Understanding Male Fertility

Understanding male fertility is just as important when planning for pregnancy, yet it’s often overlooked. Sperm health - including count, movement, shape, and DNA integrity - plays a crucial role in achieving a healthy conception and supporting early embryo development. These factors can be influenced by age, lifestyle, medical history, and the environment, and the good news is that many aspects of sperm quality are highly responsive to positive change. I’m here to help you understand what contributes to male fertility, how to identify and address potential issues early, and how we can optimise sperm health with practical, evidence-based strategies tailored to your needs.

Smiling woman with curly hair and glasses standing behind a reception desk in a warmly lit room, with a large potted plant, a fireplace, and some decorative items in the background.

“Exploring male fertility isn’t about blame or worry - it’s about compassion, knowledge, and creating the strongest foundation for the family you’re hoping for.”

How the Male Reproductive System Works

Male fertility depends on producing healthy sperm and delivering them effectively.

Key elements:

  • Spermatogenesis - takes ~72 days

  • Hormonal control - FSH and LH from the brain stimulate sperm production and testosterone

  • Sperm maturation - in the epididymis

  • Ejaculation - semen mixes with prostate and seminal vesicle fluids

A semen analysis is the primary male fertility test and evaluates:

  • Semen volume, concentration, motility and morphology

Causes of Male Infertility

Primary Testicular (Production) Causes

  • Varicocele

  • Klinefelter syndrome

  • Y-chromosome microdeletions

  • Mumps orchitis

  • Undescended testes

  • Testicular trauma

  • Chemotherapy / radiotherapy

Obstructive (Post-Testicular) Causes

  • Congenital absence of vas deferens (CFTR mutations)

  • Epididymal obstruction

  • Retrograde ejaculation

  • Vasectomy or surgical scarring

Hormonal (Pre-Testicular) Causes

  • Pituitary disorders

  • Hypogonadotropic hypogonadism

  • Thyroid disease

  • Hyperprolactinaemia

  • Oestrogen excess (from obesity, liver disease, or exogenous hormones)

Lifestyle and Environmental Factors

Strong evidence links male fertility with:

  • Smoking and vaping

  • High alcohol intake

  • Anabolic steroid or testosterone use

  • Obesity

  • Heat exposure

  • Pesticides, solvents, heavy metals

  • Stress and poor sleep

Changes can improve sperm parameters within 3 months, reflecting an entire spermatogenesis cycle.

Age and Male Fertility

Men experience gradual reproductive ageing. After 40, there is:

  • Reduced semen volume and motility

  • Increased DNA fragmentation

  • Higher miscarriage risk

After 45, risks increase for:

  • Neurodevelopmental conditions

  • Psychiatric conditions

  • Academic and behavioural difficulties in children

When to Seek Fertility Assessment

You should consider seeing a fertility specialist if:

  • Abnormal semen analysis

  • Known varicocele or undescended testes

  • History of testicular trauma or surgery

  • Prior chemotherapy or radiotherapy

  • Preparing for gender-affirming therapy

  • Family history of male infertility

Early assessment allows:

  • Timely diagnosis

  • Targeted treatments

  • The best chance of achieving pregnancy

  • Planning around age-related fertility changes

Fertility is a shared process - influenced by the health, hormones, genetics, and lifestyle of both partners.

Most fertility issues can be diagnosed, supported, or treated effectively with modern reproductive medicine.

Dr Rebecca Mackenzie-Proctor offers:

  • Comprehensive fertility assessments

  • Preconception optimisation programs

  • Female and male fertility evaluations

  • Ovulation tracking and cycle monitoring

  • Sperm optimisation programs

  • Egg freezing

  • IVF, ICSI, IUI

  • Donor services

  • Compassionate, personalised guidance at every stage

If you’re preparing for pregnancy or navigating fertility concerns, we’re here to support your next steps.

A pink-tinted digitally edited image of a statue of a woman in traditional attire, with one hand touching her face.
A collage featuring two hands, one holding a pink rose and the other holding a silver bell, surrounded by blue and yellow butterflies, with transparent labels and lines connecting the objects.