What Are the Treatment Options for Male Infertility Today?

April 23rd, 2026 by Fuad Elkhoury

You’ve been trying for a year. Maybe longer. And every month, a negative test feels like a slammed door.

This is what most couples don’t realize until they’re in the thick of it. Male factor infertility accounts for nearly half of all couples’ inability to conceive. Yet, for some reason, male infertility is often treated as an afterthought.

Yet in the US, approximately 9% of men of childbearing age experience fertility issues. But it’s not a death sentence. Fortunately, male infertility is no longer a dead end. Whether it’s microsurgical treatment of varicoceles or sperm retrieval with micro-TESE? Hormonal protocols that repair damage, hormone replacement therapy, or IVF with ICSI? Today’s treatment options are more effective than ever. We help men throughout Southern California navigate these issues every day. No judgment. No outdated advice. Only real and scientifically proven solutions.

If you want to become a father but have been unsuccessful, don’t despair. Let’s talk about effective male infertility treatment.

The Signs and Symptoms of Infertility in Males

Don’t panic ahead of time. Your partner doesn’t always get pregnant right away. This is normal. But if you’ve been having regular unprotected sex for a year and still can’t conceive, consult a doctor. If you’re in a couple, doctors recommend seeking help after six months of trying unsuccessfully to conceive. But be mindful of other signs, too. For example, you may have decreased libido or difficulty achieving or maintaining an erection. Your ejaculate volume may decrease. You may experience pain, swelling, or a lump in your testicles. Sometimes men notice a decrease in facial or body hair. This often indicates a hormonal imbalance. Don’t delay your appointment. We offer semen analysis and hormonal testing in just one visit. This way, you can get clear answers quickly.

The Leading Causes of Male Infertility Today

Causes of male infertility fall into three main categories:

• Pretesticular refers to hormonal factors;
• Testicular suggests a problem with sperm production;
• Post-testicular (blockages).

According to NCBI StatPearls, the most common specific causes include:

• Varicoceles are dilated veins in the scrotum, occurring in approximately 40% of infertile men. This is the most treatable cause.
• Hormonal imbalances include low testosterone levels, as well as thyroid and prolactin dysfunction.
• Genetic abnormalities include Klinefelter syndrome or Y-chromosome microdeletions.
• Blocks occur as a result of infections, injuries, or vasectomy.

Lifestyle and environmental factors that negatively impact men’s health include obesity, smoking, excessive heat, and exposure to endocrine disruptors.

A 2024 meta-analysis by the PMC confirmed that sperm counts are declining at an accelerated rate worldwide. It is largely due to obesity, poor diet, and exposure to chemicals.

How to Diagnose Male Infertility?

• Two semen analyses using the WHO 6th edition reference ranges.
• Hormonal testing will include FSH, LH, and total testosterone.
• Scrotal ultrasound can detect varicoceles or obstructions.
• Genetic testing is relevant if indicated, for example, for azoospermia.

We perform all of these diagnostic tests in-house. Our specialists also perform advanced sperm DNA fragmentation testing for men who have previously failed.

Low Testosterone and Male Infertility

The connection between these concepts is obvious. And yet, it’s not that simple. Testosterone is indeed necessary for libido and erectile function. But sperm production requires a different hormonal chain reaction. And this reaction begins in the brain, not the testicles. Thus, the body’s own testosterone levels decrease due to problems with the testicles or pituitary gland. And this is almost always accompanied by impaired spermatogenesis.

Also, some risk factors for male infertility include:

• Obesity
• Type 2 diabetes
• Obstructive sleep apnea
• Exposure to endocrine disruptors in plastics or household chemicals.

Low testosterone is treatable without suppressing fertility. Selective estrogen receptor modulators, aromatase inhibitors, and hCG preparations can simultaneously increase testosterone levels. They restore or improve sperm counts without the risk of iatrogenic infertility. For men with confirmed low testosterone and a desire to have children, modern urology offers targeted hormonal therapy.

Surgical Treatment Options for Male Infertility

Sometimes medication or lifestyle changes are insufficient. Urologists then offer advanced surgical solutions.

Varicocele Treatment and Infertility

Microsurgical varicocelectomy removes abnormal veins that cause testicular overheating. According to a 2024 Wiley study of 2,000 microsurgical procedures, men with non-obstructive azoospermia who underwent varicocele repair before ICSI had a 65.2% pregnancy rate, compared to 39.5% in men who did not undergo treatment.

Doctors note an improvement in sperm quality in patients within 3-6 months. Many couples are then able to conceive naturally. Some may require invasive treatments. Intrauterine insemination is extremely popular.

Vasectomy Reversal and Sperm Retrieval

For men who have had a vasectomy, doctors offer vasovasostomy, which involves restoring the patency of the vas deferens using microsurgical techniques. If restoring patency is impossible or ineffective, doctors perform sperm retrieval procedures:

• TESA/TESE – percutaneous or open testicular sperm extraction.
• Micro-TESE is the gold standard for men with non-obstructive azoospermia, using an operating microscope to detect rare sperm.

The retrieved sperm can then be used in IVF and ICSI.

Assisted Reproductive Technologies

Sometimes male infertility cannot be completely cured. Assisted reproductive technologies offer effective solutions. We’ve provided a visual comparison to help you understand your options.

Comparison of Assisted Reproductive Technology (ART) Options for Male Infertility

Based on AUA/ASRM Clinical Guidelines (2024 Amendment) | Orange County Urology Associates

* Success rates vary significantly based on female partner age, ovarian reserve, and overall health of both partners. Individual results will differ. Consult a urologist or reproductive specialist for personalized recommendations.
Source: AUA/ASRM Guideline on Diagnosis and Treatment of Infertility in Men (2020; Amended 2024). ASRM Practice Committee Documents.

Can Lifestyle Changes Improve Male Fertility?

Yes, lifestyle changes really do help. Start by achieving a healthy body mass index. Obesity lowers testosterone levels. Quit smoking and reduce alcohol consumption. Avoid overheating your testicles. Avoid hot tubs, wear looser underwear, and don’t keep your laptop on your lap. You should also reduce your exposure to environmental toxins. Pesticides, bisphenol A, and phthalates have a significant negative impact on men’s health. And be sure to schedule an appointment with your doctor. We offer evidence-based lifestyle consultations. We’ll help you understand the specific changes you need to make to restore your health and become a parent.

When to See a Urologist for Male Infertility

Have you and your partner been trying to conceive for 12 months (or 6 months if the woman is over 35)? It’s time for a male infertility evaluation. Don’t wait. Don’t assume this problem only affects women.
Orange County Urology Associates is your trusted partner. Our offices are located in Laguna Hills, Mission

Viejo, Huntington Beach, and Irvine. We provide:

• On-site semen analysis and hormonal testing
• Microsurgical varicocelectomy and post-vasectomy vasectomy repair
• Sperm retrieval (TESA, TESE, micro-TESE) and sperm cryopreservation
• Fertility-preserving hormonal therapy. This is especially important for men taking hormone replacement therapy.

Our urologists perform microsurgical varicocelectomy and vasectomy reversal using advanced techniques—including robotic-assisted approaches when appropriate.

Call us today to schedule a consultation. Let us turn your fertility questions into actionable answers.