- \n
- Possible causes of male-factor infertility include low or no sperm count, poor sperm motility, and sexual or ejaculatory dysfunction.<\/li>\n\n\n\n
- Medicine for improving sperm count or quality include Clomid, FSH, anastrozole, and hCG. These drugs should only be used by men diagnosed with infertility under the care of a physician.<\/li>\n\n\n\n
- Supplements that are available without a prescription, including antioxidants, vitamin D, L-carnitine, folate, zinc, and D-aspartic acid, may also help improve sperm health and support healthy sperm production.<\/li>\n<\/ul>\n\n\n\n
What are the causes of male-factor infertility?<\/h2>\n\n\n\n
Infertility affects one in six couples who are trying to conceive \u2014 and in at least half of all cases of infertility, a male factor is a contributing cause. This means that in the US, around 10% of all males who are attempting to conceive suffer from infertility.<\/p>\n\n\n\n
Male fertility relies on a complex system of processes, including the ability to make healthy sperm, obtain an erection, and ejaculate to ensure the sperm reaches the egg. Problems with any of these processes may contribute to male-factor infertility.<\/p>\n\n\n\n
Infertility may be diagnosed after a heterosexual couple has been actively trying to conceive for 6\u201312 months or more. In males, potential causes for infertility include low or no sperm count, poor sperm motility, and sexual or ejaculatory dysfunction.<\/p>\n\n\n\n
Low or no sperm count<\/h3>\n\n\n\n
According to the World Health Organization (WHO), a normal sperm concentration is around 15 million sperm per milliliter (mL) of semen.1<\/sup> When someone has a low sperm count, also known as oligospermia<\/a>, the condition can have an adverse effect on fertility by reducing the chances of fertilizing the egg. Oligospermia doesn\u2019t necessarily mean that you can\u2019t conceive, but it does mean that your chances of conception are lower than those with higher sperm counts. <\/p>\n\n\n\n
A 2006 study that looked at oligozoospermic couples found that those with a sperm concentration of over 2 million sperm per mL of semen had a 22.1% chance of natural conception. In cases where sperm count was less than 2 million per mL of semen, chances of natural conception dropped to 1.6%.2<\/sup><\/p>\n\n\n\n
Cryptozoospermia<\/a> refers to an extremely low concentration of sperm (less than 100,000 sperm per mL of semen). In some cases, the sperm count may be measured as zero in an initial analysis. In one 2018 study of men at infertility clinics in Turkey, cryptozoospermia was found in 27.2% of male-factor infertility cases.3<\/sup><\/p>\n\n\n\n
A complete absence of sperm is called azoospermia<\/a>. This condition is experienced by 15% of those with male-factor infertility and 1% of the general male population.4<\/sup> Because there is no sperm present in semen, azoospermia makes conception without medical intervention improbable.<\/p>\n\n\n\n
Poor sperm motility<\/h3>\n\n\n\n
Sperm motility is sperm\u2019s ability to move and \u201cswim.\u201d Poor sperm motility, or a low number of sperm swimming efficiently, is another factor that can lead to fertility issues.<\/p>\n\n\n\n
A healthy semen sample has at least 40% motile sperm, and has at least 32% progressive motility5<\/sup> \u2014 meaning that the sperm are not just moving, but moving in straight lines or large circles, paths that help the sperm reach and fertilize an egg. Various studies indicate statistically significant decreases in motility of 0.6% per year of age, resulting in a 3\u201312% decline in motility over 20 years.6<\/sup><\/p>\n\n\n\n
Read more about how to improve sperm quality and motility. <\/a><\/p>\n\n\n\n
Sexual or ejaculatory dysfunction<\/h3>\n\n\n\n
Sexual dysfunction, including reduced sexual desire and erectile dysfunction<\/a>, may cause fertility issues by making sexual intercourse more difficult. The chances of developing erectile dysfunction increase with age due to lower testosterone levels and restricted blood flow, but age is not the only cause. A 2024 study found that 24% of American men experienced erectile dysfunction, and the prevalence increases with age.7<\/sup><\/p>\n\n\n\n
During ejaculatory dysfunction \u2014 which may include premature ejaculations<\/a>, retrograde ejaculation<\/a>, or delayed ejaculation<\/a> \u2014 sperm may not effectively reach the female reproductive system, which can negatively impact fertility. The prevalence of male infertility due to ejaculatory dysfunctions is overall just under 2%.8<\/sup><\/p>\n\n\n\n
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<\/figure>\n\n\n\n<\/div>\n\n\n\nMedications to improve sperm production<\/h2>\n\n\n\n
Some causes of male-factor infertility, such as low sperm count or poor sperm quality, may be treatable with medication. Remember, these medications should only be used by men diagnosed with infertility under the care of a physician.<\/p>\n\n\n\n
The most common sperm improvement medications include:<\/p>\n\n\n\n
Clomid (clomiphene citrate) for male infertility<\/h3>\n\n\n\n
