Male Fertility Concerns
Male fertility concerns explained: when to seek help, common causes, lifestyle factors, what antioxidant and herbal supplements show, and why testosterone and steroids can reduce sperm.
Content last updated . This page has not been medically reviewed.
What infertility means
The World Health Organization defines infertility as failure to achieve a pregnancy after 12 months or more of regular unprotected sex. It may be due to male, female or unexplained factors. [1] NICHD notes that problems in the male are just as likely as problems in the female, and that a combination from both partners is equally likely. [2] The NHS suggests seeing a GP if you have not conceived after a year of trying. [3]This page uses these evidence labels: established recommendation, promising but limited, mixed, insufficient evidence.
Common causes in men
The WHO says male infertility is most commonly caused by problems in the ejection of semen, absence or low levels of sperm, or abnormal shape and movement of sperm. Other causes include blockage of the reproductive tract, hormone disorders, and testicular failure to produce sperm, for example from varicoceles (enlarged veins in the scrotum) or from chemotherapy. [1] The NHS adds infections, testicular cancer or surgery, undescended testicles and injury. It also says many cases of abnormal semen are unexplained, and that for 1 in 4 couples no cause is found. [4]A doctor can look into male causes with a medical review and tests; for example, MedlinePlus lists sperm count and hormone levels among the tests used when the testes may not be producing enough hormone. [5]
Lifestyle and environment
- Smoking, heavy alcohol intake and obesity can affect fertility; exposure to pollutants and toxins can be directly toxic to sperm. [1]
- The NHS says smoking can reduce semen quality and drinking too much alcohol can affect sperm quality. [3]
- There is a link between higher scrotal temperature and reduced semen quality, but it is uncertain whether loose underwear improves fertility. [4]
Hormones and steroids can reduce fertility
- The WHO says anabolic steroid use can cause abnormal semen parameters. [1]
- NIDA lists decreased sperm production and shrinking of the testicles among the consequences of anabolic steroid misuse in men. [6]
- The Endocrine Society recommends against starting testosterone therapy in men who are planning fertility in the near term. [7]
If you are hoping to father a child, tell your doctor before starting any testosterone product. See Testosterone and low testosterone and Men's health safety.
Supplements: what research shows
| Supplement | What the source found | Evidence |
|---|---|---|
| Oral antioxidants (18 different ones combined) | A Cochrane review of 61 studies (6,264 subfertile men) found low-quality evidence from 7 small trials that antioxidants may improve live birth rates (odds ratio 1.79) for couples attending fertility clinics, and no evidence of increased miscarriage risk; overall the authors called the evidence inconclusive because of risk of bias and small sample sizes. [8] | Promising but limited |
| Ashwagandha | A systematic review found four clinical trials (only one randomized); the reviewed data (mostly before-and-after comparisons) showed higher sperm concentration and motility, but the authors judged the data too limited to provide robust evidence. [9] | Promising but limited |
| "Male fertility" blends | Not evaluated in the sources I read. | Proper evidence not found |
For marketed "fertility" products, quality and dose vary; see Product quality and contamination and Ashwagandha and other adaptogens.
Frequently asked questions
How common is male infertility?
Problems in the male are as likely as problems in the female. [2]
Do antioxidants improve sperm?
The Cochrane review found low-quality evidence they may improve live birth rates, but called the evidence inconclusive. [8]
Should I take testosterone while trying to have a child?
The Endocrine Society recommends against starting testosterone therapy in men planning fertility in the near term. [7]
Can lifestyle changes help?
Smoking, heavy alcohol use and obesity can affect fertility, so addressing them is reasonable. [1]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
When to get help
- You have not conceived after a year, or you have a known testicular, hormone or sexual problem. [3]
- A lump, swelling or change in a testicle, or sudden severe testicle pain, which needs urgent care. [10]
- You are using steroids or hormone products and want to have children.
References
- World Health Organization. Infertility fact sheet. Read 2026-10-22.
- NICHD (NIH). What are some causes of infertility?. Read 2026-10-22.
- NHS. Infertility. Read 2026-10-22.
- NHS. Causes of infertility. Read 2026-10-22.
- MedlinePlus (NLM). Hypogonadism. Read 2026-10-22.
- NIDA (NIH). Anabolic Steroids DrugFacts. Read 2026-10-22.
- Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2018. Read 2026-10-22.
- Antioxidants for male subfertility. Cochrane Database Syst Rev 2019. Read 2026-10-22.
- Withania somnifera (Indian ginseng) in male infertility: An evidence-based systematic review and meta-analysis. Phytomedicine 2018. Read 2026-10-22.
- NHS. Testicle pain. Read 2026-10-22.