Structural Causes of Male Infertility

Structural Causes of Male Infertility Can Interfere with Conception

While a low sperm count is the most common reason for male infertility, structural causes, or issues with sperm delivery, can interfere with the reproductive process as well. During your couples consultation, Dr. James Douglas will ask about the existence of varicocele, undescended testicles or erectile dysfunction.

11331234_sAfter female infertility testing and semen analysis,

Dr. Douglas may refer the male partner to a urologist for the diagnosis and treatment of structural causes of infertility.


Varicocele is a common male factor infertility condition in which a varicose vein connected to the spermatic cord, which runs between the testes and scrotum, become enlarged. This causes blood to flow improperly and back up, causing swelling in the testes and scrotum and may prevent normal cooling of the testicle. This can lead to reduced sperm count, motility, and morphology. Varicocele is treated surgically by tying off the enlarged veins. However, the surgery does not always correct the sperm abnormalities.

Undescended Testicle

Undescended testicle is a condition when one or both testicles fail to move from the abdomen into the scrotum during fetal development. Undescended testicles are exposed to the higher temperature in the body and can result in decreased sperm production.

Abnormal Sperm Delivery

If your partner has received results of a semen analysis that indicate that things are normal, you may be experiencing problems with the delivery of sperm from the penis into the vagina, including:

Sexual Issues

Several problems during intercourse can impact male fertility, including erection difficulties (erectile dysfunction), premature ejaculation, dyspareunia, or psychological or relationship problems.

Retrograde Ejaculation

Caused when semen enters the bladder during orgasm rather than exiting out of the penis, retrograde ejaculation can result from various conditions such as bladder, prostate or urethral surgery, diabetes, and certain medications.

Duct Blockage

When the epididymis or the ejaculatory ducts are blocked, the male partner may have trouble impregnating his partner. Some men do not have tubes that carry sperm, called the vas deferens, from the testicle to the opening in the penis, which can also lead to problems conceiving. This is most commonly seen with men who have cystic fibrosis.

Misplaced urinary opening (hypospadias)

If the urinary (urethral) opening is located on the underside of the penis, sperm delivery can be hindered unless surgery corrects the issue.

Read more about the causes of infertility with ASRM Guides & Fact Sheets

Optimizing Male Fertility- an ASRM guide