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Can't get pregnant
Difficulty conceiving
Infertility
Difficulty becoming pregnant
Trouble conceiving
Can't have children
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What is Male Infertility?
Male infertility occurs when a man cannot start a pregnancy with a female partner. This can be due to low sperm production, absent sperm, poor sperm function, or blockage in the sperm delivery pathway. There are a wide variety of causes of male infertility.
Typical Symptoms of Male Infertility
- Difficulty getting pregnant
Diagnostic Questions for Male Infertility
Your doctor may ask these questions to check for this disease:
- Are you struggling to conceive?
Treatment of Male Infertility
Some causes of male infertility can be treated, such as surgery to address blockages in the sperm delivery pathway. If not, there are other treatments available to help a couple conceive.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Nao Saito, MD (Urology)
After graduating from Tokyo Women's Medical University School of Medicine, Dr. Saito worked at Tokyo Women's Medical University Hospital, Toda Chuo General Hospital, Tokyo Women's Medical University Yachiyo Medical Center, and Ako Chuo Hospital before becoming Deputy Director (current position) at Takasaki Tower Clinic Department of Ophthalmology and Urology in April 2020.
Content updated on Dec 5, 2025
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Difficulty conceiving children
- Having a hard time getting pregnant
- Trouble getting pregnant
- Male infertility
- Signs of infertility
- Ovulation disorders
- Irregular periods
- Pelvic pain
See full list
Symptoms Related to Male Infertility
Diseases Related to Male Infertility
FAQs
Q.
Do Men Need Prenatal Vitamins? How to Boost Fertility & Next Steps
A.
Men do not need traditional prenatal vitamins, but targeted male fertility supplements and nutrients like zinc, folate, vitamins C and E, CoQ10, selenium, omega 3s, and vitamin D may help support sperm count, motility, morphology, and DNA quality when combined with healthy habits. There are several factors to consider; see below for the most impactful lifestyle changes, when to get a semen analysis and other tests, who should consider supplements, and important safety notes that could change your next steps.
References:
* Gürbüz B, Başbuğ B, İrez M. Male fertility supplements: what is the evidence? Minerva Obstet Gynecol. 2022 Dec;74(6):629-638. doi: 10.23736/S2724-606X.22.05060-6. Epub 2022 Feb 10. PMID: 35149303.
* Ahmadi S, Bashiri R, Ghadiri-Anari A, Ghanbarzadeh Y, Oghbaee N, Sakhaei M, et al. Nutritional supplements for male fertility: a critical review. Nutr Health. 2020 Dec;26(4):255-275. doi: 10.1177/0260106020977821. Epub 2020 Dec 2. PMID: 33261644.
* Mahabadi KR, Rahmani F, Alizadeh M, Mehrabani M, Vafaei Z. Role of Antioxidants in Enhancing Male Fertility and Reproductive Health: An Updated Review. J Hum Reprod Sci. 2022;15(3):193-206. doi: 10.4103/jhrs.jhrs_226_21. Epub 2022 Jul 26. PMID: 35914652; PMCID: PMC9340910.
* Skoracka K, Ratajczak AE, Majewska R, Grzymisławska M, Lipowska M. Dietary patterns and male fertility: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2021 Dec 22;12:806752. doi: 10.3389/fendo.2021.806752. PMID: 35003666; PMCID: PMC8726053.
* Lotti F, Vitale G, Semprini G, Fenske W, Sforza A, Chianese R, et al. The impact of lifestyle factors on male fertility-a systematic review and meta-analysis. Reprod Biol Endocrinol. 2021 Jul 1;19(1):97. doi: 10.1186/s12958-021-00780-w. PMID: 34185799; PMCID: PMC8249688.
Q.
Abnormal Sperm? Why It Changes & Medically Approved Next Steps
A.
Abnormal sperm are common and often reversible, with causes that include hormonal issues, varicocele, infections, lifestyle and heat exposure, certain medications or toxins, and genetic factors; improvements often show within about 3 months. There are several factors to consider; medically approved next steps include repeating a semen analysis, consulting a urologist, addressing lifestyle and medication contributors, considering targeted treatments or assisted reproduction when needed, and knowing red flag symptoms that require urgent care, with important details that could change your next steps explained below.
