top of page

What Can Go Wrong With Male Fertility? Part 1

Researchers estimate about one in every three cases of infertility is due to problems with the male partner alone. While infertility is not always treatable, there are certainly some changes you can make via diet & supplementation and lifestyle strategies to boost your chances of conceiving naturally.

Male infertility is when a man has a poor chance of making his female partner pregnant. It usually is down to the quality of his sperm cells, however, in some cases, infertility is linked to sexual function and physiological structure abnormalities. Read on for the most common causes...

male infertility common causes fertile pregnancy

What are the common causes of fertility issues in men:

  • Structural issues such as varicocele. Varicocele is enlargement of testicular veins. A urologist or testicular scan will be done to investigate and possibly operate to resolve.

  • Infections. A semen culture is worth having to see if there is an infection that can be simply treated with antibiotics.

  • Hormonal issues. Testosterone is a key male hormone, which influences sperm production. Low testosterone causes changes in sperm production including volume, as well as a lowered libido.

  • Previous drug use. Replacement hormone treatment, steroids and some prescription drugs can have a negative effect on reproductive hormones that can impact sperm quality.

  • Health & lifestyle. Obesity, smoking and vaping, wearing tight clothing/underwear and stress can all impact hormone production and sperm production.

How can you check or test for male fertility?

To get an accurate picture of what’s going on with semen two seperate semen analyses should be done at least 7 days apart (ideally within about 2-3 months). Yes guys, this requires a trip to the doctor.

Testing will look for at a range of parameters including:

  • Low ejaculate volume

  • Low sperm count ie. how many sperm there are in each sample

  • Poor motility ie. movement

  • Poor morphology – shape (normal is considered above 4%)

  • Leukocytospermia. This is an unusual amount of white blood cells in the semen

  • Immunologic factors

Let's look deeper into what these mean...


An essential function of healthy sperm cells is their ability to swim. Sperm motility is measured as the percentage of moving sperm cells in a sample of semen.

  • Progressive motility – can swim in a straight line

  • Non-progressive motility – swimming but not in any particular direction

  • Total motility – total of above

Changes to motility can be caused by:

  • May be due to oxidative damage

  • Sperm antibodies

  • White blood cells in the semen

  • Infections – STI’s, semen culture

Low Volume

Ideally, your doctor will be looking for 1.5-7.5ml of semen per ejaculation. If a low reading is observed, the following questions will be asked:

  • Was the sample collected properly?

  • Is there low testosterone? Testing further may be offered

  • Duct obstruction

  • Retrograde ejaculation

  • Low protein intake inhibiting sperm production

  • Dehydration

  • Congenital abnormalities

  • Alcohol use

Low Sperm Count

An important aspect of semen quality is the concentration of sperm cells in a given amount of semen. Most men today would have been considered infertile if they had been tested one or two generations ago! Common causes occur:

  • Oligospermia – low sperm

  • Azoospermia – no sperm present in ejaculate

  • Prolactinoma - tumour of the pituitary gland (blood test)

  • Genetic issues

  • Varicocele

  • Testicular failure

DNA Fragmentation

Etiology of sperm damage is multifactorial but the majority is associated with reactive oxygen species - essentially stress. This can be caused by inflammation, diet, toxins, stress, unhealthly lifestyle etc.

Sperm DNA is housed within the head of the sperm, so whilst understanding DNA changes or mutations can seem complicated, there are actually various methods of testing such as SCSA test, SCD/Halo test, TUNEL assay. The most common and easily accessible option is the Sperm Comet or TDL. Please note, you should not be offered a test shortly after or during illness with high fever.

Sperm DNA damage is associated with a significantly increased risk of pregnancy loss after IVF and intracytoplasmic sperm injection (ICSI), as well as recurrent miscarriage. The benefits of testing however are clear; it can help reinforce the importance of lifestyle modification, predict fertility and monitor patient’s response to intervention. It is also non-invasive, compared to many other tests offered to female partners.

Fortunately there are many natural interventions which can be used to improve male fertility so please do get in touch if you are having trouble conceiving. Book a free consultation with Gail to find out more.


Gail Madalena

Registered Nutritional Therapist


Gail Madalena is a registered nutritional therapist specialising in fertility, pregnancy and women’s health. Her expertise lies in hormonal imbalances, such as irregular cycles, debilitating PMS, PCOS, endometriosis, thyroid issues and sub-optimal fertility. Her goal is to reduce hormonal side effects and symptoms by addressing the root cause of the issue. Gail helps couples optimise your nutrition and lifestyle choices, supporting you on your journey to achieving a healthy pregnancy.

I am not attempting to prevent, treat or cure any physical, mental or emotional issues. Do not disregard medical advice or delay seeking medical advice because of information you have read on this website. Do not start or stop taking any medications without speaking to your primary health care provider.


bottom of page