Male Fertility

Usually there are none. This is the part that surprises people. Most men with a sperm problem feel completely well, have normal sex drive and function, and have no idea anything is different until a semen analysis is done. You cannot tell from how you feel.

There are some signs worth acting on: pain, swelling or a lump in the testicles, difficulty with erections or ejaculation, reduced facial or body hair, or a history of undescended testes, testicular surgery or injury. But the absence of all of those tells you nothing.

That is the argument for testing early rather than waiting. A semen analysis is a simple test and it is the only way to know.

Often yes. No sperm in the ejaculate is called azoospermia, and it is not one condition but two quite different situations.

In some men, sperm is being produced normally but cannot get out, because of a blockage, a previous vasectomy, or an absent vas deferens. In these cases sperm can usually be retrieved surgically and used with ICSI, where a single sperm is injected directly into an egg.

In others, sperm production itself is affected. Even then, small amounts of sperm can sometimes be found in the testicular tissue and used. Where no sperm can be retrieved, donor sperm is an option, and our team can talk you through that pathway.

Further testing, including hormone levels and genetic testing, identifies which situation applies. It is worth getting a clear answer rather than assuming the worst.

Lifestyle genuinely matters, though it is not a cure for every problem.

Maintaining a healthy weight, exercising regularly, eating well, not smoking, moderating alcohol and managing stress all support sperm production. Heat matters too, so it is worth avoiding prolonged hot baths, saunas and laptops resting directly on your lap. Some prescription medications and recreational drugs affect sperm production significantly, so bring a full list of what you take to your appointment.

Sperm takes around three months to develop, which means changes you make today show up in a sample roughly three months later. That is the single most useful thing to know: improvements are real but they are not quick, and there is no point retesting after two weeks.

You do not need to wait a year of trying. Come sooner if you have concerns about your sperm, a history of testicular problems, surgery or injury, previous cancer treatment, or if you are taking testosterone or anabolic steroids.

If your partner is over 35, it is worth both of you being assessed earlier rather than investigating her first and getting to you months later. Around a third of fertility difficulties involve a male factor, and a semen analysis is quicker and simpler than most of the tests she will otherwise go through.

Yes, and this surprises a lot of men. Testosterone replacement and anabolic steroids suppress the body's own signals to produce sperm, and can reduce sperm production substantially or stop it altogether. The effect is often reversible after stopping, but recovery can take many months and is not guaranteed.

If you are on testosterone and thinking about children, speak to a specialist before stopping or changing anything. There are approaches that can support fertility without simply ceasing treatment, and stopping abruptly on your own is not the best first move.

Usually a semen analysis, which assesses sperm count, movement and shape, alongside hormone testing to check reproductive function. Depending on your history, your specialist may also recommend a physical assessment, genetic testing or sperm DNA testing. If you have a partner, your results are considered together to give a complete picture.

Yes, though more gradually than in women. Sperm quality and DNA integrity decline with age, which can affect both the chance of conception and miscarriage risk, and there is some evidence of increased risk of certain conditions in children of older fathers. It is one factor among several rather than a barrier on its own, and plenty of men father healthy children well into later life.

Yes. Sperm freezing is the most established method of preserving male fertility and can usually be arranged quickly. Chemotherapy and radiotherapy can cause temporary or permanent infertility, so it is best discussed before treatment starts. We coordinate with your oncology team where needed.