Male Factor Infertility

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 13, 2026

Male factor infertility refers to any condition arising from the male partner that reduces a couple's ability to conceive, including abnormalities of sperm count, motility, morphology, sperm DNA integrity, hormone levels, or reproductive anatomy. Male factor is the sole cause in approximately 20% of infertile couples and contributes alongside female factors in a further 20 to 45%.¹ Evaluating the male partner is not optional in RRM; it is a prerequisite.

Semen analysis is the starting point, but it is not sufficient alone. In a multicenter study of 1,014 couples who refused ART and pursued natural conception, only 13% of men in the isolated male factor subgroup had normal semen parameters by WHO criteria.¹ Standard semen analysis missed the diagnosis in the majority of cases. The comprehensive andrological evaluation identified treatable conditions in most: male genital tract infection in 43%, genital tract inflammation in 49%, and hypospermatogenesis in 17%. After targeted etiologic treatment, 32.5% of couples in the isolated male factor group achieved natural conception.¹

RRM evaluates male factor through semen analysis, sperm DNA fragmentation testing, hormonal assessment, and scrotal imaging. When azoospermia is present, the clinical pathway branches based on whether the obstruction is obstructive or secretory: obstructive azoospermia may be surgically correctable, while secretory causes require genetic evaluation before determining whether natural conception is possible. Restorative andrology targets the underlying cause: infection, inflammation, hormonal deficiency, varicocele, or oxidative stress.²

The infertility evaluation is couple-based from the first appointment. Treating female factors without evaluating the male partner is clinically incomplete. RRM clinicians assess both partners simultaneously.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.