Male Infertility: Causes, Testing, and Integrative Treatment Options

Clear answers to common questions about male fertility, testing timelines, and treatment considerations

When couples struggle to conceive, the focus often defaults to a female issue. This assumption is incomplete—and increasingly inaccurate. Male infertility is a significant and growing contributor to fertility challenges, yet it remains underrecognized, under-evaluated, and frequently overlooked in early fertility workups.

Current research shows that male factors are solely responsible for approximately 20–30% of infertility cases and contribute to up to 50% overall (1). At the same time, sperm counts across North America, Europe, and Australia have declined substantially over the past several decades, with no clear evidence that this trend has stabilized (2). Together, these findings point to a broader and worsening issue in male reproductive health that extends beyond isolated diagnoses or single laboratory values.

One reason male infertility is frequently missed is that it is often clinically silent. Many men experience no pain, no disruption to daily function, and no outward symptoms—other than difficulty achieving pregnancy with a partner. As a result, fertility evaluations may focus disproportionately on the female partner, delaying identification of male-specific drivers that could be addressed earlier and more effectively (3).

The encouraging reality is that male fertility is highly responsive to intervention. Unlike egg development, which is finite, sperm are produced continuously. This means that targeted changes—when guided by appropriate testing and a systems-based approach—can lead to measurable improvements in sperm health within a relatively short timeframe.

This article examines male infertility through a holistic, evidence-informed lens. It reviews how male fertility is regulated, common root causes that impair sperm health, and how functional medicine and acupuncture can support reproductive function—either as standalone strategies or alongside assisted reproductive technologies. The goal is not only conception, but optimizing the health of both partners as they prepare for pregnancy and parenthood.

Why Male Infertility Is More Common Than Most Couples Realize

Male infertility is often underestimated not because the data are unclear, but because evaluation happens too late—or not at all. In many fertility journeys, the initial clinical focus falls almost entirely on the female partner, despite the fact that male factors are equally likely to contribute to difficulty conceiving.

In practice, male partners are frequently evaluated only after extensive female testing has already been completed. When male assessment does occur, it is often limited to a single semen analysis, without further investigation into hormonal regulation, metabolic health, inflammatory burden, or environmental exposures that directly influence sperm production and function.

Population-Level Declines in Male Reproductive Health

At the same time, a broader population-level trend is unfolding. Sperm counts have declined by an estimated 50–60% since the 1970s across industrialized regions such as North America, Europe, and Australia, with no clear evidence that this decline has stabilized (2). This pattern suggests a widespread shift in male reproductive health rather than an issue affecting only a small subset of men.

Why Male Infertility Often Goes Unnoticed

Another reason male infertility is frequently missed is that it is often clinically silent. Many men with impaired sperm parameters feel entirely well and report no pain, no sexual symptoms, and no disruption to daily life (3). Without obvious warning signs, fertility concerns may go unrecognized until couples reach later—and often more invasive—stages of intervention.

Why Delayed Evaluation Matters Clinically

From a clinical perspective, this delay matters. Male fertility is one of the most modifiable components of reproductive health when addressed early. Because sperm are produced continuously, improvements in hormone regulation, metabolic function, inflammatory balance, oxidative stress, and toxic burden can translate into measurable changes in sperm quality within a relatively short timeframe.

Factors That Contribute to Male Infertility Being Underestimated

Several factors consistently contribute to why male infertility is underestimated:

Lack of obvious symptoms: Many men with abnormal sperm parameters feel completely normal and report no pain or functional complaints.
Cultural assumptions: Fertility challenges have historically been framed as a female issue, delaying or minimizing evaluation of male partners.
Incomplete testing: Male assessment is often delayed, narrowly focused, or limited to basic screening without evaluating upstream contributors.
Overreliance on assisted reproductive technologies: Advanced techniques may bypass male factors rather than identifying and correcting what is impairing sperm health.

Together, these gaps leave many men without a clear understanding of what male infertility actually involves. Unlike many medical conditions, impaired fertility in men is not defined by a single symptom, diagnosis, or lab value—and it cannot be accurately assessed through assumptions alone.

Before male infertility can be effectively addressed, it is essential to understand what it truly means—and why so many men never realize there is a problem until conception proves difficult.

