not show visible symptoms, especially in men. However, there are male infertility warning signs you should be aware of:

Low sexual drive

Male infertility warning signs include a lack of a sex drive. Changes in virility are triggered by the hormones responsible for the male reproductive system. Injuries and diseases like pituitary tumors can also cause hormonal problems.

Pain, discomfort, and swelling in the testicles

These can come from trauma or minor accidents such as a direct kick to the crotch. Sometimes, these are medical emergencies that may require surgery.

Testicular swelling can be a result of the following: 

Testicular torsion. This is characterized by a twisted testicle in the scrotum. As a result, the twisting disrupts blood flow, which impairs the functionality of the testicles. 

Varicoceles. This is an enlargement of veins in the scrotum. 

Epididymitis. This is due to a bacterial infection in the testicles.

Hydrocele. This occurs when there is the buildup of fluid around the testicles due to an injury or blockage.

Hernia. If not treated immediately, it can damage the vas deferens, the tube in which the sperm travels through. 

Erectile dysfunction (ED)

This is one of the most obvious infertility warning signs among men. It is the inability to maintain an erection firm enough for intercourse. This condition affects at least 30 million males. In most cases, ED relates to hormonal imbalances. Other causes include: 

Venous leak. A venous leak occurs when the blood vessels do not constrict enough to keep the blood in during sexual arousal.

Anxiety and stress. Studies show that psychological factors can affect a man’s sexual drive and performance.

Lifestyle choices. Alcohol, tobacco, and drugs contain ingredients that can affect the functionality of the reproductive organs. 

Issues with semen

Difficulty in ejaculating during intercourse is one of the more observable male infertility warning signs. This is often a direct result of erectile dysfunction. The inability to ejaculate can indicate problems with sperm production as well as other health conditions  such as diabetes and/or nerve problems. If a man is able to ejaculate, sometimes the problem lies in the quality of sperm. Usual causes are:

Genetic defects. Chromosomal abnormalities such as Down’s Syndrome and spina bifida can affect sperm quality.

Sexually transmitted infections (STIs). STIs like chlamydia and gonorrhea can cause infection in the reproductive organs and impair fertility  by causing substantial damage in the sperm.

Medication. Some drugs and medications can cause male infertility. For example, anabolic steroids lower sperm quantity.

Exposure to heat and radiation. The testicles have a lower temperature compared to other organs. Subjecting them to heat or high doses of radiation can cause permanent damage to sperm production. 

Other infertility warning signs in males include loss or thinning of hair, retrograde ejaculation, and enlarged breasts (gynecomastia). 

Infertility 101: Addressing Common Conception Problems

How do doctors diagnose male infertility?

After knowing male infertility warning signs, it is important to get checked by your doctor so proper treatment can be prescribed. Assessment usually begins with a thorough history taking and physical exam. This will include disclosing your medical history, as well as your sexual habits. These will help determine factors that might cause your infertility. Afterward, men can undergo additional tests, which may include: 

Semen analysis. A sample of your semen is taken for laboratory evaluation. It usually includes examining sperm count, motility, and appearance. 

Testicular biopsy. A needle is inserted through the scrotum in order to take a sample of tissue from the testes. This is an effective method to check sperm production. 

Ultrasonography. An ultrasound maps out the reproductive organ, which makes it easy to check for blockages and scarring. 

Hemizona assay and Acrosome reaction. These are examples of lab tests that examine a sperm’s penetration abilities. 

How do you treat male infertility?

Treatment of male infertility depends on the cause. This is determined by infertility warning signs and diagnosis. Male infertility can be treated with medication or certain procedures, some of which include: 

Hormone therapy

Certain medications can alter hormone levels that affect fertility. For example, injecting recombinant human follicle-stimulating hormone (rhFSH) into the blood helps increase sperm count.


Surgical procedures can address damage and blockages within the reproductive organs. For example, cutting off abnormal veins can repair varicoceles. Moreover, doctors can remove obstructions within the reproductive tract. 

Lifestyle changes

Proper diet, exercise, and avoidance of bad habits, such as alcoholism and smoking, can improve fertility. 

Assisted Reproductive Technologies

For couples who are trying to conceive, assisted reproductive technologies (ART) may also be advised. These are fertility methods used to stimulate pregnancy. Examples of ART include: 

  • Intrauterine insemination (IUI). This procedure places sperm directly into the uterus using a fine catheter. It is most effective at the time of ovulation. 
  • In-vitro fertilization (IVF). IVF surgically collects eggs and are combined with sperm in a petri dish where fertilization can occur. Doctors then plant embryos into the uterus. Additionally, this procedure requires hormone pre-treatment. 
  • Intracytoplasmic sperm injection (ICSI). In this advanced procedure, doctors inject a single, healthy sperm into an egg to create an embryo. 

Key Takeaways

Male infertility accounts for 30% of all infertility cases. It typically stems from problems in sperm production and other physical dysfunctions, though symptoms of male infertility are not usually obvious. Sometimes, it is not until the couple tries to conceive that problems will be more evident. It is also important to understand fertility and check for any infertility warning signs. In doing so, couples can seek the treatment they need. 

Learn more about Getting Pregnant here. 


Hello Health Group does not provide medical advice, diagnosis or treatment.

Medically reviewed by

Mary Rani Cadiz, MD

Obstetrics and Gynecology

Written by Honey Buenaventura · Updated Jan 29, 2021

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