Half of the Equation
Male Infertility
A male factor contributes to roughly half of all infertility cases, yet men are frequently evaluated last or not at all. At Texas Regional Urology, we provide thorough male fertility evaluation at our offices in The Woodlands, Tomball, and Kingwood.
What is male infertility?
Understanding Male Infertility
Infertility is generally defined as the inability to conceive after a year of regular unprotected intercourse, or six months if the female partner is over 35. A male factor is involved in about half of couples, either alone or alongside a female factor, which is why evaluating both partners simultaneously saves time. Causes include varicocele — enlarged veins in the scrotum and the most common correctable cause — along with hormonal imbalances, prior infections, undescended testicles, genetic conditions, obstruction, prior vasectomy, chemotherapy or radiation, certain medications, and lifestyle factors including anabolic steroid and testosterone use. Some cases have no identifiable cause. Importantly, a semen analysis is quick, inexpensive, and non-invasive — there is no good reason to skip it
How would I know if I had a fertility problem?
Symptoms of Male Infertility
For most men there are no symptoms at all beyond the inability to conceive — fertility problems are usually silent, and men with severely abnormal semen parameters typically feel entirely normal. When signs are present, they may include reduced sex drive, erectile difficulty, pain or swelling in the testicles, a visible or palpable mass in the scrotum, decreased body hair, or unusually small or firm testicles. A history of undescended testicle, testicular injury or torsion, mumps after puberty, chemotherapy, or anabolic steroid use raises concern regardless of symptoms. The absence of symptoms is not evidence of normal fertility.
How is male infertility evaluated?
How We Evaluate Male Infertility
Evaluation begins with a detailed history covering prior conception, childhood surgeries, infections, injuries, medications, supplements, occupational heat and chemical exposure, and any steroid or testosterone use — the last of which is a frequent and reversible cause we specifically ask about. Physical exam assesses testicular size and consistency, the presence of a varicocele, and whether the vas deferens is present on both sides. Semen analysis is the cornerstone, and because results vary considerably, at least two samples collected weeks apart are needed for an accurate picture. Hormone testing including testosterone, FSH, LH, and prolactin identifies endocrine causes, and scrotal ultrasound, genetic testing, or specialized sperm function studies are added when findings warrant.
Why Choose Texas Regional Urology for Fertility Evaluation?
Why Patients Choose TRU
Here is what we can do
Male Infertility Treatment Options at Texas Regional Urology
Treatment depends entirely on the cause, and a meaningful share of male infertility is correctable. Some men need a medication stopped rather than started. Others benefit from surgical correction of a varicocele or from hormonal treatment. When sperm production is severely impaired or absent, assisted reproductive technology using retrieved sperm offers a path forward, and we coordinate closely with fertility centers on those cases.
Addressing Reversible Causes
Testosterone therapy and anabolic steroids suppress sperm production and are a common, correctable cause — recovery often takes months after stopping. Certain medications, excess heat exposure, heavy alcohol use, smoking, and obesity all measurably affect semen quality.
Hormonal Treatment
When testing identifies a hormonal cause, medications such as clomiphene or hCG can stimulate the body's own testosterone and sperm production. These raise fertility potential rather than suppressing it, unlike standard testosterone replacement.
Varicocele Repair
Surgical correction of a varicocele improves semen parameters in a substantial share of men and is the most commonly performed procedure for male infertility.
Coordination with Reproductive Specialists
For men with obstruction, absent sperm, or severe impairment, sperm retrieval combined with IVF or ICSI is often successful. We work alongside Houston-area reproductive endocrinology practices to keep both partners' care coordinated.
Answers to your Male Fertility Questions
Frequently Asked Questions
After a year, or six months over 35.
Couples who have not conceived after twelve months of regular unprotected intercourse should both be evaluated, shortened to six months if the female partner is over 35. Evaluate earlier if there is a known risk factor on either side.
Yes — always evaluate both partners together.
A male factor contributes in roughly half of cases, and semen analysis is fast, inexpensive, and non-invasive compared to female testing. Skipping it can waste months of treatment aimed at the wrong partner.
No — it does the opposite.
Testosterone replacement suppresses the signals that drive sperm production and is a recognized cause of infertility. Men trying to conceive should discuss alternatives that raise natural production instead.
Often yes, depending on the cause.
Varicocele repair, hormonal treatment, stopping a contributing medication, and lifestyle changes all improve semen parameters in many men. Because sperm take about three months to develop, improvement takes at least that long to appear.
Not necessarily — options exist afterward.
Vasectomy reversal and surgical sperm retrieval combined with IVF both offer paths to biological children after a vasectomy. Success depends on time elapsed and other factors your urologist will review with you.
Trying to conceive without success?
