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 can be felt in the testicle, sometimes accompanied by a dull ache.
What to do: A urologist can determine whether a varicocele is present using an ultrasound. In severe cases, a minor surgical procedure or embolization can help normalize blood flow.
2. Hormonal Disorders
Hormonal balance is crucial for sperm production. A deficiency in testosterone (hypogonadism) or imbalances in 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 reveal 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 changes (e.g., Klinefelter syndrome or alterations to the Y chromosome) can lead to severely reduced or even absent sperm production.
Signs: Genetic causes are often only discovered when there is an issue with having children, as there are usually no obvious external symptoms.
What to do: In cases of significantly impaired semen analysis, specialists often recommend a genetic test. Together with a human geneticist, you can discuss further family planning.
4. Infections
Sexually transmitted infections (e.g., chlamydia, gonorrhea) or mumps in adulthood can block the sperm ducts or damage testicular tissue.
Signs: Burning during urination, discharge, or pain in the testicles can be warning signs. In adult mumps infections, swollen salivary glands are often observed, and the testes may be affected.
What to do: If an infection is suspected, you should definitely see a doctor and get tested. Early antibiotic treatment can prevent further complications.
5. Ejaculation and Erection Disorders
Sometimes the quality of the sperm is not the issue. It may not even reach successful transfer. Retrograde ejaculation (where semen enters the bladder instead of exiting) or erectile dysfunction can block the natural path to fertilization.
Signs: Absence of ejaculation, low semen 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, which can further impair fertility.
Signs: Often, there are no direct physical warning signs—the limitations usually only appear in semen analysis or through the inability to conceive.
What to do: Reduce or avoid nicotine, alcohol, and illegal substances. Ensure regular relaxation periods and incorporate stress management into your daily routine (e.g., exercise, relaxation techniques, adequate sleep).
7. Overweight and Nutrition
Being overweight alters 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 a week) and gradual, healthy weight loss promote fertility.
8. Environmental Factors and Toxins
Certain environmental toxins (e.g., pesticides, solvents, heavy metals) as well as radiation (e.g., X-rays, extreme heat environments) can reduce sperm quality over time.
Signs: Often, there are no direct symptoms. However, those who are frequently exposed to chemicals or radiation in their profession are at higher risk.
What to do: Ensure adequate protective measures at work, such as appropriate clothing or masks. If possible, avoid excessive sauna use or long hot baths, and do not keep electronic devices close to the groin area for extended periods.
9. Sperm DNA Damage
Even if there are enough sperm present, their DNA may be so severely damaged that successful fertilization is not possible. Oxidative stress occurs when free radicals overwhelm the body—promoted by smoking, unhealthy diet, environmental toxins, or chronic diseases.
Signs: Usually only detected through specialized semen tests or further fertility examinations.
What to do: A diet rich in antioxidants (e.g., vitamins C and E, zinc, selenium) can help neutralize free radicals. Quit smoking, reduce stress, and avoid excessive heat and toxins.
10. Congenital Malformations and Developmental Disorders (Less Common but Relevant)
Cryptorchidism—when one or both testicles 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 impacts 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 testicle may feel smaller or less palpable.
What to do: Those who were operated on late or not at all should have their sperm quality tested. A urologist can determine 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.