The decision to have a baby is a joyful milestone in your life and relationship. But for 10-15% of couples, that joy gives way to the frustration and heartbreak of infertility. It can be especially difficult to understand because we feel like it should be easy. But conception is actually a very complex process that depends on so many conditions being just right.

A problem in any one of many biological steps can stop conception in its tracks.

When pregnancy doesn’t happen, it’s not always easy to determine why. It could be a problem with either partner or a combination of factors. In about 40% of cases, the cause – or part of the cause – is found to be the man.

Although there are many causes of male infertility, they tend to fall into one of four categories: medical issues, medical treatments, environmental factors, and lifestyle factors.

1. Medical Issues

Medical issues tend to be problems with sperm or mechanical problems (blockages). But many more medical conditions that affect fertility aren’t associated with reproduction.

Infertility in men is often related to issues producing sperm. It’s essential to produce enough sperm that are shaped correctly and can move the way they should. Some men don’t produce sperm or don’t produce enough. It may only take a single sperm to fertilize an egg, but the odds are stacked against success. It’s a dangerous journey to reach the egg, and millions of sperm don’t survive the trip.

A semen analysis can determine if you’re producing enough sperm to improve the odds, if they’re good swimmers, and if they’re the right size and shape.

Sometimes the issue is a mechanical one, including:

Many medical conditions not directly related to reproduction can also influence fertility. Some affect how sperm is developed, causing low amounts or abnormally shaped sperm. Others affect sperm mobility by causing blockages, sperm that can’t move correctly, seminal fluid that’s too thick, or erectile dysfunction.

Some medical conditions that may affect fertility include:

  • Autoimmune issues
  • Cancer
  • Celiac disease
  • Chromosomal abnormalities
  • Cystic fibrosis
  • Depression
  • Diabetes
  • Extreme stress
  • Hormone imbalances
  • Hyperprolactinemia (too much of the hormone prolactin)
  • Infection (sexually transmitted)
  • Injury to the genitals or pelvic area
  • Kidney failure
  • Klinefelter syndrome
  • Swollen veins around the testicles, called varicocele
    Thyroid problems

2. Medical Treatments

Certain medical treatments can also affect male fertility, including:

  • Anabolic steroids
  • Calcium channel blockers (medications taken for high blood pressure)
  • Chemotherapy
  • Exposure to some medicines, like spironolactone, cimetidine, or ketoconazole
  • Radiation therapy
  • Sulfasalazine, a medication taken for rheumatoid arthritis (RA) or ulcerative colitis (US)
  • Tricyclic antidepressants

If you think prescription medications may be affecting your fertility, your prescribing doctor may be able to recommend another option.

3. Lifestyle Factors

Certain lifestyle and environmental factors can affect sperm production or function. Some are out of your control (age), but others are not. Making healthy changes, like quitting smoking, can improve your fertility and overall health.

Some lifestyle factors to consider include:

  • Age (over 40)
  • Alcohol abuse
  • Drugs like cocaine or marijuana
  • Excessive exercise
  • Exposing testes to high temperatures, like frequent hot tub use
  • Exposure to testosterone
  • Obesity
  • Smoking tobacco

4. Environmental Factors

While rare, exposure to toxins can have a negative effect on your fertility. Beware of toxins at home or in the workplace, like:

  • Chemical exposure
  • Heavy metals
  • Herbicides
  • Pesticides
  • Pollution
  • Radiation
  • Solvents

Ways to Support Your Fertility

There are some lifestyle factors you can influence that can improve the health of your sperm as well as your overall health.

  • Avoid anabolic steroids, recreational drugs, and excessive alcohol use
  • Eat a healthy diet
  • Exercise regularly, but not excessively
  • Maintain a healthy weight
  • Manage your stress
  • Quit smoking

If you and your partner are struggling to conceive, a urologist is an important part of the medical team to find the cause of your challenges. Once the cause is determined, treatments can help improve your chances of having a baby.

Don’t delay – schedule an appointment with a urologist today!