What Male Infertility Actually Means (And Why Symptoms Are Often Silent)

Male infertility is defined clinically as the inability of a man to achieve pregnancy with a fertile female partner after 12 months of regular, unprotected intercourse. This is a functional definition based on reproductive outcome—not on symptoms or how a man feels day to day.

The Clinical Definition of Male Infertility

Unlike many medical diagnoses, male infertility is not defined by pain, discomfort, or daily functional impairment. A man may feel entirely healthy while still having sperm parameters that significantly reduce the likelihood of conception. This outcome-based definition is one reason male infertility often goes unrecognized until pregnancy does not occur.

Why Many Men Have No Obvious Symptoms

Male infertility frequently develops quietly. Many men with impaired sperm parameters have normal energy levels, normal sexual function, and no pain or discomfort. Because spermatogenesis occurs internally and continuously, disruptions in sperm count, motility, morphology, or DNA integrity can progress for years before fertility is evaluated directly (3).

Without a clear external signal, fertility impairment may remain invisible until conception efforts fail.

What Symptoms of Male Infertility Can Look Like

When symptoms are present, they are often subtle and not immediately linked to fertility concerns. These may include changes in libido, erectile or ejaculatory dysfunction, breast tissue changes, reduced facial or body hair, or intermittent testicular pain or swelling (3). Importantly, a significant proportion of men with abnormal semen analyses report none of these symptoms, reinforcing why symptom-based screening alone is insufficient.

Male Fertility Is a Systems-Level Process

From a clinical standpoint, male fertility depends on multiple tightly regulated systems working together:

Hormonal regulation via the hypothalamic–pituitary–gonadal (HPG) axis
Adequate testosterone production and receptor sensitivity
Proper testicular temperature regulation and blood flow
Efficient sperm maturation, transport, and protection from oxidative damage

Disruption at any point—whether hormonal, metabolic, inflammatory, vascular, or environmental—can impair fertility without producing overt symptoms. This is why fertility challenges are often identified only after months or years of unsuccessful attempts to conceive.

Understanding male infertility as a systems-level condition, rather than a single diagnosis, is critical. It explains why surface-level assessments may miss the root cause and why comprehensive evaluation is often necessary to identify modifiable contributors to impaired sperm health.

How Male Fertility Works: From Hormones to Sperm Quality

Male fertility relies on a coordinated sequence of hormonal signaling, cellular energy production, vascular support, and protective mechanisms that allow sperm to develop, mature, and function effectively. Disruption at any stage can impair fertility—even when individual lab values appear only mildly abnormal.

Hormonal Signaling and the HPG Axis

The process begins in the brain. The hypothalamus releases gonadotropin-releasing hormone (GnRH), stimulating the pituitary gland to produce luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH signals the testes to produce testosterone, while FSH supports spermatogenesis within the seminiferous tubules. Balanced communication along this axis is essential for normal sperm production.

Energy Production, Mitochondrial Function, and Oxidative Stress

Within the testes, sperm development is highly energy-dependent. Spermatogenesis requires adequate mitochondrial function, sufficient nutrient availability, and protection from oxidative stress. Because sperm cells are particularly vulnerable to reactive oxygen species, even low-grade inflammation, toxin exposure, or metabolic dysfunction can impair motility, morphology, and DNA integrity without significantly altering testosterone levels.

Temperature Regulation and Vascular Health

The testes are positioned outside the body to remain slightly cooler than core temperature. Conditions that increase local heat or impair venous drainage—such as prolonged sitting, tight clothing, frequent hot tub or sauna use, or varicocele—can negatively affect sperm production and quality.

Sperm Maturation and Seminal Fluid Support

After production, sperm mature in the epididymis and gain motility before mixing with seminal fluid from the prostate and seminal vesicles. This fluid provides nutrients, buffering capacity, and protection during transport. Prostate inflammation, infection, or oxidative stress at this stage can further impair sperm function even when counts appear normal.

Because spermatogenesis is continuous and takes roughly three months from start to finish, male fertility reflects current physiological conditions rather than distant health history. This explains why targeted interventions can lead to measurable improvements within a relatively short timeframe.

This is why single lab markers rarely tell the full story—and why a more comprehensive evaluation is often needed before deciding on next steps.

