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As most male doctors will tell you, reduced fertility in men* is far more common than people realise.
Fertility challenges affect up to 1 in 5 couples, with male factors contributing to around half of all cases.
ON THIS PAGE
- Male fertility testing
- What treatments are available?
- Tips to boost your fertility
- Common causes of male infertility
- Male fertility and mental health
- When to visit a male fertility doctor
- About Dr Michael Macpherson
When conception is framed purely as a women’s health issue, we miss a big part of the picture.
Fertility is a shared journey. It really does take two to tango.
As a GP with a strong interest in men’s health, here’s what I want every man to know before seeing a fertility specialist
* Though I’ve used a cisgender context to discuss this complex area of medicine, I recognise and respect that not everyone identifies with binary genders.
Men’s Fertility Testing
Male fertility testing with your GP involves:
- A detailed medical and reproductive history
- A physical examination of the groin, testicles, and penis
- A semen analysis (to assess sperm count, movement, and shape)
- Blood tests to check hormone levels
Sometimes imaging or genetic testing is recommended, depending on the initial findings.
Guidelines for Managing Male Infertility
In October 2025, Australian doctors were introduced to long-awaited, evidence-based guidelines for managing male infertility.
The guidelines are designed to improve the chances of successful conception while addressing health conditions that are often underdiagnosed but can significantly affect a man’s fertility.
In practice, they importantly bring men back into focus, encouraging doctors to assess male fertility factors alongside their partner’s — recognising that fertility is very much a shared journey.
What Fertility Treatments Are Available?
While we can’t directly boost sperm quality, there are many effective ways to improve your chances of conception.
The Male Reproductive System
Once I have a clear picture of what’s happening physically and psychologically, I may refer you to a fertility specialist or urologist for further management.
Depending on your diagnosis, here are some common treatment options.
Assisted Reproductive Technologies
Men with low sperm counts or reduced sperm quality may benefit from assisted reproductive technologies such as:
- In vitro fertilisation (IVF) – An egg is combined with sperm in a laboratory, and the resulting embryo is transferred to the uterus.
- Intracytoplasmic sperm injection (ICSI) – A single sperm is injected directly into an egg, often used when sperm quality is very low.
Surgery
If a blockage in the reproductive tract is contributing to reduced fertility, surgery may be an option.
Several surgical approaches can clear blockages, and a specialist referral is arranged if appropriate.
Artificial Insemination
Artificial insemination may be recommended when:
- Erectile dysfunction is present
- Sperm count is low
- Sperm have difficulty reaching the egg naturally
This process involves preparing a semen sample to concentrate healthy sperm, which is then placed directly into your partner’s uterus.
Hormone Therapy
If hormone abnormalities are identified, you may need a referral to an endocrinologist.
Doctors usually address underlying medical conditions and lifestyle factors before considering testosterone replacement therapy or other medications.
Psychological Care
Mental health challenges—such as stress, anxiety, depression, or trauma—can contribute to low libido, erectile dysfunction, and premature ejaculation.
Psychologists, counsellors, and psychiatrists play an important role in treating psychological factors that impact male fertility.
Tips to Boost Your Fertility
These aren’t quick fixes, but practical steps that may help improve fertility over time.
For some men, simply telling themselves, “I’m gonna be a dad!” can be an excellent motivator to get as healthy as possible and increase their chances of conceiving.
Practical ways to support your fertility include:
- Watch your weight: Obesity (BMI over 30) is associated with reduced fertility and sexual dysfunction. Even modest weight loss can significantly improve testosterone levels and fertility outcomes.
- Limit alcohol: Excessive alcohol intake negatively affects sperm quality. Moderate drinking (1–2 standard drinks on most days, 3–4 on occasion) is unlikely to impact sperm production, though it may affect sexual performance.
- Stop smoking: Smoking is linked to reduced sperm quality. Remember, it takes about three months for sperm to regenerate after quitting.
- Manage heat exposure: Avoid prolonged high temperatures around the testicles.
