Here's What You Should Know About Male Infertility Treatments and Testing
Updated on Oct 28, 2026
When you’re ready to start a family, it’s discouraging if things take longer than expected. You may be wondering if it’s too soon to think about female or male infertility treatments.
Generally, if your partner isn’t pregnant after 12 months (6 months, if your partner is 35 or older) of regular, unprotected intercourse, it’s worth talking to your healthcare team. They can help uncover if you or your partner might have a fertility issue that would benefit from treatment.
Male factors contribute to 30–50% of cases of infertility. Luckily, help is available. Male infertility treatments range from lifestyle changes to medication, surgery, and services at a fertility clinic.
First, you need to figure out the root of the problem. It may be a minor concern or require some testing. Then, your healthcare team can help come up with a plan. Here’s what you should know.
Key Takeaways
- There are several possible causes of male infertility, ranging from genetic conditions to lifestyle factors.
- Male infertility treatments depend on the underlying issue that’s causing it.
- Sometimes, healthy lifestyle changes are all that’s needed to improve male fertility.
- Other times, men have a blockage or hormone issue that needs medical treatment.
- To find the best path forward for your family, both partners may need a fertility check.
What Causes Male Infertility?
Male infertility may have more than one cause. To figure it out, your doctor may do a physical exam and other testing to learn more about your health.
Reproductive Tract Blockages
The tubes that carry sperm can get blocked. Blockages prevent sperm from becoming part of the semen. These blockages may be caused by an infection or an injury. A medical history, physical exam, semen analysis, and, when needed, imaging tests can help determine if there’s a blockage.
Hormonal Problems
Hormones from the brain and testes regulate sperm production. Sometimes, there’s an imbalance of hormones. Low testosterone or disorders of the pituitary gland or testes can interfere with sperm production. Blood hormone levels (FSH, LH, testosterone) can help identify disorders responsible for hormone imbalances or sperm production issues.
Other Sperm Production Issues
Conditions such as varicocele (enlarged veins in the scrotum), undescended testicles, and infections can affect sperm production. Chemotherapy and use of anabolic steroids can also be a factor. Your physician will take your medical history and check for physical signs that may contribute to the problem.
Know more: Inito – How to Produce More Sperm
Poor Sperm Quality
Even if your body makes sperm, that sperm doesn’t always lead to conception. A low sperm count or some abnormalities in sperm movement (motility) or shape (morphology) can prevent fertilization. Semen analysis can help identify these issues.
Genetic Conditions
Some genetic disorders can affect the testicles and sperm. One example is called Klinefelter syndrome. Your healthcare team can order genetic tests, such as chromosome analysis (karyotyping), to help diagnose genetic conditions. Additional tests may vary depending on the suspected condition.
Sexually Transmitted Infections (STIs)
Infections such as chlamydia, gonorrhea, or orchitis can damage the reproductive tract. These diseases may interfere with sperm transportation through the body, potentially affecting male fertility. Testing and treatment will depend on your signs and symptoms.
Lifestyle and Environmental Factors
Male infertility may also be related to an unhealthy habit or something in your environment. Smoking, heavy alcohol use, obesity, and exposure to certain toxins may negatively affect sperm production and quality. Lifestyle changes won’t just benefit your fertility, but also your general health.
How Is Male Infertility Treated?
Male infertility isn’t one condition. It may be a combination of factors that should be addressed holistically.
No Treatment
Not every case of male infertility needs immediate treatment. Some couples just need a little more time. Studies show that 23% of untreated couples conceive after 2 years. After four years, this rate goes up to 33%. Even in men with very low sperm, called severe oligozoospermia, 7.6% produce a pregnancy within two years without treatment.
Lifestyle Changes
Even if your doctors find a specific cause of male infertility, healthy lifestyle changes are still worth making. Just remember, these changes can’t replace medical treatment for some underlying causes of male infertility.
What to Avoid
Research has linked smoking to lower sperm counts and poorer sperm morphology, motility, and DNA integrity. Stopping smoking has beneficial effects on sperm and overall health.
High alcohol intake may reduce semen volume. Experts aren’t sure if moderate drinking makes a big difference.
