Updated by the Progyny Clinical Team — October 2025.
Infertility is often described as a female issue, but sperm is half the equation. If you produce sperm, you’re just as likely to experience fertility challenges as someone with ovaries. The good news is that there are clear ways to understand what’s happening and to take the next steps.
What is male infertility?
About 1 in 8 heterosexual couples experience infertility, defined as not being able to conceive within six to twelve months of unprotected sex. Experts estimate that male factors are solely responsible for about one-third of cases and contribute in about half overall.
When specialists talk about male infertility, they usually mean problems with the number of sperm, how they move, how they look, or whether they carry healthy DNA. Sometimes one factor is involved, but more often, several overlap.
Underlying causes may include hormonal imbalances, advancing age, lifestyle or environmental exposures such as smoking, poor diet, pesticides, or chemotherapy. Common medical causes include varicocele (enlarged scrotal veins), blockages in the reproductive tract, and certain genetic or chromosomal conditions.
Are sperm counts really declining?
Recent research suggests that average sperm counts in the Western world have dropped significantly — possibly by as much as 50% since the 1970s. While the decline appears consistent across multiple studies, experts note the exact magnitude and causes are still debated.
Possible culprits include endocrine-disrupting chemicals found in plastics and pesticides, combined with increasingly sedentary lifestyles, disrupted sleep, and diets high in processed foods.
Why symptoms are hard to spot
Unlike people with ovaries, who may see clues about their fertility through their monthly cycle, people with sperm rarely get obvious signals. For many, the only indicator is difficulty conceiving.
In some cases, you might notice things like:
- Erectile dysfunction: More common in people with infertility, sometimes linked to hormones.
- Low testosterone: Can cause fatigue, weight gain, or trouble maintaining an erection. While sperm production doesn’t require high testosterone, broader hormonal imbalance may still affect fertility.
- Low semen volume or “dry orgasm”: May suggest a blockage or issue with ejaculation.
But most people with male infertility don’t experience symptoms outside of challenges getting pregnant with a partner.
Testing sperm health
The most common way to assess male fertility is a semen analysis. This simple test looks at:
- How many sperm are present
- How well they move
- Whether they’re the right shape and size
Results won’t label you “fertile” or “infertile,” but they can flag areas that may affect your chances of conception. Plenty of couples conceive naturally even when semen parameters are outside the typical range.
You can get semen testing at a fertility clinic, through a urologist, at a cryobank, or with a mail-in kit.
Key takeaway
Male infertility is common and often symptom-free. A semen analysis is the best first step to understanding sperm health.
If you have questions, Progyny is here for you. Please contact your Progyny Care Advocate for support.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.