Written by Ben Bunting: BA(Hons), PGCert.
Having a baby is generally a natural and simple experience. However, some couples find it difficult to conceive. In fact, data sugests that up to 15% of couples experience fertility issues within the first year of unprotected sex. 
In this article we shall cover the following points:
- What is male infertility
- Is infertility common
- Male infertility symptoms
- What genetics cause infertility
- What to do if you're concerned
- Infertility treatments
- Infertility prevention
- Coping with infertility
What Is Male Infertility?
Infertility can affect both men and women. As a man, your fertility depends on the quality and quantity of your sperm. If the sperm is of poor quality, or if the sperm ejaculate is low, it’s going to be difficult to, and in some cases, it’s impossible to get pregnant. 
If you’ve been trying to conceive without success for 12 months, and you have been having intercourse at least twice a week, it’s might be time to visit your doctor. 
If you are aware of the factors that could have an impact on your chances of getting pregnant, it’s best if you seek help early on. Both you and your partner should ideally be tested for reproductive issues at the same time. Infertility is something that should be tackled as a couple.
Is Infertility Common?
Infertility is an issue that affects many people. In around 8% of couples struggling with infertility, the issue is only within the male partner. For around 35% of couples, the issue is with both. 
This means that the man contributes to infertility in about half of all cases. A Danish study of the population foud that about 75% of men have poor semen quality which causes infertility.  Furthermore, 1% of men may not produce any sperm at all. 
Sperm health is also a contributing factor to infertility, it can be affected by things like nutrition and someone’s lifestyle choices.
What Are The Male Infertility Symptoms?
In the majority of cases, the signs of infertility aren’t obvious. You will probably have no issues with sexual activity, ejaculations, or erection, and to the naked eye, your semen will appear healthy.
That said, here are some key points you may wish to take note of:
- General sexual dysfunction - low libido, unable to ejaculate or releasing small volumes of semen, impotency.
- Abnormal pain or lumps around the groin.
- Loss of smell.
- Fatty deposits around your breast area knwon as gynecomastia.
- Respiratory infections.
- Lack of body hair which would allign with low testosterone.
- Age - fertility may reduce with age.
However, the big symptom is not being able to conceive after consciously trying regularly for a long period of time.
If you are struggling to conceive after 12 months, you will need medical tests to help identify to cause of your infertility.
What Can Cause Male Infertility?
Infertility can be caused by many issues that have an impact on sperm production or how well the sperm travels. There are specific medical tests that can help to figure out the cause.
Around 2% of all men have a problem where their sperm production is low, exhibits poor motility or is abnormal. 
Some men will also have other physical problems, including those who have chosen to have a vasectomy but have now decided they would like to have children. Obstructions (blockages) in the tubes that come from the testicles to the penis can also prevent men from ejaculating sperm. 
The less common causes of male infertility include:
- The pituitary gland (a hormone controller in your brain) producing low levels of hormones. This affects the amount of luteinizing hormone and follicle-stimulating hormone which can reduce testosterone and sperm production.
- Sexual issues which have an effect on how successfully semen is able to enter the vagina. This is often referred to as 'retarded ejaculation'. 
- The male is producing sperm antibodies which are known as Antisperm Antibodies (ASA). These are proteins that fight against the sperm. You will find these in 9%-12% of infertile men. 
- Male infertility can also be from genetics.
We've already written an extensive article covering the widespread causes of male infertility, here.
What Genetics Cause Male Infertility?
Some changes to gene mutation of chromosomes can be a cause of infertility in men and contribute between 15-30% of cases. 
This is because they are harmful to the production of sperm and can block the flow of sperm.
The most common causes of infertility that are genetic are chromosomal conditions that have an impact on the way that sperm is produced. Including:
- Klinefelter syndrome, a condition that means you are born with an extra X chromosome
- Y chromosome deletions, a condition that means you are missing some of the makeup of your Y, specifically that chromosomes that are essential for sperm production.
- Other genetic problems, including Down syndrome.
- Infertility can also be because of mutations, DNA changes, in single genes, however, this far less common.
Other genetic conditions may be discovered in the future. These findings could help to explain further if any other sperm production problems don’t currently have a cause.
What Should YOu Do If You Are Concerned About Your Fertility?
If you and your partner have been trying to conceive for around 12 months without success, the best thing you can do is to plan a visit to your family planning clinic or your doctor. 
Infertility isn’t just one person’s problem, it’s something a couple must handle together. Even if your partner has had children in a previous relationship, both people still need to be tested.
At the end of the day, things change. Infertility can also be an indication that you have other health problems, possibly ones you are unaware of. This makes it important that you checked out. 
How Is Male Infertility Diagnosed?
In accordance to the World Health Organizarion guidelines, a qualified professional will speak to you about your medical history, complete a full physical examination, and conduct semen analysis. This will check a range of things including the shape, number, and movement of your sperm. 
They may take a blood sample too, this is to check on the levels of hormones that are controlling the sperm production, this is linked to genetic testing.