Common Causes of Male Infertility

Male fertility isn’t controlled by a single system or switch. It depends on many processes working together—from hormone signaling and sperm production to maturation, transport, and ejaculation. In most real-world cases, infertility develops from a combination of factors rather than one clear-cut cause.

Low Sperm Count (Oligospermia)

Low sperm count is defined as fewer than 15 million sperm per milliliter of semen. When fewer sperm are present, the chances of successful fertilization drop—especially if other aspects of sperm health are also affected. Low counts are commonly linked to hormone imbalance, toxin exposure, metabolic dysfunction, chronic inflammation, and nutrient deficiencies.

Poor Sperm Motility

Motility refers to how well sperm are able to move forward through the female reproductive tract. Even when sperm counts are normal, impaired movement can make conception difficult. Motility is particularly sensitive to oxidative stress, mitochondrial dysfunction, inflammation, and environmental or chemical exposures, all of which can interfere with the sperm’s ability to generate energy and move efficiently.

Abnormal Sperm Morphology

Morphology describes the shape and structure of sperm. When morphology is abnormal, sperm may struggle to penetrate and fertilize the egg. These changes are often associated with broader physiological stressors, including endocrine disruption, poor metabolic health, chronic inflammation, and inadequate nutrient status.

Hormonal Imbalances and HPG Axis Disruption

Healthy spermatogenesis depends on coordinated signaling between testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). Disruption of this axis can impair sperm production even when testosterone levels fall within reference ranges. Contributors may include chronic stress, thyroid dysfunction, excess estrogenic burden, insulin resistance, and inflammatory signaling.

Varicocele and Vascular Contributors

A varicocele involves enlarged veins in the scrotum that impair normal blood flow and heat regulation. This can raise testicular temperature and reduce oxygen delivery, both of which negatively affect sperm production and quality. Varicoceles are among the most common potentially reversible contributors to male infertility and often coexist with other underlying stressors.

Genetic Causes of Male Infertility

Some men have genetic factors—such as Y-chromosome microdeletions or chromosomal abnormalities—that directly impair sperm production or quality. While these factors cannot be changed, identifying them is important for setting expectations and guiding appropriate treatment or assisted reproductive decisions.

Lifestyle and Environmental Factors Affecting Sperm Health

Everyday lifestyle and environmental exposures play a major role in sperm health. Smoking, alcohol or drug use, poor sleep, chronic stress, extremes of body weight, and exposure to endocrine-disrupting chemicals, pesticides, plastics, and other toxins can all interfere with hormone signaling and sperm integrity (3,8,10).

Because these factors often overlap, male infertility is rarely resolved by addressing a single number or lab value in isolation. Meaningful improvement usually requires identifying and correcting the combination of influences affecting sperm health.

Why a Systems-Based Approach Improves Male Fertility Outcomes

In real clinical practice, male infertility is rarely caused by a single abnormal lab value. Focusing on isolated findings—such as sperm count or testosterone alone—often misses what is actually limiting fertility and rarely leads to lasting improvement.

A systems-based approach evaluates how the body is functioning as a whole. Hormone signaling, metabolic health, inflammation, oxidative stress, detoxification capacity, and daily lifestyle factors all influence sperm production and quality. When these systems are out of balance, sperm health is affected—even if individual test results appear only mildly abnormal.

Instead of asking only whether sperm parameters fall outside reference ranges, this approach asks a more clinically useful question: why are they impaired in the first place?

Why Single Lab Markers Often Miss the Root Cause

Isolated lab values provide limited insight into fertility when viewed out of context. A borderline sperm count or “normal” testosterone level does not reveal whether upstream drivers—such as metabolic stress, inflammation, toxic burden, or hormonal signaling disruption—are interfering with spermatogenesis. Without understanding these contributors, treatment strategies often remain incomplete or short-lived.

Key Questions a Systems-Based Fertility Evaluation Asks

A comprehensive evaluation looks beyond surface-level findings and assesses the broader physiological environment influencing sperm health:

Is hormone signaling between the brain and testes functioning appropriately?
Is metabolic or mitochondrial stress limiting sperm energy and motility?
Is inflammation or oxidative stress damaging sperm structure or DNA?
Are environmental or chemical exposures interfering with endocrine signaling?
Is the body absorbing and utilizing the nutrients required for spermatogenesis?