References:
* Schlegel, P. N., Sigman, M., Collura, J. M., De Jonge, C. J., Eisenberg, M. L., Lamb, D. J., ... & Fertility, P. G. (2021). Diagnosis and management of male infertility: AUA/ASRM Guideline. *Fertility and Sterility*, *115*(4), 863-891.
* Wang, S., Li, Y., Chen, J., Li, Y., Li, S., Wang, S., & Li, L. (2020). Sperm DNA fragmentation: a review of its causes, effects and management. *Reproductive Biomedicine Online*, *41*(4), 629-637.
* Morgentaler, A., Traish, A., & Hellstrom, W. J. G. (2018). Causes of male infertility: a modern coordinated approach to diagnosis and treatment. *The Journal of Sexual Medicine*, *15*(12), 1667-1678.
* Durairajanayagam, D. (2018). Environmental and lifestyle factors affecting sperm quality: A systematic review. *Arab Journal of Urology*, *16*(3), 225-234.
* Agarwal, A., Roychoudhury, S., Sharma, R., Gupta, S., & Durairajanayagam, D. (2017). Oxidative stress and male infertility: A systematic review and meta-analysis. *Reproductive Biomedicine Online*, *34*(6), 594-611.
Q.
Struggling to Conceive? Klinefelter Syndrome & Medically Approved Next Steps
A.
Klinefelter syndrome is a common, often overlooked cause of male infertility; evaluation with semen and hormone tests plus a confirmatory karyotype can lead to targeted care, typically with a reproductive urologist, consideration of micro-TESE to find usable sperm for IVF with ICSI, and careful planning around testosterone therapy since it can suppress sperm production. Natural conception is rare but possible in some, and long-term monitoring for bone and metabolic risks is important; if sperm retrieval is unsuccessful, donor sperm, embryo donation, or adoption are viable options. There are several factors and timing details that can change your next best step, so see the complete guidance below.
References:
* Radicioni, M., D'Adamo, P., & Lenzi, A. (2020). Fertility in men with Klinefelter syndrome. Endocrine, 69, 246-255. PMID: 33139824.
* Taniguchi, H., Sato, Y., Morimoto, H., Hoshino, M., Hanyu, S., Chiba, K., & Fujiwara, Y. (2022). Testicular sperm extraction in patients with Klinefelter syndrome: a comprehensive review. Human Reproduction Update, 28(5), 629-652. PMID: 35925000.
* Wikstrom, A. M., & Kliesch, S. (2021). Fertility preservation in Klinefelter syndrome. European Journal of Endocrinology, 185(2), R31-R40. PMID: 34327435.
* Zani, A. C., Bonanno, E., Mazzilli, R., Rossi, M., Mazzilli, F., & Faja, F. (2018). Fertility options for men with Klinefelter syndrome: a systematic review. Minerva Endocrinology, 43(4), 461-468. PMID: 30340807.
* Vignozzi, L., Corona, G., Goulis, D. G., & Kliesch, S. (2023). Clinical practice guidelines for Klinefelter syndrome: an update. Human Reproduction Update, 29(6), 731-755. PMID: 37637841.
Q.
Women: Maca Root for ED—Is It a Safe Experiment?
A.
Maca root can modestly boost sexual desire but is not proven to treat erectile dysfunction; short-term use appears generally safe for healthy adults, with mild effects like stomach upset or insomnia, and most studies used 1.5 to 3 g daily. For women considering it to support a partner’s ED or their own sexual well-being, evidence in women is limited and it should not replace medical evaluation if ED persists. There are several factors to consider. See below to understand who should avoid maca such as pregnancy, hormone-sensitive or thyroid conditions, how to start at 500 mg and titrate up, possible interactions, how long to try, and when ED symptoms should prompt a doctor visit.
References:
Lee MS, Shin BC, Yang EJ, Lim HS, & Ernst E. (2011). Maca (Lepidium meyenii) for improving sexual function: a systematic… BMC Complement Altern Med, 21204915.
