When a couple is unable to conceive a child after a year of trying, they are considered infertile. In 40% of cases, this is caused by male-factor infertility; the next 40% of cases are caused by female-factor infertility; the final 20% of cases have an unknown cause.

Read on to learn about the top causes of male infertility — and treatment options.

1. Medications (and Hormones)

Certain medications can affect your sperm quality. This includes your sperm’s production, volume, or motility — all things that affect your fertility. When you meet with your urologist, bring a list of your medications. They can see if anything you’re taking may be contributing to your infertility. Medications that can affect fertility include calcium-channel blockers, anabolic steroids, antibiotics, and antihistamines.

Your urologist can also run tests to check your hormones. Hormone problems don’t commonly cause male infertility, but they may play a role.

2. Low Sperm Count

A common cause of infertility, low sperm count can be attributed to poor sleep, high stress, chronic exposure to harmful chemicals, lack of exercise, or a medical condition. You can naturally increase your sperm count by:

  • Getting a checkup with your urologist
  • Using protection during sex
  • Eating healthy and exercising
  • Avoiding toxins
  • Avoiding heat

3. Varicocele

The most common cause of infertility in men is a varicocele, a swollen vein in the testicle. Varicoceles are easily repaired with surgery. It takes a few months to be fully healed from this surgery. After this surgery, your sperm count and motility should increase.

4. Testicular Trauma or Surgery

Testicular cancer, undescended testicles, and other trauma can increase the risk of infertility. Surgery can also affect fertility — even if it’s on a body part that doesn’t seem like it’s directly related. This includes abdomen, back, pelvis, or prostate surgery. Infertility can also be caused by treatment for some health conditions, like multiple sclerosis or diabetes. When you meet with your urologist, tell them about your health history. Your urologist will be better able to determine the cause of your infertility.

5. Toxins

Men often don’t realize how much toxins can damage your fertility — or how many toxins they come in contact with every day. These include household cleaners, BPA, medical toxins, and those from drinking, smoking, and drug use.

Some toxins are impossible to avoid. There are ways to limit your exposure to some toxins. Avoid using pesticides around the house and yard. Use glass containers for food instead of plastic. And of course: stop drinking and smoking.

6. Infection

Infection can damage sperm or cause scarring in your reproductive system. Sexually transmitted infections, like gonorrhea or AIDS, can also impact sperm quality. Resolving these infections can improve fertility.

7. Ejaculation Issues and Erectile Dysfunction

Some men have trouble getting or maintaining an erection or ejaculating.

Ejaculation problems, like reverse ejaculation and ejaculatory inability, can be caused by traumatic injury or surgery. Premature ejaculation, which occurs when a man ejaculates during intercourse sooner than he or his partner would like, can also prevent the sperm from being in the right place to meet the egg.

Some men have structural issues, like tubule blockage, which is damage to the tubes that carry sperm. Because the tubes don’t correctly connect, they are unable to conduct the sperm out of the body.

Erectile dysfunction (ED) is when you can’t get an erection that’s not as firm or lasts as long as you would like. There are many causes of ED.

8. Mental Illness

Severe depression and extreme stress can affect your sexual function. Extreme stress can cause ED. Stress can interrupt the signals between your body and your brain, preventing you from getting an erection. Depression can negatively affect sperm concentration. Some medications used to treat depression can also cause ED.

9. Chromosomal Abnormalities

Your urologist may recommend genetic testing to see if you have chromosomal abnormalities that are affecting your fertility. Common genetic disorders include:

  • Spermatogenesis: Inability to produce healthy sperm cells
  • Azoospermia: Inability to produce any sperm cells
  • Oligospermia: Defects that result in very poor or low-quality sperm

Other genetic disorders can affect fertility, such as malformed sperm that can’t survive long enough to fertilize the egg.

Treatments for Male Infertility

The right treatment for your male infertility depends on the cause.

Surgery. A varicocele occurs when the veins in your spermatic cord aren’t able to allow adequate blood flow. This causes a backup of blood and swelling of the testes, which affects fertility. Surgery repairs the vein and returns normal function. After a surgical varicocele repair, you may experience minor pain and bruising. You’ll be able to return to your normal activities in a few days.

Surgery may also correct ejaculation problems and blockages, allowing for sperm to travel through the structures and out to meet the egg.

Timed Intercourse. Though there are five days in a woman’s fertile window, there are only 24 hours during a woman’s cycle when the egg is able to be fertilized. To increase the chances of conception, have intercourse every other day during the ovulation period. Your partner can use ovulation predictor kits to figure out when she is ovulating.

Avoiding Lubricants. Because they are viscous, lubricants can trap sperm and prevent them from reaching the egg. Most lubricants stop sperm from traveling well. Ask your doctor about alternatives to use while trying to conceive.

Healthy Lifestyle. Staying healthy is especially important while trying to conceive. Your fertility (and your partner’s) is affected by diet, smoking, drinking, exposure to toxins, lack of exercise, and obesity. Consider giving up drinking and smoking. Eat a healthy diet and exercise at least three times a week.

Assisted Reproductive Technology (ART). Many couples find success through ART. There are many different choices, and one may work for you.

  • Intrauterine insemination (IUI): Your sperm is placed into your partner’s uterus during ovulation.
  • In Vitro Fertilization (IVF): Your sperm meets your partner’s egg outside of the body, and the resulting embryo is placed into your partner’s uterus.
  • Intracytoplasmic Sperm Injection (ICSI): One sperm is placed into an egg, and the resulting embryo is placed into your partner’s uterus.

Medication. Medication can treat some of the causes of infertility. Antibiotics can treat infections. Hormone imbalances and erectile dysfunction can be treated by medication.

How Urologists Treat Male Infertility

If you think you have a fertility issue, schedule an appointment with your urologist. They will perform an exam and run tests to see if you are experiencing male infertility. If you do, your urologist will decide what treatments will help you resolve your fertility issues.