Male infertility belongs in the fertility conversation
When we talk about fertility, the focus is almost always on women: their age, their cycles, their eggs. But infertility can involve male factors, female factors, a combination of both, or remain unexplained. It is not just a “women’s issue”.
At femme, we’re all about open, honest conversations about reproductive health, and that includes shining a light on the silent struggles men can face too.
So... what actually is male infertility?
Male infertility means a reduced chance of achieving a pregnancy because of a factor involving the male reproductive system. The World Health Organization notes that common male factors include problems with semen ejection, low or absent sperm, or differences in sperm movement and shape.
The NHS uses semen analysis as a core fertility test for men, checking for problems such as a low sperm count or sperm that are not moving properly.
What can affect male fertility?
Sperm production or quality
Low sperm count, absent sperm, reduced motility or abnormal morphology can all affect fertility.
Medical factors
Infections, previous injury, hormonal disorders, varicocele and some medical treatments can affect sperm production or delivery.
Lifestyle factors
Smoking, excessive alcohol intake and obesity are associated with poorer fertility. The NHS also notes a link between higher scrotal temperature and reduced semen quality, although simple fixes such as looser underwear have uncertain benefit.
Sometimes there is no clear cause
Many cases of abnormal semen remain unexplained, which is one reason proper assessment matters more than blame.
What about the decline in sperm counts?
A large 2022 systematic review and meta-regression of studies using samples collected between 1973 and 2018 reported a substantial fall in average sperm concentration among men unselected by fertility status. That is an important population-level finding, but it is not the same as saying every man’s sperm count has fallen or that a particular individual is infertile.
For an individual or couple, fertility assessment still depends on personal history and appropriate testing rather than population headlines.
The awareness gap and the pressure to be fine
Fertility problems can become tangled up with ideas about masculinity, virility and identity. Phrases such as “shooting blanks” or assumptions that a fertility diagnosis makes someone less of a man add shame to what is already a medical and emotional issue.
Men can also feel pressure to stay strong for a partner while their own anxiety, grief or loss of confidence goes unspoken. Fertility struggles can affect relationships and mental health on both sides.
Talking about male fertility earlier is not about shifting blame. It is about making sure both partners are included in assessment and support from the beginning.
So what can we do about it?
- Start the conversation openly and without judgement.
- Include men in fertility education from the beginning.
- Challenge harmful language and stereotypes.
- Offer mental health support to both partners where it is needed.
- Test appropriately rather than waiting until the end. Semen analysis is a standard part of male fertility assessment.
Final thoughts
Male infertility is real, and it deserves to be taken seriously. The sooner we can ditch the shame and start talking about it, the better informed couples and individuals can be.
At femme, we believe in breaking taboos, busting myths and creating space for all reproductive health conversations, including the ones we have not been having enough of.
Sources
NHS: Causes of infertility
NHS: Diagnosis of infertility
WHO: Infertility
