Male Infertility Is More Common Than You Think

Male infertility deserves an equal place in the conversation

When a couple has spent months or years trying to conceive, the medical conversation often centers almost entirely on the woman. She may undergo bloodwork, ultrasounds, medications, procedures, and repeated treatment cycles before anyone takes a close look at the male partner.

That imbalance can delay answers. Male-factor infertility is involved in roughly 40% to 50% of infertility cases, either on its own or alongside a female factor. In other words, evaluating only one partner does not provide the full picture.

At Nodal, we believe fertility care should begin with complete information. Testing both partners early is not about placing blame. It is about giving a family the clearest possible path forward.

What is male-factor infertility

Male-factor infertility refers to a condition involving sperm production, function, or delivery that may make conception more difficult. A fertility evaluation may look at sperm count, movement, shape, semen volume, and other factors. Some results point to a clear cause, while others require additional testing by a reproductive urologist or fertility specialist.

Male infertility can be associated with medical conditions, hormonal or genetic factors, prior infections or treatments, medications, lifestyle factors, or structural concerns. Sometimes no single cause is identified. A semen analysis is an important starting point, but it is not always the end of the evaluation.

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Why a semen analysis should happen early

A semen analysis is generally one of the first tests recommended when a couple begins an infertility evaluation. It is relatively simple and noninvasive, and results can help a care team decide whether further evaluation or a change in treatment may be appropriate.

No single semen analysis can predict fertility with certainty. Results may also vary from one sample to another, so a provider may recommend repeat testing if the first result is outside the expected range. Even with those limitations, testing the male partner early can prevent a couple from moving through female-focused treatment without examining another major part of the equation.

How sperm health can matter in IVF and surrogacy

In gestational surrogacy, an embryo is created through IVF before it is transferred to a gestational carrier. The health of the egg and sperm can both influence fertilization and embryo development. Transfer success is affected by many factors, including embryo characteristics, the uterine environment, clinic protocols, and individual medical history, so sperm quality should not be treated as the only variable. It should, however, be part of the full clinical picture.

If testing identifies a male factor, a fertility specialist may discuss additional evaluation or options such as lifestyle changes, treatment of an underlying condition, medication, surgery, or assisted reproductive techniques. The right next step depends on the diagnosis and should be determined with a qualified clinician.

The stigma around male infertility can delay care

Infertility is a medical issue, not a measure of masculinity or personal failure. Yet stigma can make testing feel uncomfortable or easy to postpone. That hesitation can leave both partners carrying unnecessary uncertainty and may place an unfair physical and emotional burden on the woman.

A better approach is to evaluate both partners at the beginning. That creates a shared understanding of the challenge and gives the care team more useful information before recommending the next treatment.

Questions to ask your fertility care team

If you are beginning or reassessing fertility treatment, consider asking: Has each partner received an appropriate fertility evaluation? Should a semen analysis be completed or repeated? Do the results warrant a consultation with a reproductive urologist? Could a male factor affect the IVF or embryo-creation plan? What additional testing would meaningfully change treatment?

You deserve a care plan built around the full picture. If you are exploring surrogacy or want to better understand what may come next, Nodal can help you navigate the journey with clearer information and dedicated support.

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