Overview
If a couple has not conceived after a year of regular unprotected intercourse, both partners should be assessed. A male factor contributes in a large share of couples, and many causes can be treated.
Symptoms
- Difficulty conceiving
- Problems with erection or ejaculation
- Pain or swelling in the testicles
- Visible enlarged veins in the scrotum (varicocele)
When to see a doctor
Seek care promptly if you have:
- A lump or swelling in a testicle
- Testicular pain
Causes
- Problems with sperm production
- Varicocele
- Blockages in the sperm passages
- Hormonal problems
- Infections
- Genetic conditions
Risk factors
- Smoking, alcohol and some drugs
- Obesity
- Heat exposure
- Some medicines
- Previous testicular injury or surgery
Diagnosis
- Semen analysis, usually twice
- Hormone tests
- Scrotal ultrasound and Doppler
- Genetic tests in selected men
Treatment
- Lifestyle changes and treating infections.
- Varicocele surgery, which can improve semen quality in selected men.
- Hormonal treatment where indicated.
- Surgical sperm retrieval for assisted reproduction, coordinated with fertility partners.
At MJ Shah Hospital: Fertility and sexual health are medical questions with medical answers. Consultations are private, and many problems improve with the right diagnosis. Men's Health & Andrology →
FAQs
Is infertility usually the woman's problem?
No. Male factors are involved in a large share of couples, so both partners should be tested from the start.
Does varicocele surgery help?
In selected men with abnormal semen results and a clinical varicocele, repair can improve sperm quality. Your urologist will advise whether it applies to you.
Is the consultation confidential?
Yes. Consultations are private and your records are protected under our privacy policy.
Medical review: pending — Dr. Abhishek M. Shah · Content prepared October 2026. This guide is general information and does not replace a consultation.