Other things to avoid include:
- Artificial lubricants during sex that could affect sperm
- Illegal and recreational drug use, such as marijuana
- Unnecessary prescription drugs, with the help of your healthcare team
- Exposure to pesticides and toxic heavy metals, such as lead, mercury, boron, and cadmium
- Other avoidable chemical exposures
- Prolonged, repeated heat exposure around the testes (like in saunas and hot tubs)
What to Improve
Researchers have found that diets with more fruits, vegetables, whole grains, nuts, and seafood are associated with better sperm quality. These foods should replace processed meats, sweets, and sugar-sweetened drinks.
If you have extra body fat, research suggests that losing just 5-10% of your total body weight can lead to better sperm outcomes, such as count and quality.
Also, don’t dismiss the effects of stress. A recent study found links between psychological stress and impaired semen parameters, particularly sperm concentration and motility.
Know more: 9 Sperm Killers to Avoid When You're Trying to Conceive
Oral Therapies
Some causes of male infertility may be treated with oral therapies (treatments you take by mouth). Examples include antioxidants, aromatase inhibitors, clomiphene, L-carnitine, N-acetylcysteine, nutritional supplements, and tamoxifen. Here’s what you should know about each category.
Supplements
There’s a lot of interest in supplements for male fertility. Some oral therapies, including antioxidants, L-carnitine, N-acetylcysteine (NAC), and other nutritional supplements, have been studied in men with idiopathic infertility (no known cause) or abnormal semen.
Recent studies suggest that L-carnitine, CoQ10, and NAC may improve some sperm parameters.
Improvements were seen in sperm concentration, motility, and morphology in a recent review using L-carnitine and NAC. Whether these benefits translate into higher pregnancy or live-birth rates isn’t clear.
Another larger review of 50 studies found that supplements didn’t clearly increase pregnancy or live-birth rates, despite improvements in sperm measures.
Know more: From A to Zinc: The Best Vitamins for Male Fertility
Hormonal Medications
Clomiphene and tamoxifen are also known as selective estrogen receptor modulators (SERMs). SERMs stimulate the body’s production of hormones that support testosterone and sperm production. Doctors may consider SERMs in men with unknown or hormone-based infertility problems.
A study found clomiphene increased sperm concentration and motility in infertile men. Older studies have also reported that tamoxifen may increase sperm density in some men with low sperm counts. However, these medicines aren’t suitable in every case and might not always impact pregnancy rates.
As a result, current guidelines don’t routinely recommend SERMs for male infertility. A semen analysis and hormone testing can help your doctor decide if SERMs might be helpful for you.
Sexual Counseling and Behavioral Therapy
Issues like erectile dysfunction or premature ejaculation can benefit from counseling and treatment. Sex therapy can help address male infertility.
It can also guide you and your partner on a schedule for intercourse that’s most likely to cause pregnancy. For the best chance of pregnancy, have intercourse at least twice a week during the woman’s most fertile days (also called the fertile window).
Know more: When to Have Sex to Conceive
Surgery
Physical causes of male infertility may require surgery. Here are some examples.
Ejaculatory Duct Obstruction
A blockage or cyst (fluid-filled sac) in the ejaculatory ducts can cause several problems. Blockages can reduce semen volume or prevent sperm from reaching the semen. This can lead to semen that doesn’t have sperm in it.
Doctors may drain a cyst or remove a blockage through the urethra. For some men, these procedures improve semen quality.
Varicocele Repair (Varicocelectomy)
A varicocele is an enlargement of the veins around the testicle. This condition may affect sperm production. Repairing it with surgery can fix a clinically detectable large varicocele. This may help with abnormal semen parameters and low sperm counts.
Studies show that semen parameters can improve after surgery. But the effect on pregnancy rates isn’t guaranteed.
Vasovasostomy or Vasoepididymostomy
Certain procedures can help restore the flow of sperm from the testicles into the semen. These procedures may reverse a vasectomy or fix infection-related blockages.
If surgery doesn’t work, a fertility specialist may use assisted reproductive technology to retrieve the sperm.