In some cases, your doctor may want a urine sample so they can see if any sperm is present.
This can happen if there is an issue known as retrograde ejaculation. You may sometimes be referred for an MRI, testicular biopsy ( a small surgery that takes a small tissue sample for testing), or ultrasound.
What Treatments Are Used For Male Infertility?
1 in 8 infertile men can receive treatment for their infertility, and after treatment, couples can usually conceive pregnancy naturally. Some treatments include completely natural remedies such as clinically proven phytotherapy or herbal medicines often overlooked by western medicinal practitioners in the past.  You can check out Fertiligy which combines 12 proven nutrients to improve male fertility and libido.
If treatments are unsuccessful your doctor may recommend for you, as a couple, to look at assisted reproductive treatment to achieve pregnancy. This includes in vitro fertilization (IVF). 
These aren’t used ot treat infertility by the means of curing it, however, they can assist you and your partner to become pregnant, even if you have an extremely low sperm count.
When looking at genetic causes of infertility, there are not currently any treatments. If you aren’t able to father children naturally, assisted reproductive treatment offers you the best chance of having biological children.
Is There Anything That Can Help To Prevent Infertility?
There are many things that can be harmful to the production of sperm, therefore it is best that you aim to avoid:
Avoid Being Overweight
This has been linked to sperm production problems. If you want to prevent this from being a problem, you need ot ensure you are within a healthy weight range for your body type. 
Overcome Addictions to Alcohol, Smoking, and Drugs
Addictions can be disruptive to the proper function of biological processes. Anything in excess can easily become an addiction and, therefore, you need to monitor your intake. If you are trying to conceive you should ideally avoid them altogether. 
Maintain an Optimum Testicular Temperature
If you wear clothing that is too tight for you it can affect the circulation of blood in the genital region leading to a rise in the temperature of the testicles. A higher testicular temperature has been linked with infertility by having an impact on sperm production. 
Avoid Mobile Phone and Laptop Radiation
Most electronic gadgets emit a low level of radiation which may affect sperm production. Make sure you don’t sit with a laptop on your lap for extended periods of time. You should also try to avoid having your mobile phone in the pocket of your pants or on your belt. 
Eat Nutritious Food
Nutrition is an important part of staying fertile. A lack of nutrients, such as zinc and vitamin D can cause problems in sperm production. Make sure you are eating a balanced and healthy diet which can help reduce inflammation.
You may need to look for ways to supplement with nutrients if your diet is lacking, and there is strong evidence circulating reagarding the use of antioxidants such as vitamin A (as found in Fertiligy). 
Exercise is important in any healthy lifestyle. The effects of exercise on spem health and male fertility is inconclusive, however, it does seem that recreational exercise is beneficial, whereas very intense, eleite sports can be harmful. 
The general consensus is that a bit of exercise is better than none, but hardcore regimes can have the opposite effect.
Be Mindful of Your Working Environment
Some work environments can have an impact on your fertility, so if you work somewhere like this, you need to make sure you are wearing the protective clothing that is provided. You should also follow all occupational health and safety guidelines. If you are dealing with chemicals, you should ideally stay away from any that are harmful.
How To Cope With Infertility
It can be an upsetting and shocking experience to learn that you are infertile. It’s not something that you can prepare for. For some fertility problems can impact their sense of sexuality, potency, and masculinity.
It is completely normal to react emotionally. Talking with a counselor, sexual therapist, or doctor can help you if you are feeling negative. And, of course, turning to partner, family, and friends can also help. There are also programmes available combining multiple therapeutic methods to help with the distress of infertility. 
Male infertility is extremely common, and the data would suggest it is a condition that is on the rise. 
Some of the symptoms allign with low testosterone, this can include low libido, desire and even less body and facial hair.
Furthermore, look for other physical sugns such pain and swelling around the gron area.
Loew levels of ejaculation can also point towards infertility, but the biggest marker is being unable to conceive after 12 months of regular unprotected intercourse.
If this is the case, visit a doctor who can then refer you to a specialist.