Because sperm are produced continuously, improvements in these areas can lead to measurable changes in sperm quality within a single spermatogenic cycle. Just as importantly, a systems-based approach does not replace conventional fertility care—it strengthens it by improving the physiological foundation on which all fertility treatments depend.

Testing That Matters for Male Fertility

Because male infertility is rarely driven by a single factor, meaningful progress depends on comprehensive, targeted evaluation rather than isolated screening. Testing helps clarify why sperm parameters are impaired and guides a personalized plan to improve fertility outcomes.

Semen Analysis Is a Starting Point, Not the Endpoint

A foundational first step is a semen analysis, which evaluates sperm count, motility, morphology, and overall semen volume. While this test is essential, it represents only a snapshot of sperm output. It does not explain what is driving abnormalities—or why results may fall into a borderline range despite ongoing difficulty conceiving.

For that reason, semen analysis should be viewed as an entry point rather than a conclusion.

To move beyond surface-level findings, additional testing is often warranted based on clinical history, symptom patterns, and initial results.

→ Advanced Functional Lab Testing

Core Testing Used in Male Fertility Evaluation

The goal of further testing is not to collect data for its own sake, but to identify physiological patterns that are limiting sperm health and can be addressed systematically.

Semen analysis

Assesses sperm concentration, motility, morphology, and total sperm count. Abnormal findings signal the need for deeper evaluation rather than serving as a final answer.

Comprehensive hormone panel

Evaluates total and free testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, sex hormone–binding globulin (SHBG), and prolactin. Hormonal imbalance can impair spermatogenesis even when testosterone appears within reference ranges.

Thyroid panel

Includes TSH, free T3, and free T4. Thyroid dysfunction can disrupt metabolic signaling, hormone balance, and sperm production.

Metabolic and lipid markers

Insulin resistance, dyslipidemia, and metabolic inflammation are increasingly recognized contributors to impaired sperm quality and hormonal dysregulation.

Toxin and environmental exposure testing

Identifies heavy metals, endocrine-disrupting chemicals, and other environmental burdens that interfere with hormone signaling and increase oxidative stress (10).

Gut health testing

Assesses digestion, absorption, inflammation, and microbial balance. Poor gut function can limit nutrient availability, impair detoxification pathways, and disrupt hormone metabolism.

Immunologic infertility testing

In selected cases, evaluates antisperm antibodies or immune-mediated factors that may interfere with sperm function or fertilization.

Genetic testing

May be appropriate when sperm counts are severely low or absent, or when there is a history of recurrent assisted reproductive failure.

The purpose of this testing approach is clarity. When hormonal, metabolic, inflammatory, environmental, or nutritional drivers are identified and addressed, improvements in sperm quality often follow as a downstream effect.

Once testing clarifies the underlying contributors, treatment can be tailored accordingly. This may include targeted nutrition, supplementation, lifestyle modification, detoxification strategies, stress regulation, and integrative therapies such as acupuncture.

How Acupuncture Supports Male Fertility

Acupuncture is often used in integrative fertility care because it works at the level of physiological regulation rather than symptom suppression. Instead of targeting a single pathway, it influences multiple systems that directly affect sperm production, hormone signaling, circulation, and nervous system balance.

Improved Circulation, Temperature Regulation, and Testicular Environment

One of the clearest ways acupuncture supports male fertility is by improving blood flow to the testes and reproductive organs. Better circulation supports temperature regulation, oxygen delivery, and nutrient availability—factors that are essential for healthy spermatogenesis. These effects are particularly relevant in men with vascular issues, inflammation, oxidative stress, or varicocele-related changes.

Hormonal Regulation Along the HPG Axis

Acupuncture also has a regulatory effect on the endocrine system. Research suggests it can influence signaling along the hypothalamic–pituitary–gonadal axis, supporting more balanced secretion of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone (4). This matters because many men with fertility challenges have hormone signaling disruptions even when testosterone levels fall within conventional reference ranges.

Effects on Sperm Quality, Oxidative Stress, and Mitochondrial Function

Studies have shown that acupuncture may improve sperm motility, morphology, and concentration (4). These changes are thought to be driven by reduced oxidative stress, improved mitochondrial efficiency, and modulation of inflammatory signaling—all critical components of sperm health that are often overlooked in standard fertility care.