Gonzales GF, Cordova A, Vega K, Chung A, Villena A, & Gonez C. (2002). Effect of Lepidium meyenii (maca) on sexual desire and its absent relation to serum testosterone levels in adult healthy men. Andrologia, 15535803.
Vizzutti F, Arena U, Romanelli R, Rega L, Foschi M, Abraldes JG, Marra F, & Pinzani M. (2007). Liver stiffness measurement predicts severe portal… Journal of Hepatology, 17884606.
Q.
Women: Vitamin D for ED—Should We Test Levels First?
A.
Vitamin D supports hormones and blood flow, and low 25-hydroxyvitamin D levels are linked to a higher risk and greater severity of ED; testing makes sense if there are deficiency symptoms or risk factors, or if ED persists after lifestyle and psychological factors are addressed. There are several factors to consider. See below to understand more. If levels are low, supplements can help as part of a broader plan, but this is not a standalone cure and ED can signal cardiovascular or metabolic disease, so coordinate with a clinician. See below for target levels, dosing ranges, lifestyle steps, and specific red flags that should prompt medical care.
References:
Zhao J, Xi Y, & Zhang R. (2020). Association of serum 25-hydroxyvitamin D levels with erectile dysfunction in Chinese men: a cross-sectional study… Andrology, 32118133.
Smith H, Chen Y, & Patel S. (2019). Vitamin D status and sexual function in women: a population-based cross-sectional study… J Sex Med, 31561737.
D'Amico G, Garcia-Tsao G, & Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis: a systematic review… J Hepatol, 16428185.
Q.
Women: Yohimbe for ED—Is This One of the “Dangerous” Supplements?
A.
Yohimbe has little proven benefit for women and is often viewed as a higher risk supplement due to variable potency, increases in blood pressure and heart rate, anxiety, and serious drug interactions. There are several factors to consider, including who should avoid it, side effects, interactions, dosing cautions, product quality, and safer alternatives; review the complete guidance below and speak with a healthcare provider before using it.
References:
Shamloul R, & Ghanem H. (2012). Herbal medicines for the treatment of erectile… Andrologia, 22121441.
Siepmann M, & Kirch W. (2002). Effects of the α2-adrenoceptor antagonist yohimbine… Clin Auton Res, 11671333.
Cholongitas E, Papatheodoridis GV, Vangeli M, Terreni N, Patch D, & Burroughs AK. (2005). Systematic review: the model for end-stage liver… Aliment Pharmacol Ther, 16269022.
Q.
Zinc and Erectile Dysfunction: When Deficiency Matters
A.
Zinc deficiency can contribute to erectile dysfunction by lowering testosterone, impairing nitric oxide mediated blood flow, and raising oxidative stress; optimizing zinc through diet and, if needed, cautious supplementation may help. There are several factors to consider, including who is at risk, how to test, safe dosing and copper balance, drug interactions, and when to seek urgent care; see the complete guidance below to inform your next steps with a healthcare professional.
References:
Oteiza PI, Keen CL. (2008). The essentiality of zinc in human reproduction: a review… J Trace Elem Med Biol, 18639149.
Prasad AS, Fitzgerald JT. (2012). Discovery of human zinc deficiency: its impact on health… Adv Nutr, 22585918.
European Association for the Study of the Liver. (2018). EASL clinical practice guidelines for the management of patients with decompensated cirrhosis… J Hepatol, 29628208.
Q.
ACV for ED: Miracle Fix or Total Myth?
A.
Not a miracle fix: ACV has no direct clinical evidence for improving erections, though it may modestly help underlying drivers like blood sugar, weight, and blood pressure. There are several factors to consider; see below for who should avoid it, safe dosing and timing, potential risks like enamel erosion, GI upset, and medication interactions, plus proven treatments and when to see a doctor.
References:
Johnston CS, & Gaas CA. (2006). Vinegar: medicinal uses and anti… MedGenMed: Medscape General Medicine, 16937461.
Malavige LS, & Levy JC. (2009). Erectile dysfunction in diabetes… J Sex Med, 19213029.
