Fertility

Male fertility is the ability to cause pregnancy in a fertile female. If you are thinking about reducing your fertility, you can read about vasectomy here.

Why is this important?

If you and your partner have tried unsuccessfully to conceive for a year or more through regular unprotected sex, you should seek advice from your GP.

If your female partner is over 35, or if you think that either partner may have a fertility problem, see your GP after six months of trying.

There are many things that might affect your ability to conceive, and there are various options for treatment or assisted conception.

Who does it affect?

Around 1 in 7 couples in the UK may have fertility problems. Many couples with fertility problems go on to conceive, with or without treatment. Both men and women can experience difficulties with fertility.

What could be affecting your fertility?

In men, the most common cause is poor quality of semen, meaning there is a lower amount of sperm in the semen than normal. Up to a fifth of young men find themselves with a low sperm count and it is the cause of infertility in up to 20% of couples who struggle to conceive.

Low sperm count could be caused by various factors, including:

  • A hormone imbalance such as hypogonadism, where the testes produce few or no hormones
  • An inherited genetic problem
  • Undescended testicles
  • A problem with the male genital tract - for example, the tubes that carry sperm can be damaged and blocked by illness or injury
  • A genital infection or condition such as chlamydia, gonorrhoea, prostatitis or varicocele (dilated veins within the testicles).

Your fertility could also be affected by certain medications, including testosterone replacement therapy, long-term anabolic steroid use, and cancer medications (chemotherapy), or by surgery to the scrotum.

Your lifestyle can also be a factor - smoking, drinking alcohol, being overweight and stress can all affect your fertility.

Smoking can reduce your sperm count, though it should increase again if you quit.

Age and fertility

Male fertility reduces slightly from about the mid-forties, as the quality of sperm declines, so it’s worth having a semen analysis if you’re over 40 and your partner is having problems conceiving.

These figures show typical ability to conceive after one or two years of trying:

Fertility1
Fertility2

Talking to your partner

The process of trying to conceive can be emotional, so you will need to support each other as much as possible. Stress is just one of the things that can affect fertility. The problem could be with either a male or female partner, so it’s important that both of you speak to a clinician.

If you decide to get treatment or explore different options for having a child, it may be costly, time-consuming and stressful, so you should talk through what is right for both partners and for your relationship in the longer term.

More support

Get tested

Prepare

When you first seek advice from a fertility clinic or GP, the clinician may recommend you keep trying for a while if you’ve been having regular, unprotected sex for less than a year.

If you've been trying for more than a year, your clinician may recommend a range of tests to determine what's stopping you from conceiving. You may also be offered counselling to support you if you’re struggling to conceive.

In about one third of cases, fertility problems are due to the male partner.

What kind of tests are there?

A clinician is likely to carry out a physical examination, checking your testicles and penis for abnormalities including testicular lumps or signs of infection.

Further testing might include:

  • A semen analysis - you will be asked to supply a small amount of ejaculate (semen) which can be tested to check if you have a low sperm count, low sperm motility (sperm are not moving properly) or abnormal sperm. You may be asked to stop having sex for a few days before the test to ensure you produce enough ejaculate.
  • A chlamydia test - you will need to supply a urine sample. If you have chlamydia, you will be prescribed antibiotics to treat it.
  • Many other tests can be carried out to see whether something is affecting your female partner’s fertility. Read about these here.

What to do next

Whether or not a clear cause is found, your clinician will talk you through the next steps. This may include referral to a fertility clinic for further investigation or treatment.

Questions?

As there are many causes for subfertility there is no single test, however, a semen sample is usually an important part of the investigation. This checks the number and activity of sperm in the sample.

Subfertility problems can affect both men and women. In 25% of cases no cause for the subfertility is found. In women, common causes are not producing an egg each month, endometriosis, or damage to the fallopian tubes following infection or trauma. In men, common causes are low sperm count or low sperm activity. Read more about female fertility here.

Treatment of the cause of the fertility problem may improve fertility. Many couples with fertility problems go on to conceive, with or without treatment. Couples who have been trying to conceive for three years and have not conceived have a 25% chance or less of conceiving in the following year.

Staying healthy with a healthy diet, giving up smoking, alcohol and recreational drugs and reducing the stress in your lifestyle can improve your chances of conceiving. Timing sex to be at the most fertile time can also improve the chances of conception. The most fertile time of the month is your partner’s average cycle length in days minus 14 - this gives you the most likely day of ovulation.