Stress Regulation and Nervous System Balance

Chronic psychological or physiological stress can suppress reproductive hormone signaling and impair sperm production. Acupuncture has been shown to reduce stress, anxiety, and depressive symptoms while promoting parasympathetic nervous system activity (7). This shift toward a more regulated nervous system supports hormonal balance and overall reproductive function.

Sexual Function and Reproductive Outcomes

Acupuncture may also benefit men experiencing sexual dysfunction, including psychogenic erectile dysfunction or premature ejaculation. Clinical studies suggest it can reduce psychological erectile dysfunction (5) and exert ejaculation-delaying effects in selected cases (6), which may indirectly support fertility efforts.

Importantly, acupuncture is not positioned as a replacement for conventional fertility care. It functions as a complementary therapy that can enhance natural conception potential and improve sperm quality in men pursuing assisted reproductive technologies. When integrated with functional medicine, lifestyle modification, and appropriate medical care, acupuncture offers a low-risk, systems-oriented way to support male fertility.

Lifestyle and Nutritional Strategies That Support Male Fertility

While care should always be individualized, certain lifestyle and nutritional foundations consistently influence male fertility. Because sperm production reflects current physiological conditions, daily habits can meaningfully affect sperm quality within a single spermatogenic cycle.

Lifestyle Factors That Influence Sperm Health

Environmental exposures and daily behaviors play a significant role in sperm health and hormone regulation.

Toxin and substance exposure
Smoking, nicotine use, marijuana, illicit drugs, and excessive alcohol consumption are associated with reduced sperm count, impaired motility, and abnormal morphology. These exposures increase oxidative stress and disrupt endocrine signaling, directly affecting spermatogenesis.

Heat exposure and testicular temperature
The testes require a temperature slightly below core body temperature for optimal sperm production. Frequent hot tub or sauna use, prolonged laptop use on the lap, tight clothing, and extended sitting can increase scrotal temperature and negatively impact sperm quality.

Sleep and circadian regulation
Consistent, restorative sleep supports testosterone production, hormone regulation, and metabolic health. Chronic sleep deprivation is associated with lower testosterone levels and impaired sperm parameters.

Stress management and nervous system regulation
Chronic stress activates the hypothalamic–pituitary–adrenal axis, which can suppress reproductive hormone signaling. Practices such as breathwork, meditation, moderate exercise, and acupuncture support nervous system regulation and fertility function.

Physical activity and body composition
Regular, moderate movement improves circulation, insulin sensitivity, and hormonal balance. Both obesity and being underweight are associated with impaired sperm quality, highlighting the importance of metabolic balance rather than extremes.

Foods and Environmental Exposures That Impair Male Fertility

Certain dietary and environmental exposures are consistently associated with impaired sperm quality and are best minimized when optimizing male fertility.

Ultra-Processed Foods

Ultra-processed foods increase inflammatory and oxidative burden, which can impair sperm motility, morphology, and DNA integrity.

Refined Carbohydrates and Excess Added Sugars

High intake of refined carbohydrates and added sugars promotes insulin resistance and hormonal dysregulation, both of which negatively affect spermatogenesis.

Industrial Seed Oils

Industrial seed oils (such as soybean, corn, canola, sunflower, and safflower oils), particularly when consumed through ultra-processed foods, contribute to oxidative stress and membrane instability in sperm cells.

High Alcohol Intake

Excessive alcohol consumption can disrupt testosterone production, impair spermatogenesis, and increase oxidative stress within the testes.

Large Amounts of Soy Products

High soy intake in men with existing sperm abnormalities may exert estrogenic effects that further impair sperm quality (9).

Pesticides, Microplastics, and Endocrine-Disrupting Chemicals

Environmental contaminants found in food packaging and non-organic produce can interfere with hormone signaling and increase toxic burden (10).

Reducing overall toxic burden—both dietary and environmental—supports hormonal balance, mitochondrial function, and sperm DNA integrity.

Nutritional Foundations for Male Fertility

Diet provides the raw materials for sperm development, DNA integrity, and hormone regulation. A nutrient-dense, anti-inflammatory dietary pattern supports these processes more effectively than isolated dietary changes.

Antioxidants

Found in fruits, vegetables, nuts, and seeds. Antioxidants protect sperm from oxidative damage and support motility and DNA integrity (8).

