By Joseph P. Alukal, MD
We’ve long been conditioned to view infertility as primarily a women’s issue. This misconception is so entrenched that many couples never consider assessing male fertility until all female factors have been explored. But here’s the truth: roughly half of all infertility cases involve male factors, either as the sole cause or as a contributing factor. This delay in addressing men’s fertility has real consequences—not just for family-building timelines but also for men’s broader health.
As a reproductive urologist, I see this knowledge gap play out in my clinic every day. Men often avoid fertility evaluations for several reasons: fear that the process will be uncomfortable, embarrassment about the topic, or the belief that it’s unnecessary. A common response or sentiment is: “I’ve got too much going on at work, and this just doesn’t sound like a good time.” These barriers are understandable, but they don’t change the stakes. Fertility evaluations aren’t just about conception—they’re a gateway to identifying and addressing critical health issues like diabetes, testicular cancer, or hormonal imbalances. And yet, studies show that men are only able to identify 51% of risk factors associated with male infertility and 45% of health issues linked to this condition.
Unfortunately, these gaps have been filled by social media, with often damaging effects. One recent study of social media sensationalism in the male infertility space found that 44% of articles contained misleading or inaccurate information. To honor Men’s Health Month, I’d like to help shine a light on some common myths about men’s fertility and health. By debunking these misconceptions, we can empower men to take charge of their reproductive health—and, in doing so, improve their overall well-being.
Myth #1: Infertility is primarily a women’s health issue.
FACT: Male factors contribute to infertility in roughly 50% of cases.
For decades, infertility has been framed as a women’s health issue, leading to widespread neglect of male fertility. This misconception not only reduces the likelihood of a full diagnosis for couples but also places an unfair emotional burden on female partners. As I often regularly remind my male patients, “Infertility is a shared challenge—it’s not just her responsibility to address.”
In fact, studies show that roughly one in two couples presenting for infertility care will find an issue with the male partner if they look. In ~20% of cases male infertility is the sole driver, and in ~30-40% it’s a contributing factor. Despite the data being crystal clear, however, male evaluations are often overlooked or delayed. When they do occur, too often men are asked only to provide a semen sample, which is analyzed without further medical follow-up. But this approach misses the bigger picture. An abnormal semen analysis can often signal broader health concerns, from undiagnosed diabetes to testicular cancer. Addressing male fertility early isn’t just about improving chances of conception — it’s about safeguarding lifelong health.
Myth #2: Young men are in the prime of their health, so they don’t require regular physician visits.
FACT: Young men face significant health risks. Being proactive about regular evaluation and testing can identify and head off serious health issues later in life.
No group sees doctors less frequently than men aged 18-45. While there’s been heightened focus on the mental health of young men post-pandemic — and a corresponding boost in access with the explosion of virtual mental health solutions — there’s been far less attention given to the physical health of young men.
For young men, routine checkups can be rare, with many men going decades without a physical exam. I regularly meet 40-year-old patients who tell me their last exam was a sports physical in college. This lack of care can delay the detection of serious conditions like testicular cancer, hormonal imbalances, or diabetes — issues that not only impact fertility but also long-term health. For these men, fertility evaluations can serve as a valuable opportunity to get men “in the door” to address latent health issues and get on a healthy trajectory for life. In one case, a patient came to me after he and his spouse had had trouble conceiving. During his evaluation, we found a testicular mass that turned out to be cancer. It was curable, thankfully, but catching it earlier could have saved the couple months of stress and uncertainty.
And while perceived cost might be a barrier for some, the truth is a semen analysis costs less than $200 on average — a small investment compared to the $15,000–$20,000 price tag of an IVF cycle. Male fertility evaluations, considered best clinical practice, are included in comprehensive benefits solutions like Progyny’s.
Myth #3: Testosterone supplements improve fertility.
FACT: Testosterone supplementation can actually inhibit sperm production, acting as an imperfect contraceptive.
Testosterone is a hormone that’s widely associated with masculinity. It’s perhaps not surprising, therefore, that many men assume that testosterone supplements — often marketed for energy, enhanced libido, and muscle building – will enhance fertility. But the reality is quite the opposite.
Use of testosterone supplements and replacement therapy has increased three-fold in men over 40 in the past decade — driven in part by the availability of largely unregulated over-the-counter products. Men who use these supplements are often unaware that they suppress the hormones that stimulate sperm production, leading to a significant drop in sperm count. Studies have shown that regular testosterone use for 10-12 weeks can lead to significant suppression of sperm production, causing either a very low sperm count or a complete absence of sperm. Worse yet, it can take anywhere from months to more than a year after stopping testosterone treatment for sperm counts to return to baseline levels.
This is why I always advise patients to consult a reproductive specialist before starting testosterone or any new supplements. If family planning is on your horizon, it’s critical to avoid treatments that could inadvertently harm fertility.
Myth #4: Male fertility evaluations are unnecessary until conception problems arise.
FACT: Delaying male fertility evaluations can lead to missed diagnoses of broader health issues.
One of the most common misconceptions I hear is that male fertility doesn’t need to be evaluated unless a couple is actively struggling to conceive. This is not a wise strategy. For most couples trying to conceive, time is of the essence. Identifying or addressing male-factor infertility early can make the difference between pursuing less invasive treatments like IUI or needing costly IVF cycles. As I tell my patients, “Treating mild sperm abnormalities now can save you and your partner time, money, and unnecessary stress down the road.”
Waiting to assess male factors can also mean missing critical health issues, many of which are linked to abnormal semen analysis results. Studies show that over 50% of male infertility cases can be attributed to underlying medical conditions, with conditions like diabetes affecting up to 51% of affected men, and men with infertility showing twice the risk of developing testicular cancer.
Myth #5: Most male infertility issues are not solvable or take too long to address.
FACT: Many male infertility issues are treatable, often within months.
Conditions like diabetes, varicoceles, and hormonal imbalances can often be corrected, leading to significant improvements in sperm quality. For example, I’ve treated patients with unrecognized diabetes who saw improvements in sperm count after managing their blood sugar levels. Similarly, surgical correction of a varicocele — a common vein abnormality in the scrotum — can result in better sperm quality within three to six months.
Some male infertility issues are wholly or partially caused by lifestyle and behavioral habits that may be relatively easily addressed. For example, a man with an abnormal sperm count who consumes alcohol regularly may find that he can normalize sperm count by reducing or stopping alcohol use — potentially obviating the need for costly infertility treatments for both him and his partner. And while it’s true that sperm production cycles take approximately three months, this timeline is manageable with the right care and realistic expectations.
Infertility is a men’s health issue
Male fertility isn’t just about building a family — it’s a critical component of overall health. Fertility evaluations provide a crucial opportunity to identify broader health concerns, establish care relationships, and set men on a path to better well-being. Men who want to be proactive about their reproductive, and overall, health will benefit from a comprehensive model like Progyny that includes access to a national network of top reproductive urologists, personalized care through Progyny Care Advocates, and evidence-based solutions tailored to each member’s needs.
This Men’s Health Month let’s break the stigma around male fertility and empower men to take charge of their reproductive health. Because when men’s health thrives, families thrive.