Male infertility does not mean that the desire to have children must remain unfulfilled. By knowing the most common causes and seeking medical advice in a timely manner, you can do a lot for your fertility. Whether it's lifestyle adjustments, medical treatments, or a combination of both – today's medicine offers numerous possibilities. The key is to approach the topic openly and seek the appropriate support so that the dream of having your own child becomes within reach.
1. Varicocele
A varicocele is an enlargement of the veins in the scrotum (similar to varicose veins in the legs). It leads to disrupted blood flow, overheating of the testes, and often results in reduced sperm quality.
Signs: Often, an enlarged or twisted vein in the testis can be felt, sometimes accompanied by a dull ache.
What to do?: A urologist can determine whether a varicocele is present through an ultrasound. In severe cases, a minor surgical procedure or embolisation can help normalise blood flow.
2. Hormonal Disorders
The hormonal balance is crucial for sperm production. A deficiency in testosterone (hypogonadism) or imbalances of other hormones (e.g., LH, FSH, thyroid hormones) can impair fertility.
Signs: Reduced libido, fatigue, decreased muscle strength, or increased abdominal fat may indicate a testosterone deficiency.
What to do?: A simple blood test can provide insights into hormone levels. Depending on the cause (e.g., genetic, medication-related, or disease-related), appropriate therapy – from hormone substitution to adjusting certain medications – can help.
3. Genetic Factors
Certain congenital alterations (e.g., Klinefelter syndrome or changes to the Y chromosome) can lead to severely impaired or even absent sperm production.
Signs: Genetic causes are often only discovered when there is an unfulfilled desire to have children, as there are usually no obvious external symptoms.
What to do?: In cases of severely impaired semen analysis, specialists often recommend a genetic test. Together with a human geneticist, further family planning can be discussed.
4. Infections
Sexually transmitted infections (e.g., chlamydia, gonorrhoea) or mumps in adulthood can block the sperm ducts or damage testicular tissue.
Signs: Burning during urination, discharge, or testicular pain can be warning signs. In cases of mumps infection in adulthood, swollen salivary glands are often observed, and the testes may be affected.
What to do?: If an infection is suspected, it is essential to see a doctor and get tested. Early antibiotic treatment can prevent subsequent damage.
5. Ejaculation and Erection Disorders
Sometimes, the quality of the sperm is not the issue. In some cases, sperm are never successfully transferred. Retrograde ejaculation (where sperm enters the bladder instead of exiting) or erection disorders can block the natural path to fertilisation.
Signs: Absence of ejaculation, low ejaculate volume, or erection problems.
What to do?: A medical evaluation (urology, andrology) is important. Depending on the cause, medications, physical therapies, or psychological support can help.
6. Lifestyle Factors
Smoking, alcohol, and drugs have been proven to negatively affect sperm quality. For example, smoking reduces sperm motility, while alcohol disrupts hormonal balance and certain drugs lower testosterone production. Chronic stress also increases cortisol levels, further impairing fertility.
Signs: Often no direct physical warning signs – the limitations usually only appear in the semen analysis or through an unfulfilled desire to have children.
What to do?: Reduce or avoid nicotine, alcohol, and illegal substances. Ensure regular periods of rest and integrate stress management into your daily routine (e.g., exercise, relaxation techniques, sufficient sleep).
7. Overweight and Diet
Being overweight changes hormone levels: The proportion of estrogen increases while testosterone decreases. Severe overweight (obesity) can also trigger comorbidities such as diabetes or high blood pressure, which also reduce fertility.
Signs: A Body Mass Index (BMI) over 25 is considered overweight, and over 30 is classified as obesity.
What to do?: Focus on a balanced diet with plenty of fruits, vegetables, and high-quality proteins. Moderate but regular exercise (2–3 times per week) and gradual, healthy weight loss promote your fertility.
8. Environmental Factors and Toxins
Certain environmental toxins (e.g., pesticides, solvents, heavy metals) as well as radiation (e.g., X-rays, high-heat environments) can reduce sperm quality over time.
Signs: Often no direct symptoms are noticeable. However, those who are professionally exposed to chemicals or radiation are at higher risk.
What to do?: Ensure adequate protective measures at work, such as appropriate clothing or masks. If possible, avoid frequent sauna sessions or extended hot baths and do not keep electronic devices permanently in the vicinity of your groin.
9. Sperm DNA Damage
Even if there are sufficient sperm, their DNA can be so heavily damaged that successful fertilisation is not possible. Oxidative stress occurs when free radicals in the body become excessive – promoted by smoking, unhealthy diet, environmental toxins, or chronic illnesses.
Signs: Usually only detected through specialised semen tests or further fertility examinations.
What to do?: A diet rich in antioxidants (e.g., vitamins C and E, zinc, selenium) can help neutralise free radicals. Avoid smoking, reduce stress, and avoid excessive heat and toxins.
10. Congenital Malformations and Developmental Disorders (Rare but Relevant)
Cryptorchidism – when one or both testes do not descend into the scrotum in time. This condition is corrected in many affected individuals during childhood, but not always in time to completely rule out later effects on fertility. Other malformations or scarring in the vas deferens area can also impair fertility.
Signs: Often detected at birth or during childhood. In adulthood, a testis may feel smaller or less palpable.
What to do?: Those who were operated on late or not at all should have their sperm quality checked. A urologist can assess whether further interventions or supportive measures are advisable.
Conclusion
Male infertility does not mean that the desire to have children must remain unfulfilled. By knowing the most common causes and seeking medical advice in a timely manner, you can do a lot for your fertility. Whether it's lifestyle adjustments, medical treatments, or a combination of both – today's medicine offers numerous possibilities. The key is to approach the topic openly and seek the appropriate support so that the dream of having your own child becomes within reach.