What Causes Infertility in Men?

Cause

Examples

Reduced sperm production

Increased temperature of the testes

Excessive heat

Disorders that cause a prolonged fever

Hormonal disorders

Adrenal gland disorders

Hyperprolactinemia (high levels of prolactin, a hormone that stimulates milk production)

Hypogonadism

Hypothyroidism

Pituitary gland disorders

Genetic disorders

Cystic fibrosis

Klinefelter syndrome

Other disorders that cause an abnormality in the sex chromosomes

Disorders of the testes

Infections

Injury to the testes

Mumps that affects the testes (mumps orchitis)

Shrinking of the testes (as can occur when excess alcohol is regularly consumed)

Tumors in the testes

Undescended testes (testes that remain in the abdomen rather than move to the scrotum)

Varicose veins in the testes (varicocele)

Medications and other substances

Alcohol, when consumed in large amounts

Anabolic steroids

Antimalarial medications

Cannabis

Cotrimoxazole (an antibiotic)

Medications used to treat malaria

Estrogen-like compounds taken to treat prostate cancer

Gonadotropin-releasing hormone (GnRH) agonists (hormonal medications used to treat prostate cancer, fibroids, endometriosis, and other disorders)

Monoamine oxidase inhibitors (MAOIs—a type of antidepressant)

Opioids (narcotics)

inflammatory bowel disease)

Exposure to industrial or environmental toxins

Heavy metals, such as lead

Pesticides (which can have effects similar to those of female hormones or decrease the effects of male hormones)

Phthalates (chemicals used to make plastics more flexible)

Polychlorinated biphenyl compounds (PCBs)

Absence of sperm in semen

Disruption of the sperm’s passage out of the body

Missing epididymides (which provide the space and environment for sperm to mature), usually in men with cystic fibrosis

Blocked or missing vasa deferentia (tubes from the epididymides to the ejaculatory ducts), usually in men with cystic fibrosis

Missing seminal vesicles (which provide nourishment for sperm)

Blockage of both ejaculatory ducts

Retrograde ejaculation (semen travels back into the bladder rather than out of the penis)

Diabetes mellitus

Nervous system dysfunction

Pelvic surgery, such as prostate removal

Removal of lymph nodes in the area behind the abdomen (as may be done to treat Hodgkin lymphoma)

Erectile dysfunction (the inability to attain or maintain an erection sufficient for sexual intercourse)

Blood vessel disorders

Diabetes mellitus

Brain and nerve (neurologic) disorders, such as Alzheimer disease, Parkinson disease, multiple sclerosis, stroke, and nerve damage due to prostate surgery

Psychological problems, such as performance anxiety or depression

Certain medications, such as some antidepressants, certain hormonal medications, and medications used to treat high blood pressure (including beta-blockers)

Unknown causes (idiopathic)

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