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Male Fertility

A host of issues can cause fertility complications. Still, it’s estimated that close to half of all infertility cases suffered by couples are related to men’s infertility or a combination of women’s and men’s infertility. Male infertility is any men’s health issue that lowers the chances of his partner getting pregnant.

Male fertility specialists at TUCC can shed light on the causes and potential treatments for men’s infertility problems.

Causes of Male Infertility​

Producing mature, healthy sperm capable of travel depends on several conditions. Some potential causes of infertility in men include:

  • Sexually transmitted diseases or other infections.
  • Blockages, congenital disabilities, or physical damage. Some men are born with blockages in parts of the testicle or other abnormalities that prevent sperm from entering the semen. Physical trauma to the testicles, prostate, and urethra can also result in fertility issues.
  • Retrograde ejaculation is a disorder in which semen doesn’t come out of the penis during ejaculation and instead enters the bladder. It can be caused by diabetes, medications, bladder, prostate, or urethra surgery.
  • Genetic diseases. Rare cases of cystic fibrosis chromosomal disorders can cause infertility.
  • Autoimmune disorders, where a man’s immune system mistakenly targets and damages sperm cells as foreign viruses.
  • Hormonal problems. Specific hormonal imbalances such as those in the pituitary and thyroid glands can cause infertility.
  • Erectile dysfunction and premature ejaculation. Learn more about the erectile dysfunction treatment options at the Center for Men’s Health at TUCC here.
  • Varicoceles, widening of the veins along the spermatic cord that holds up a man’s testicles. It forms when valves inside the veins along the spermatic cord prevent blood from flowing correctly.
  • Lifestyle factors. Excessive exercise, heat, alcohol, drugs, food, stress, and exposure to environmental toxins can also impact a man’s fertility.
Illustration of the male reproductive system.

At TUCC’s Center for Men’s Health, you will receive expert care from a reproductive urology program guided by a fellowship-trained andrologist.

A comprehensive male fertility evaluation will involve a careful history, focused physical examination, semen analysis, and assessment of reproductive hormones.

Your TUCC physician will review your history and perform a physical exam to evaluate the testes and spermatic cords. This includes checking for a varicocele (dilated vein of the scrotum) and the presence of the vas deferens (sperm duct), while ruling out other possible abnormalities.

A semen analysis can identify problems that might be contributing to infertility — whether that’s a blockage preventing the normal passage of sperm through the ejaculatory ducts, low concentration of sperm, or poor motility, for example.

The Urology Center of Colorado now offers semen analysis through Fellow. This is a convenient, at-home mail-in testing kit. Rigorous peer-reviewed evaluation has confirmed the accuracy of results obtained with the proprietary preservative buffer and algorithmic analysis when compared to a traditional semen analysis.

The Fellow Semen Analysis is $189/testing kit. This includes a prepaid shipping label to facilitate the ease of sending off your sample. Due to the variability of semen quality, your physician may recommend a second test at an appropriate interval to confirm abnormalities.

Semen analysis can detect:

  • Azoospermia: The complete absence of sperm in the ejaculate, possibly due to production issues or obstruction.
  • Oligospermia: Low sperm concentration
  • Asthenospermia: Poor sperm motility
  • Problems with Sperm Form and Structure: Possibly interfering with the sperm’s ability to reach and fertilize an egg.

Hormonal dysfunction does not impact the fertility of most men. However, assessment of your reproductive hormones may be recommended by your urologist and hormonal treatments may improve fertility in selected circumstances.

Close collaborative partnerships are maintained with reproductive endocrinologists (female fertility specialists) to facilitate specialized treatments for which in-vitro fertilization (IVF) is required.

Male Infertility Diagnosis

If your semen analysis proves irregular and you’ve been diagnosed with infertility, your TUCC physician will first discuss potential behavioral changes that could improve your chances of conceiving. This could include having sex less often to build up a better concentration of sperm. Meanwhile, retrograde ejaculation—when semen enters the bladder instead of emerging through the penis during orgasm—can often be treated with over-the-counter cold medicine. Finally, if abnormal hormone levels are detected following a semen analysis, you may be a candidate for hormonal replacement therapy.

Male Infertility Treatments

Our Doctors are specially trained in basic to advanced male infertility procedures and men’s reproductive health. With modern technology and methods—and the best male fertility doctors in Colorado—the number of treatment options at TUCC for male infertility has expanded. Depending on the cause of infertility, treatments may include:

  • Medications. An analysis can determine the correct medication path.
    • In addition, hormone therapy can increase the number of sperm.
  • Lifestyle Changes. TUCC urology and male reproductive doctors can guide you through several lifestyle changes that could potentially improve fertility, including:
    • Maintain a healthy body weight
    • Exercise
    • A healthy diet
    • No smoking
    • No alcohol consumption
    • No cannabis use
    • No illegal drug use
  • Surgery. Surgery could be an option depending on your specific condition and the results of your semen analysis. Male fertility surgeries include:
    • Vasectomy Reversal: An outpatient surgery where the vas deferens are reconnected in your scrotum. 
    • Vasoepididymostomy: Blockages are removed from your vas deferens. Blockages can be caused by infection or injury and a previous vasectomy.
    • Sperm Retrieval: Surgeons can perform a biopsy of the testicle to locate sperm.

TUCC Male Fertility Doctors
Denver, Lone Tree & Co Springs


Male Fertility FAQs

Male infertility is the inability to conceive a child with a known fertile female.

Male infertility can be caused by many factors such as hormone disorders, medications, injury or infection of the reproductive anatomy, obstruction, illness, sexual dysfunction or drugs, tobacco, and alcohol use.

Yes. Male infertility can be caused by low sperm mobility, malformed sperm, anti-sperm antibodies, poor sperm viability (forward progression), and blockages in the sperm ducts that prevent the sperm from entering the semen.

Semen analysis is a pain-free procedure that measures the amount and quality of a man’s ejaculate. You must provide a sample of your semen, collected into a sterile container during masturbation or by using a special condom that collects the sample during intercourse.

Having erectile dysfunction does not mean you are infertile. However, erectile dysfunction can interrupt or prevent intercourse.

According to the Mayo Clinic, normal sperm densities range from 15 million to greater than 200 million sperm per milliliter of semen. Therefore, you have a low sperm count if you have fewer than 15 million sperm per milliliter or less than 39 million sperm total per ejaculate.

Low sperm count is one of the leading causes of male infertility. However, even if a male has decreased fertility, a fertile female may still be able to get pregnant.

If the low sperm count is caused by swelling of the veins that drain testicles (varicocele) or blockage of the sperm ducts (ejaculatory duct obstruction), these can be treated with surgery. In addition, these can be treated with certain medications if the condition is caused by infection or hormonal imbalances. In some cases, the low sperm count can’t be treated, and the only option for fertility is to use assisted reproductive technology (ART).

Yes, alcohol can lower sperm count. Excessive drinking can lower testosterone levels and decrease sperm production, leading to low sperm count.

Regarding boxers vs. briefs: though wearing tight underwear holds your testicles close to your body and might seem to cause pressure and increase the temperature in your scrotum, there is NO proven impact on fertility.

We’re here to help.

For appointments at any TUCC location, request an appointment online.