Though Clomid (clomiphene citrate) is typically used to treat female infertility, it may also help in cases of low sperm count or quality. Clomid is an estrogen modulator, meaning it blocks estrogen from interacting with the pituitary gland. This can increase the levels of other male fertility hormones<\/a>, including <\/p>\n\n\n\n
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- testosterone<\/li>\n\n\n\n
- luteinizing hormone (LH)<\/li>\n\n\n\n
- follicle-stimulating hormone (FSH)<\/li>\n<\/ul>\n\n\n\n
Clomid has been shown to increase sperm concentration and motility, which could help oligospermic or poor motility patients achieve pregnancy.9<\/sup><\/p>\n\n\n\n
For azoospermic patients, Clomid may resume sperm production or increase the odds of a successful testicular sperm extraction, in which sperm cells are retrieved via needle directly from the testes and then transferred to a lab to mature.<\/p>\n\n\n\n
In a study of 42 azoospermic patients given clomiphene citrate, 64.3% of the patients had sperm in their semen analyses post-treatment (ranging from 1 to 16 million sperm\/mL with an average concentration of 3.8 million\/mL). Sufficient sperm for intracytoplasmic sperm injection (ICSI) was retrieved via testicular sperm extraction in all patients, even though 35.7% remained azoospermic.10<\/sup><\/p>\n\n\n\n
FSH for male infertility<\/h3>\n\n\n\n
Follicle-stimulating hormone (FSH) is a hormone released by the pituitary gland in the brain. In males, it stimulates testicular growth and helps aid the creation of sperm cells. Across 17 clinical trials evaluating FSH use in infertile men, FSH was shown to increase overall pregnancy rates, especially in men with oligozoospermia, oligoasthenoteratozoospermia or OAT \u2014 in which all semen parameters are abnormal\u2014 and hypogonadism (low testosterone).11<\/sup><\/p>\n\n\n\n
FSH is typically an injectable hormone medication sold under the brand names Follistim and Gonal-F. Unfortunately, FSH is not effective for those with testicular failure, in which the testes cannot produce sperm even with proper levels of LH, FSH, and testosterone.<\/p>\n\n\n\n
Anastrozole or letrozole for male infertility<\/h3>\n\n\n\n
Anastrozole and letrozole are medications that work to decrease the production of estrogen and increase testosterone in the body. Both have been shown to help correct hormonal imbalances and improve sperm production in men with subfertility.<\/p>\n\n\n\n
In a 2017 study, 86 men with low T were treated with 1mg of anastrozole daily; 95.3% of patients had an increased serum T and decreased serum E2 after treatment, and sperm concentration and total motile counts improved in 18 of 21 men.12<\/sup> Letrozole has similarly been shown to improve testosterone-to-estrogen ratios and semen parameters in infertile men.13<\/sup><\/p>\n\n\n\n
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<\/figure>\n\n\n\n<\/div>\n\n\n\nTestosterone replacement therapy for sperm production?<\/h3>\n\n\n\n
If a man has low testosterone levels that are contributing to infertility, why not just take injectable testosterone?<\/p>\n\n\n\n
The use of exogenous (or external) testosterone, known as testosterone replacement therapy, seems like it would be beneficial for fertility. After all, a small amount of testosterone is necessary for the production of healthy sperm. And in fact, in a 2023 survey published by Legacy<\/a>, 72% of respondents believed taking testosterone would improve<\/em> a person\u2019s fertility.<\/p>\n\n\n\n
However, adding testosterone to the body disrupts the hypothalamic-pituitary-gonadal axis, the balance and flow of hormones from one part of the endocrine system to another. Exogenous testosterone actually works to inhibit the production of other fertility hormones, significantly impairing or even halting sperm production altogether.<\/p>\n\n\n\n
In most cases, men taking testosterone will have zero sperm count within 4\u20136 months of starting therapy. TRT should not be undertaken by those who hope to conceive. Check out our guide to testosterone replacement therapy.<\/a><\/p>\n\n\n\n
hCG for male infertility<\/h3>\n\n\n\n
Human chorionic gonadotropin (hCG) is actually a hormone primarily produced by the placenta during pregnancy \u2014 if you or your partner have ever used a pregnancy test \u201cpee stick,\u201d it\u2019s hCG that the test is measuring in your urine. However, hCG also functions much like LH does in the body.<\/p>\n\n\n\n
Treatment with hCG may help improve the condition of low testosterone (hypogonadism) caused by issues in the hypothalamus or the pituitary gland. According to a 2021 literature review spanning over 40 years of research, hCG therapy is considered the top choice for patients suffering from secondary hypogonadism because it triggers the body to produce testosterone and sperm without side effects on fertility, such as those seen in testosterone replacement therapy.14<\/sup><\/p>\n\n\n
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<\/figure>\n\n<\/div>\n\n\n\nTrying to conceive?<\/p>\n\n\n\n
Find out which sperm test is best for you.<\/p>\n\n\n\n