Omega-3 Fatty Acids

Present in fatty fish, flaxseeds, and walnuts. Omega-3s support cell membrane fluidity, hormone signaling, and sperm structure.

Zinc

Essential for testosterone production, sperm motility, and DNA synthesis. Found in oysters, seafood, lean meats, beans, and nuts.

Folate (Vitamin B9)

Supports sperm production and reduces the risk of chromosomal abnormalities. Found in leafy greens, legumes, and fortified foods.

Vitamin D

Adequate vitamin D status is associated with improved sperm motility and reproductive hormone regulation.

Supplementation as Targeted Support — Not a Standalone Solution

Certain nutrients play important roles in sperm energy production, antioxidant defense, hormone regulation, and DNA integrity. In clinical practice, supplementation is most effective when used to correct identified deficiencies or support specific physiological bottlenecks.

Commonly used supplements in male fertility care may include coenzyme Q10, L-carnitine, selenium, vitamin C, vitamin D, omega-3 fatty acids, and L-arginine. These compounds support mitochondrial function and reduce oxidative stress when appropriately matched to individual needs.

Because excessive or mismatched supplementation can be ineffective—or counterproductive—selection and dosing are best guided by testing and clinical evaluation rather than self-prescribing.

Addressing Male Infertility Through Integrative Care

Male infertility is most effectively addressed when care goes beyond isolated lab values or one-off interventions. Lasting improvement comes from identifying the physiological factors driving impaired sperm health and addressing them together, rather than in isolation.

An integrative care approach focuses on recognizing underlying patterns that commonly contribute to fertility challenges, including hormonal dysregulation, metabolic imbalance, chronic inflammation, oxidative stress, toxic burden, and nutrient insufficiency. Once these drivers are identified, care can be tailored using targeted nutrition, lifestyle strategies, and evidence-informed therapies rather than generalized recommendations.

This reflects a systems-based view of fertility, where reproductive function is understood as part of overall health. Supporting hormone regulation, mitochondrial function, detoxification pathways, and stress resilience helps create a more favorable internal environment for sperm production and quality.

→ Functional & Integrative Medicine

The Role of Advanced Testing in Integrative Fertility Care

Within integrative fertility care, advanced testing is used to refine and individualize treatment, not to repeat basic screening. Its role is to clarify which physiological drivers are most relevant when sperm parameters are impaired without a clear explanation or when progress stalls despite standard evaluation.

Advanced diagnostics can help identify patterns related to metabolic stress, inflammation, toxic burden, hormone metabolism, or nutrient utilization that are not always evident on routine testing. This allows care to be prioritized and sequenced more precisely, supporting targeted intervention and objective tracking of meaningful progress over time.

Supportive Therapies That Enhance Fertility Outcomes

For many men, supportive therapies further improve outcomes when layered thoughtfully into care. Acupuncture, targeted nutritional therapy, and lifestyle interventions work together to support hormone signaling, circulation, mitochondrial function, and nervous system regulation. When used strategically, these therapies strengthen the physiological foundation on which fertility depends rather than acting as isolated fixes.

Integrative Care Works Alongside Conventional Fertility Treatment

Importantly, an integrative approach is not positioned as a replacement for conventional fertility care. It works alongside it. By improving underlying physiology, integrative care can support natural conception and may also enhance outcomes for couples pursuing assisted reproductive technologies by improving sperm quality before intervention.

When Male Infertility Evaluation Is Warranted

Male fertility evaluation is most effective when initiated early and intentionally, rather than as a last step after prolonged difficulty conceiving. Waiting until later stages of fertility treatment can delay identification of male-specific contributors that are often modifiable when addressed sooner.

Situations Where Male Fertility Evaluation Should Not Be Delayed

Evaluation is strongly indicated when one or more of the following are present:

No pregnancy after 12 months of regular, unprotected intercourse
No pregnancy after 6 months when the female partner is age 35 or older
Abnormal semen analysis, even if values are only mildly outside reference ranges
History of hormonal imbalance, metabolic dysfunction, or chronic inflammatory conditions
Known toxin or environmental exposures, including endocrine-disrupting chemicals
Prior fertility treatment failure, including unsuccessful IVF or ICSI cycles

In these cases, earlier evaluation can clarify whether sperm quality, hormone regulation, oxidative stress, or metabolic factors are contributing—and whether targeted intervention may improve outcomes.