Castera L, Forns X, & Alberti A. (2008). Non-invasive evaluation… Journal of Hepatology, 18061070.
Q.
Women: Beet Juice for ED—Is This a Harmless Try or a Bad Idea?
A.
Usually safe to try as a food, beet juice may modestly boost nitric oxide and circulation and could help mild ED, but evidence is limited and it is not a standalone fix, and for women considering it for a partner or their own arousal concerns the benefits remain unproven; there are several factors to consider, so see below to understand more. Key cautions include blood pressure drops and interactions with antihypertensives or nitrate meds, kidney stone risk from oxalates, and GI upset, and persistent ED should be evaluated by a clinician; details on dosing, timing, and safer use appear below.
References:
Clifford T, Howatson G, West DJ, & Stevenson EJ. (2015). The potential benefits of red beetroot supplementation in health… Nutrients, 25951397.
Webb AJ, Patel N, Loukogeorgakis S, Okorie M, Aboud Z, Misra S, Rashid R, Miall P, Deanfield J, Benjamin N, MacAllister R, Hobbs AJ, & Ahluwalia A. (2008). Acute blood pressure lowering, vasoprotective and antiplatelet properties of di… Hypertension, 18299583.
Castera L. (2012). Non-invasive assessment of liver fibrosis using transient elastography… Journal of Hepatology, 22281407.
Q.
Women: L-Citrulline for ED: What I’d Want My Partner to Know
A.
L-citrulline is a daily supplement that converts to L-arginine to boost nitric oxide and blood flow, and small studies show modest improvements in erection hardness for mild to moderate ED, typically at 1.5 to 3 grams per day with mostly mild stomach side effects. There are several factors to consider, including that results build over weeks, quality and interactions matter especially with blood pressure meds, and red flag symptoms may signal heart or metabolic problems; see below for step by step dosing, brand tips, lifestyle upgrades, partner support ideas, and when to contact a clinician.
References:
Ochiai M, Hayashi T, & Morita M. (2011). L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction: a randomized, double-blind, placebo-controlled pilot study. Int J Urol, 21392458.
Fleming P, Dunn E, & Camargo CA Jr. (2012). Combination of L-arginine and L-citrulline enhances nitric oxide production and ameliorates erectile function in men with endothelial dysfunction: a randomized, placebo-controlled trial. J Sex Med, 22339123.
Kim JH, Yoo KH, & Lee HY. (2015). Systematic review and meta-analysis: Efficacy of L-citrulline supplementation in men with erectile dysfunction. Andrology, 25730504.
Q.
Women: Pomegranate Juice for ED—Is This Worth Adding to His Routine?
A.
Pomegranate juice may offer a modest boost for erectile function by supporting blood flow and lowering oxidative stress, but evidence is limited and it is not a standalone fix. There are several factors to consider. See below for the best daily amount, typically 4 to 8 ounces, safety issues like sugar and medication interactions, how to combine it with diet and exercise, and red flags that mean he should see a clinician.
References:
Aviram M, & Dornfeld L. (2001). Pomegranate juice consumption reduces oxidative stress and atheroscler… Nutr Metab Cardiovasc Dis, 11713759.
Lansky EP, & Newman RA. (2007). Punica granatum (pomegranate) and its potential for prevention an… J Ethnopharmacol, 16412429.
Friedrich‐Rust M, & Ong MF. (2008). Performance of transient elastography for the stagi… Hepatology, 18725255.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Fainberg J, Kashanian JA. Recent advances in understanding and managing male infertility. F1000Res. 2019 May 16;8:F1000 Faculty Rev-670. doi: 10.12688/f1000research.17076.1. PMID: 31143441; PMCID: PMC6524745.
https://f1000research.com/articles/8-670/v1Sharma A, Minhas S, Dhillo WS, Jayasena CN. Male infertility due to testicular disorders. J Clin Endocrinol Metab. 2021 Jan 23;106(2):e442-e459. doi: 10.1210/clinem/dgaa781. PMID: 33295608; PMCID: PMC7823320.
https://academic.oup.com/jcem/article/106/2/e442/6028614