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Male Infertility - Causes

Alexey Kryvenko, medical expert
Last reviewed: 04.07.2025

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The causes of male infertility are varied, therefore the causes leading to pathozoospermia are divided into the main ones, which are most common, and additional ones, which have both independent significance and are combined with the main factors of infertility in men.

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The main causes of male infertility:

Varicocele.
Infectious and inflammatory diseases of the male genital organs.
Pathozoospermia of unknown cause.
Isolated seminal fluid disorders.
Immunological infertility.
Congenital malformations (cryptorchidism, monorchidism, hypospadias, epispadias, etc.).
Systemic diseases (tuberculosis, liver cirrhosis, chronic renal failure, chronic respiratory diseases, diabetes mellitus, infectious mumps complicated by orchitis, diseases of the nervous system, etc.).
Surgical interventions for inguinal hernia, hydrocele, urethral stricture, bladder surgery, sympathectomy, etc.
Some types of therapeutic treatment: radiation, hormonal and chemotherapy, use of tranquilizers and antihypertensive drugs, sulfonamides, nitrofuran derivatives, drugs.
Sexual disorders.
Ejaculation disorders.
Obstructive azoospermia.
Necrozoospermia.
Endocrine forms of infertility:
- hypergonadotropic hypogonadism (primary);
- hypogonadotropic hypogonadism (secondary);
- normogonadotropic hypogonadism;
- hyperprolactinemia;
- testosterone deficiency states.

Additional causes of male infertility:

Habitual intoxications: alcohol abuse and smoking.
Occupational hazards: contact with organic and inorganic substances, exposure to ionizing radiation.
Thermal factor: work in conditions of high and low temperatures, prolonged feverish state with an increase in body temperature over 38 C.
Trauma of the scrotal organs.
Psychological infertility (conflict situations in interpersonal relationships).
Alimentary factor.

A temporary decrease in fertility may occur after operations involving prolonged anesthesia, as well as after scrotal trauma if they are accompanied by tissue damage, scrotal hematoma, hemospermia, or hematuria. Severe testicular trauma may cause damage to the blood-testicular barrier and lead to the formation of antisperm antibodies, as with vas deferens obstruction.

Chronic exposure to heavy metals (lead, cadmium, mercury) and other substances (pesticides, herbicides, etc.) are also causes of male infertility. Not all specialists note the effect of alcohol on male infertility. It has been proven that cigarette smoking causes the development of pathozoospermia.

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