Why Earlier Male Evaluation Improves Outcomes

Male fertility is highly responsive to physiological change. Because sperm are produced continuously, addressing contributing factors earlier allows time for measurable improvement in sperm parameters before conception attempts or assisted reproductive intervention.

Early evaluation also reduces unnecessary delays, prevents over-reliance on invasive procedures, and supports healthier conception and pregnancy outcomes by optimizing male physiology alongside female care.

You may request a free 15-minute consultation with Dr. Martina Sturm to review your health concerns and outline appropriate next steps within a root-cause, systems-based framework.

Frequently Asked Questions About Male Infertility

How common is male infertility?

Male factors are solely responsible for approximately 20–30% of infertility cases and contribute to up to 50% overall. Declining sperm counts over recent decades have made male infertility an increasingly common and underrecognized contributor to fertility challenges.

When should a man be evaluated for infertility?

If pregnancy has not occurred after 12 months of regular, unprotected intercourse, both partners should be evaluated. If the female partner is 35 or older, evaluation is typically recommended after 6 months.

What are the signs of male infertility?

Many men have no obvious symptoms. When symptoms are present, they may include low libido, erectile or ejaculatory dysfunction, breast tissue changes, reduced facial or body hair, or testicular pain or swelling. In many cases, male infertility is identified only through testing.

What tests are used to evaluate male fertility?

A semen analysis is the starting point. Depending on results and clinical history, further evaluation may include hormone testing, thyroid assessment, metabolic markers, environmental or toxin exposure testing, gut health assessment, and, in selected cases, genetic or immunologic testing.

What lifestyle factors negatively affect sperm quality?

Smoking, excessive alcohol intake, marijuana or illicit drug use, chronic stress, poor sleep, obesity or being underweight, frequent heat exposure to the testes, ultra-processed foods, refined carbohydrates and sugars, and exposure to endocrine-disrupting chemicals can all impair sperm quality.

Can diet improve male fertility?

Yes. A nutrient-dense, anti-inflammatory diet that supports metabolic health and reduces oxidative stress is associated with improved sperm count, motility, and DNA integrity. Key nutrients include antioxidants, omega-3 fatty acids, zinc, folate, and vitamin D.

Do supplements help with male infertility?

Supplements may be helpful when used to address identified deficiencies or physiological needs. Their effectiveness depends on individual context and should be guided by testing rather than used as a standalone strategy.

Can acupuncture help with male infertility?

Acupuncture may support sperm quality, hormonal regulation, stress reduction, and certain forms of sexual dysfunction. It is most effective when used as part of a comprehensive, integrative care approach.

Does improving male fertility matter if we are planning IVF or ICSI?

Yes. Optimizing sperm quality may improve assisted reproductive outcomes and support healthier embryo development, even when advanced reproductive technologies are used.

How long does it take to improve sperm quality?

Spermatogenesis takes approximately 74 days. Meaningful improvements in sperm parameters typically occur over about three months once underlying contributors are identified and addressed.

Still Have Questions?
If the topics above reflect ongoing symptoms or unanswered concerns, a brief conversation can help clarify whether a root-cause approach is appropriate.

Request a Free 15-Minute Consultation

Resources

Human Reproduction Update – Global perspectives on male infertility prevalence and contributing factors
Human Reproduction Update – Temporal trends in sperm count: a systematic review and meta-regression analysis
Mayo Clinic – Male infertility: symptoms, causes, and risk factors
Andrology – Efficacy and proposed mechanisms of acupuncture in the treatment of male infertility
The Journal of Sexual Medicine – Acupuncture for psychogenic erectile dysfunction: randomized controlled trial outcomes
Asian Journal of Andrology – Effects of electroacupuncture on testosterone levels and premature ejaculation
Fertility and Sterility – Acupuncture for infertility: clinical effectiveness and limitations
Andrology – Dietary patterns and semen quality parameters: systematic narrative review
Reproductive Toxicology – Soy food, isoflavone intake, and semen quality in men attending infertility clinics
Environmental Science & Technology – Detection of microplastic and nanoplastic particles in human testicular tissue