 http://www.nichd.nih.gov/. (2018). How common is infertility? [online] Available at: https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common
 Sharpe, R.M. (2012). Sperm counts and fertility in men: a rocky road ahead. EMBO reports, 13(5), pp.398–403. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3343360/
 Taylor, A. (2003). Extent of the problem. BMJ : British Medical Journal, [online] 327(7412), pp.434–436. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC188498/
 Centers for Disease Control and Prevention. (2019). Infertility. [online] Available at: https://www.cdc.gov/reproductivehealth/infertility/index.htm
 Jørgensen, N., Joensen, U.N., Jensen, T.K., Jensen, M.B., Almstrup, K., Olesen, I.A., Juul, A., Andersson, A.-M., Carlsen, E., Petersen, J.H., Toppari, J. and Skakkebæk, N.E. (2012). Human semen quality in the new millennium: a prospective cross-sectional population-based study of 4867 men. BMJ Open, 2(4), p.e000990. https://bmjopen.bmj.com/content/2/4/e000990
 Cocuzza, M., Alvarenga, C. and Pagani, R. (2013). The epidemiology and etiology of azoospermia. Clinics, [online] 68(Suppl 1), pp.15–26. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583160/
 Kumar, N. and Singh, A. (2015). Trends of male factor infertility, an important cause of infertility: A review of literature. Journal of Human Reproductive Sciences, 8(4), p.191. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691969/
 www.hfea.gov.uk. (n.d.). Infertility surgery for men | Human Fertilisation and Embryology Authority. [online] Available at: https://www.hfea.gov.uk/treatments/explore-all-treatments/infertility-surgery-for-men/
 Read, J. (1999). Sexual problems associated with infertility, pregnancy, and ageing. BMJ : British Medical Journal, [online] 318(7183), pp.587–589. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115031/
 A. S., V., Dhama, K., Chakraborty, S., Abdul Samad, H., K. Latheef, S., Sharun, K., Khurana, S.K., K., A., Tiwari, R., Bhatt, P., K., V. and Chaicumpa, W. (2019). Role of Antisperm Antibodies in Infertility, Pregnancy, and Potential for Contraceptive and Antifertility Vaccine Designs: Research Progress and Pioneering Vision. Vaccines, [online] 7(3). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789593/
 Dada, R., Shamsi, M. and Kumar, K. (2011). Genetic and epigenetic factors: Role in male infertility. Indian Journal of Urology, 27(1), p.110. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114572/
 nhs.uk. (2020). How long does it usually take to get pregnant? [online] Available at: https://www.nhs.uk/pregnancy/trying-for-a-baby/how-long-it-takes-to-get-pregnant/
 Cedars, M.I., Taymans, S.E., DePaolo, L.V., Warner, L., Moss, S.B. and Eisenberg, M.L. (2017). The sixth vital sign: what reproduction tells us about overall health. Proceedings from a NICHD/CDC workshop. Human Reproduction Open, [online] 2017(hox008). Available at: https://academic.oup.com/hropen/article/2017/2/hox008/3957910
 Barratt, C.L.R., Björndahl, L., De Jonge, C.J., Lamb, D.J., Osorio Martini, F., McLachlan, R., Oates, R.D., van der Poel, S., St John, B., Sigman, M., Sokol, R. and Tournaye, H. (2017). The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance—challenges and future research opportunities. Human Reproduction Update, [online] 23(6), pp.660–680. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850791/
 Jiang, D., Coscione, A., Li, L. and Zeng, B.-Y. (2017). Effect of Chinese Herbal Medicine on Male Infertility. International Review of Neurobiology, [online] pp.297–311. Available at: https://pubmed.ncbi.nlm.nih.gov/28807164/
 NHS Choices (2019). Getting started - IVF. [online] Available at: https://www.nhs.uk/conditions/ivf/getting-started/
 Sansone, A., Di Dato, C., de Angelis, C., Menafra, D., Pozza, C., Pivonello, R., Isidori, A. and Gianfrilli, D. (2018). Smoke, alcohol and drug addiction and male fertility. Reproductive Biology and Endocrinology, 16(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769315/
 PARAZZINI, F., MARCHINI, M., LUCHINI, L., TOZZI, L., MEZZOPANE, R. and FEDELE, L. (1995). Tight underpants and trousers and risk of dyspermia. International Journal of Andrology, 18(3), pp.137–140. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2605.1995.tb00400.x
 McGill, J.J. and Agarwal, A. (2014). The Impact of Cell Phone, Laptop Computer, and Microwave Oven Usage on Male Fertility. Male Infertility, pp.161–177. https://link.springer.com/chapter/10.1007/978-1-4939-1040-3_11
 Nassan, F.L., Chavarro, J.E. and Tanrikut, C. (2018). Diet and men’s fertility: does diet affect sperm quality? Fertility and Sterility, 110(4), pp.570–577. https://pubmed.ncbi.nlm.nih.gov/30196939/
 Yan, X., Dong, L., Liu, Y., Yang, F., Tan, K., Li, J., Chang, D. and Yu, X. (2019). Effects of physical exercises on semen quality and reproductive outcomes in male infertility: A protocol for systematic review and meta-analysis of randomized controlled trials. Medicine, [online] 98(41), p.e17494. Available at: https://journals.lww.com/md-journal/fulltext/2019/10110/effects_of_physical_exercises_on_semen_quality_and.41.aspx
 Lemmens, G.M.D. (2004). Coping with infertility: a body-mind group intervention programme for infertile couples. Human Reproduction, 19(8), pp.1917–1923.https://academic.oup.com/humrep/article/19/8/1917/2356352
 Dissanayake, D.M.I.H., Keerthirathna, W.L.R. and Peiris, L.D.C. (2019). Male Infertility Problem: A Contemporary Review on Present Status and Future Perspective. Gender and the Genome, 3, p.247028971986824. https://journals.sagepub.com/doi/full/10.1177/2470289719868240