Male Infertility

Infertility is defined as the inability to conceive a child after a year or more of frequent, unprotected sexual intercourse. About 15 percent of couples in the United States face infertility issues. In about half of these cases, male infertility plays a role.
Causes of Male Infertility
Male infertility is most often caused by a low sperm count; underdeveloped, misshapen or immobile sperm; or blockages that prevent delivery of sperm. Other factors that contribute to male infertility include the following conditions:
  • Varicoceles (dilated veins in the scrotum that hinder sperm development by preventing proper drainage of blood)
  • Retrograde ejaculation (when the semen goes back into the bladder instead of out through the penis)
  • Immunologic infertility (when the sperm are attacked by antibodies that develop as a result of an injury, surgery or infection)
  • Obstruction of the normal sperm passage (such as from a prior vasectomy or surgery)
  • Low levels of testosterone or history of testosterone abuse
  • Side effects of certain medications

Diagnosing Male Infertility
Your doctor may want to order tests to help diagnose the cause of your infertility, including the following:
  • Semen analysis (including volume, count, concentration, mobility and shape)
  • Blood tests to measure hormone levels such as follicle-stimulating hormone and testosterone
  • Tests to identify any infection or inflammation, antisperm antibodies or sperm viability

Additional tests can identify causes of male infertility that occur less often, such as chromosome defects.

Treating Male Infertility
Depending on the cause of the infertility, your doctor may recommend medication, surgery or both. If neither approach is effective, you may want to consider assisted reproductive techniques (ART).
  • Surgery - If your doctor diagnoses varicoceles (dilated scrotal veins) as the cause of your infertility, a minor outpatient procedure known as a varicocelectomy may be needed to repair the veins. In some cases, obstruction can also be corrected through surgery. 
  • Medication - Some medications are effective in correcting retrograde ejaculation, immunologic infertility and low testosterone production.
Assisted Reproductive Techniques (ART)
If surgery or medication does not resolve male infertility, other techniques can promote conception without intercourse, which may include the following procedures. 
  • In an intrauterine insemination (IUI) , sperm is placed directly into the woman’s uterus via a catheter. IUI has been successful in overcoming sperm count and movement problems, retrograde ejaculation and immunologic infertility.
  • With in vitro fertilization (IVF), fertilization typically occurs in a Petri dish in which the egg is joined with the sperm. After 48 to 72 hours of incubation, the fertilized egg (embryo) is placed in the woman’s uterus and a normal pregnancy should result.
  • In intracytoplasmic sperm injection (ICSI), a needle is used to inject a single sperm directly into an egg. Once the egg is fertilized, it is placed in the woman’s uterus and a normal pregnancy is anticipated. 

Houston Methodist is one of just a handful of centers in the United States with a national reputation for male reproductive medicine and surgery. Our doctors also work closely with an OB-GYN to ensure a coordinated approach to infertility treatment.


Our physicians at Houston Methodist specialize in treating male infertility at the following convenient locations: