The most common sign: pregnancy is not occurring
Infertility is generally defined as not achieving pregnancy after 12 months of regular unprotected intercourse. Evaluation is usually recommended after six months when the female partner is 35 or older, and earlier when either partner has a known risk factor.
Male and female factors may occur separately or together. Both partners should therefore be assessed rather than assuming the problem lies with one person.
Possible symptoms and warning signs
Most men with low sperm count or poor sperm movement feel completely well. When symptoms are present, they may include:
- Difficulty with erection or ejaculation
- Very low semen volume, painful ejaculation or semen that appears to travel backwards into the bladder
- Reduced sexual desire
- Pain, swelling, a lump or a feeling of heaviness in a testicle
- A visibly enlarged vein pattern around a testicle, which may suggest a varicocele
- Reduced facial or body hair, breast enlargement or other possible signs of a hormonal disorder
- A history of an undescended testicle, testicular injury, surgery, infection or cancer treatment
Risk factors that may not cause symptoms
Some fertility risks remain silent. These include smoking, heavy alcohol intake, anabolic steroids or external testosterone, obesity, certain medicines, heat or toxin exposure, diabetes and some genetic conditions.
Testosterone taken as an injection, tablet, gel or bodybuilding drug can suppress sperm production. Anyone trying to conceive should tell the clinician about all hormones, medicines and supplements.
What a fertility assessment may include
The clinician may review the couple’s reproductive history, general health, medicines, sexual function and previous pregnancies. A male assessment commonly includes a semen analysis and, where indicated, physical examination, hormone tests, ultrasound or genetic testing.
One abnormal semen result does not automatically mean permanent infertility. Semen measures vary, so a repeat test may sometimes be advised.
When to seek help without waiting
Arrange an earlier consultation for testicular pain or swelling, erection or ejaculation problems, previous testicular surgery or injury, undescended testis, chemotherapy or radiotherapy, testosterone or anabolic-steroid use, or a known fertility condition in either partner.
Book a consultation with Sampurna
Sampurna Women Care & IVF provides fertility evaluation and treatment at JC18, JC Block, Sector III, Salt Lake, Bidhannagar, Kolkata – 700106. Patients from Bangladesh may begin with an online consultation. When an in-person visit is recommended, the team can assist with medical-visa documentation and visit planning; visa approval remains subject to the relevant government authorities.
Call or WhatsApp +91 81003 46614 to book a consultation. Recommendations vary according to both partners’ medical history, test results and preferences.
Frequently asked questions
Can a man be infertile with normal sexual function?
Yes. Erections, desire and ejaculation may be normal even when sperm count, movement or shape is abnormal.
Does normal-looking semen mean sperm are healthy?
No. Appearance cannot show sperm concentration, motility or morphology; these require laboratory analysis.
Can male infertility be treated?
Some causes are reversible or manageable, while others may require assisted reproduction. Treatment depends on the diagnosis and both partners’ factors.
Should both partners be tested?
Yes. Parallel assessment usually saves time because male and female factors may coexist.
Does a low count always mean IVF?
No. The next step depends on severity, cause, repeat results, duration of infertility and the female partner’s factors.
Medical disclaimer
This article provides general educational information and is not a diagnosis or substitute for individual medical advice. Fertility factors and treatment options vary. Consult a qualified clinician for recommendations based on your circumstances.