- Avoid recreational and performance-enhancing drugs: Opioids, marijuana, stimulants, and anabolic steroids can impair sperm production and sexual function.
- Have LOTS of sex: Scheduling intimacy isn’t always romantic, but fertility specialists recommend vaginal intercourse every 2–3 days around ovulation to maximise the chance of conception.
What Can Cause Infertility in Men?
There isn’t just one cause — male fertility is influenced by physical, hormonal, lifestyle, and psychological factors.
Sexual Function
Ongoing erectile dysfunction, premature ejaculation, or low libido can make regular intercourse difficult, which naturally affects the chances of conception.
Often, sexual difficulties have a psychological component. The pressure of “trying for a baby” can quickly turn something enjoyable into something stressful.
And stress, unfortunately, doesn’t help performance.
Did you know?
Sperm takes around three months to produce in your testicles. This means what you do to or put in your body now will affect sperm health and your chances of conceiving in three months’ time.
Understanding what’s contributing to your stress and mental health is an essential part of fertility care.
I can provide support and, if helpful, arrange a referral to a psychologist.
Hormones
Low testosterone (hypogonadism) is a common hormonal cause of male infertility.
Healthy testosterone levels are important for:
- Libido
- Erections
- Normal sperm production
If hormone levels are off, both sexual function and fertility can suffer, but these issues are often manageable once identified.
Sperm Health
For pregnancy to occur, sperm need to:
- Be present in adequate numbers
- Move well (motility)
- Have a healthy structure
A typical ejaculation contains tens to hundreds of millions of sperm. While higher numbers improve the odds, pregnancy can still happen with lower counts if the sperm are healthy and mobile.
It’s also worth noting that sperm count and motility naturally decline with age.
Tube Blockages
Sperm travel through small tubes (including the epididymis and vas deferens) before ejaculation.
If these pathways are blocked because of infection, injury, or prior surgery, sperm may not be released properly, even if production is normal.
Lifestyle Factors
Lifestyle plays a bigger role than many realise.
Smoking, excessive alcohol, recreational drugs, poor sleep, obesity, and chronic stress have all been linked to reduced sperm quality.
The encouraging part? Many of these are modifiable. Positive changes today can genuinely improve fertility in the coming months.
Male Fertility & Mental Health
Infertility can be emotionally difficult to deal with.
Unfortunately, stigma and outdated ideas about masculinity can make it difficult to talk about, which only adds to the pressure.
If you’re struggling, please know that fertility challenges are very common. They are not, in any way, a reflection of your masculinity or worth.
Your mental health matters just as much as your physical health. Talk to someone if you’re in need.
When to Visit a Male Fertility Doctor
The World Health Organisation describes infertility as not conceiving after 12 months of regular unprotected intercourse. But that’s only a guide.
It’s important to remember that not getting pregnant within your ideal timeframe doesn’t mean something is wrong.
Even when your swimmers are perfectly healthy, age, sperm health, timing, and egg quality all play a role in conception.
What’s more, it takes a mighty good dose of luck for the right sperm to meet the right egg at the right moment.
Many men also experience temporary physical, hormonal, or psychological issues that can affect fertility, including:
- Erectile dysfunction (impotence)
- Reduced libido (sex drive)
- Mental health concerns
- Hormone imbalances
Visiting your GP is an excellent first step if you have any questions or worries.
After a thorough history and examination, along with initial tests, they can often determine what’s going on, how they can help, and whether you need a referral to a fertility specialist.
Personalised Advice & Treatment
If you’re concerned about your fertility, or if you’ve been trying without success, speak with your GP.
Even when no major treatment is required, personalised advice can reduce anxiety, clarify your next steps, and give you a plan.
Fertility isn’t just a women’s health issue. It’s a shared journey, and you don’t have to navigate it alone.
Dr Michael Macpherson (BAppSc, MBBS, FRACGP) is a local GP at Doctors of South Melbourne.
His special interests include men’s health, sports medicine, and chronic disease management.
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