Assisted Reproductive Treatments
When lifestyle changes, medicines, or surgery aren’t enough, assisted reproductive techniques (ART) can help. Doctors need to consider several male and female fertility factors before finding the best treatment option.
Intrauterine Insemination
Intrauterine insemination (IUI) is a simpler type of fertility treatment. Washed sperm are inserted into the uterus during ovulation.
IUI can help if sperm counts are mildly low or there’s low sperm motility. As long as enough healthy, moving sperm are available, IUI may be all the extra support that’s needed for conception.
One study looked at 672 IUI cycles in couples with male-factor infertility. The pregnancy success rate was 12.95% per cycle.
If sperm counts are very low or have a lot of abnormal features, IUI isn’t the best option. Other fertility treatments, known as IVF or ICSI, may work better.
Know more: What Are the Factors That Affect IUI Success Rates?
IVF and ICSI
IVF (in vitro fertilization) involves retrieving eggs from the ovaries for fertilization with sperm in a laboratory. Then, the embryo is transferred back to the uterus.
ICSI (intracytoplasmic sperm injection) is a specialized form of IVF. Providers inject a single sperm directly into an egg. ICSI may be used for:
- Severe male-factor infertility
- Very low sperm counts
- Poor sperm movement
- Past problems with fertilization
Sperm may need to be surgically removed from the testicles or reproductive tract for ICSI in men with azoospermia (no sperm in the semen).
Know more: Is ICSI More Effective Than IVF? Key Differences Explained
There’s a lot to consider when choosing male infertility treatments. Your physician can help you weigh the options based on your test results. They’ll also consider your partner’s fertility and your past attempts and treatments.
Genetic Treatments
Klinefelter syndrome (47, XXY) is the most common genetic cause of male infertility. It almost always leads to non-obstructive azoospermia. That means there’s no sperm in the semen even though there isn’t a blockage.
Fortunately, modern medicine can still make fatherhood possible. A study of 64 men with Klinefelter syndrome found that sperm was successfully retrieved in 50% of patients. The method was a procedure called microdissection testicular sperm extraction (micro-TESE).
The second known genetic cause of azoospermia is Y-chromosome microdeletions. Sperm retrieval can also work for men with this condition. Success depends on the specifics of their genetics, including the region of the Y chromosome that’s affected. Some forms of the disorder have a better chance of retrieval, such as AZFc deletions.
Treatment for genetic causes of male infertility may include:
- Genetic counseling to understand how your genes may affect your children
- Sperm retrieval surgery (TESE or micro-TESE) to take sperm directly from the testicles
- ICSI to fertilize the egg using the retrieved sperm
What About Low Sperm Count Treatment (Oligospermia)?
A sperm concentration below 16 million/mL is considered low. Treatment is based on the underlying cause, hormone levels, and other semen-test results.
If low sperm is caused by a large varicocele or a blockage, you may need a procedure to fix it.
Hormone-related issues can be treated with medication. In men with hypogonadotropic hypogonadism, the body doesn’t make enough hormones. As a result, the testes aren’t stimulated to produce testosterone and sperm.
Treatment with the hormones hCG (human chorionic gonadotropin) and FSH (follicle-stimulating hormone) can help. In some men, doctors may consider clomiphene.
Testosterone replacement therapy should not be used to treat infertility in men trying to conceive, as testosterone replacement suppresses sperm production. It doesn’t treat male infertility.
If there’s no clear cause of oligospermia, antioxidants and supplements, such as L-carnitine, CoQ10, and NAC, may improve low or abnormal sperm. But if these changes and treatments don’t help, you and your partner can explore infertility treatments, such as IVF.
When Should You See a Specialist?
Consider a fertility evaluation if:
- You and your partner have been trying for 12 months without success (6 months if your partner is over 35)
- You have a history of testicular injury, surgery, or an undescended testicle.
- You notice testicular pain, swelling, or changes in sexual function.
- A semen analysis has already shown abnormal results.
Remember, male infertility is a medical condition. You didn’t do anything wrong to deserve it.
Most cases can be diagnosed and treated successfully. There’s no need to wonder or try to figure it out alone. A fertility specialist can guide you towards the right testing and available options.
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Anastasia Climan
RDN, CD-N
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