Male infertility: what to check first and what actually helps

Struggling to conceive can feel personal and confusing. Many men want clear, practical steps — not medical jargon. This page lays out the most common causes of male infertility, simple checks you can do now, and the real next steps if you need help.

Common causes and simple checks

Low sperm count, poor sperm movement (motility), and abnormal shape (morphology) are the usual culprits. Other causes include blockages that stop sperm from exiting, varicocele (enlarged veins in the scrotum), hormonal problems, infections, genetic issues, and some medicines. Lifestyle often plays a role: smoking, heavy drinking, recreational drugs, frequent hot baths, tight underwear, and anabolic steroids all harm sperm.

Start with a few quick checks at home: stop smoking, cut back alcohol, avoid hot tubs and saunas, switch to looser underwear, and don’t use anabolic steroids. If you’re overweight, losing even 5–10% of body weight can improve hormone balance. These changes won’t fix every problem, but they’re cheap, safe, and often help.

Tests and treatment options

The first medical test is a semen analysis. It measures count, motility, and shape. Your doctor may also order blood tests for hormones (FSH, LH, testosterone) and a scrotal ultrasound to look for varicoceles or blockages. If sperm isn’t present at all, genetic testing and a urology referral are common next steps.

Treatments match the cause. Infections get antibiotics. Varicoceles can be repaired with minor surgery, which helps some men. Hormone problems sometimes respond to medication like injectable hormones or oral drugs prescribed by a specialist. For many couples, assisted reproductive techniques work well: IUI (intrauterine insemination) if sperm quality is mildly reduced, or IVF with ICSI (intracytoplasmic sperm injection) for more severe issues.

Over-the-counter supplements are popular. Zinc, folate, vitamin D and CoQ10 show mixed but promising results in some studies. Supplements are not a guarantee; talk to a doctor before starting anything, especially if you take prescription meds.

When to see a specialist? If you’ve tried to conceive for 12 months (or 6 months if your partner is over 35), get evaluated. Also see a doctor sooner if you have testicular pain, noticeable lumps, or a history of cryptorchidism (undescended testicle) or childhood chemo/radiation.

Practical checklist: get a semen analysis, fix obvious lifestyle harms, see a urologist or fertility clinic if initial tests are abnormal, and discuss assisted conception when needed. Infertility can be treated in many cases — being proactive and getting the right tests is the best first move.