Male Infertility

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If male infertility is impacting your ability to start your family, our men’s health specialists can help identify the physical and psychological concerns that may be the cause. We’ll recommend treatments to help you and your partner achieve a pregnancy.

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What Is Male Infertility?

About one-half of infertility problems can be caused by male infertility, an umbrella term that covers problems related to making or moving sperm, or the health of your sperm. Men most commonly learn of their fertility problems after experiencing difficulty creating a pregnancy with their partner.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

What Causes Male Infertility?

Many factors can cause infertility in men. You might have irregularities in your hormone balance, how your testicles work, how much sperm you produce, or even the size of your testicles’ veins. Previous urologic conditions or undescended testicles may also be to blame.

Moving sperm through and out the penis may be impacted by a blockage or an ejaculation disorder.

Certain medical conditions such as thyroid disease, testicular cancer, and depression, and medications used to treat these and other conditions can also cause infertility. Testosterone replacement therapy, sometimes used to treat sexual dysfunction, can impact your fertility. Extended exposure to extreme environmental conditions that include pesticides or radiation can also be to blame.

Infertility Testing

If you and your partner are having trouble conceiving, our doctors will perform multiple tests to identify the underlying cause. They’ll use this information to recommend the most appropriate treatments for your condition.

Physical Examination

Your urologist will perform a physical examination and order blood tests to check for hormone imbalances. You’ll return twice for a semen analysis; first to check the health of your sperm, then four weeks later to confirm any findings. In rare cases, your doctor may request genetic testing.

Male Infertility Treatment Options


Depending on your needs, medication to increase sperm production may be prescribed. Your doctor may prescribe antibiotics if an infection is present.

Varicocele Surgery

Varicoceles are enlarged, entangled veins in the testicles that can impair sperm quality and production. Duke urologic surgeons use minimally invasive techniques to reach the veins and halt the blood flow that feeds the varicocele. This procedure often “cools down” the testicles and improves sperm production.

Obstruction or Structural Abnormality Repair

Surgery can clear a blockage in the ejaculation ducts or reconstruct reproductive structures that prevent the transport of sperm. If repair is not possible, sperm retrieval may be considered.

Sperm Retrieval

Retrieves sperm from the reproductive tract. This may be an alternative to vasectomy reversal, although doctors recommend not having a vasectomy if there’s a chance you may want to have a reversal.

Why Choose Duke Urology

Personalized Treatment
Duke’s board-certified urologists identify the cause of your male infertility and recommend a personalized treatment plan that meets your needs.

Expertise in the Male Reproductive System
Our doctors are consistently recognized for their experience and expertise.

Access to Wide Range of Specialists
We have access to advanced genetic testing and counseling when more uncommon causes of infertility may be the cause. We work closely with the Duke Fertility Center because evaluating and correcting male infertility at the same time as the female evaluation can expedite the process of achieving a successful pregnancy. 

Best Hospital for Urology in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our urology program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

This page was medically reviewed on 04/23/2024 by