Infertility is a deeply personal and emotional journey that often goes unspoken, yet it affects millions of individuals and couples worldwide. According to the World Health Organization (WHO), 1 in 6 adults globally will face infertility issues at some point in their lives.
June marks World Infertility Awareness Month, a time to shed light on this global health challenge while encouraging open conversations and proactive solutions.
Importantly, infertility is not just a women’s issue; male fertility factors account for 40% of cases, yet they often remain overlooked.
Here, we explore some of the most common factors affecting male fertility and why awareness is critical for couples hoping to conceive.
1. Low sperm count
Low sperm count, or oligospermia, is one of the leading causes of male infertility. This condition occurs when the concentration of sperm in semen is below the threshold needed for successful conception.
According to Dr Anthony Picton, a fertility specialist at Vitalab Fertility Clinic in Johannesburg, many men are unaware that sperm count is affected both internally and externally by factors such as lifestyle choices, hormonal imbalances, and exposure to toxins.
Studies also highlight the impact of heat exposure, with professions like mining and farm work creating conditions that may impair sperm production.
2. Lifestyle choices
Excessive alcohol use can lower testosterone levels and reduce sperm production. Similarly, marijuana commonly used recreationally has been shown to impair sperm motility and overall quality.
“Men are often unaware of how these habits impact their fertility,” says Dr Lusanda Shimange-Matsose, director at Medfem Fertility Clinic. “The choices you make today can impact your ability to conceive tomorrow. Moderation and mindfulness are key.”
Stress, a silent contributor to infertility, is another factor affecting South African men. High-pressure environments, financial strain, and societal expectations to provide for a family can all contribute to hormonal imbalances that disrupt sperm production.
3. Testosterone supplementation and fertility misconceptions
Many men turn to testosterone supplements to address low energy levels, muscle loss, or reduced libido. However, these treatments can have the unintended side effect of suppressing natural sperm production.
Picton warns that testosterone therapy is often prescribed without sufficient explanation of its impact on fertility, saying, “Men need to understand the risks before pursuing these treatments.”
For South Africans, where access to over-the-counter supplements is common, education about reproductive health should be prioritised.
Fertility experts recommend consulting a doctor before taking any hormone-based treatments, especially for younger men planning to start families.
4. Age and health factors beyond the physical
Unlike women, who are often reminded of the biological clock, men tend to believe that age doesn’t affect their fertility.
However, sperm quality declines with age, increasing the risk of genetic abnormalities and reducing the chances of conception.
Shimange-Matsose explains, “While men produce new sperm daily, factors like age, chronic illnesses and lifestyle habits can negatively affect sperm quality.”
In South Africa, high rates of conditions such as diabetes and hypertension further complicate male fertility. Men often focus on their physical health without considering how it relates to reproductive health. Regular health screenings and early interventions can help address these issues.
5. Environmental and occupational hazards
Occupational hazards unique to South Africa, such as exposure to pesticides, heavy metals, and radiation, can also impair male fertility. Miners, farmers, and industrial workers are particularly vulnerable.
Shimange-Matsose says, “We often see men who are unaware that their work environments are contributing to their fertility challenges. Protective measures and regular health checkups are crucial.”
Infertility remains a taboo subject in many South African communities, where women are often blamed first when conception fails. Yet male infertility is responsible for nearly half of all cases.
“We need to normalise conversations about male fertility,” says Picton.
“It’s a shared journey, and both partners should be evaluated when there are challenges conceiving.”
The emotional toll of infertility, feelings of inadequacy, guilt, and frustration, can strain relationships and mental health. Shimange-Matsose advises couples to seek both medical and emotional support. Fertility clinics often offer counselling to help navigate this challenging process.
Proactive steps for better fertility outcomes
For couples looking to conceive, early consultation with a fertility specialist is key.
In addition, lifestyle changes such as reducing alcohol intake, quitting smoking, managing stress, and maintaining a healthy diet can improve fertility outcomes.
Regular exercise, while beneficial for overall health, should also be balanced, as excessive high-intensity workouts may negatively impact sperm quality.
For men who wish to delay fatherhood, sperm freezing is a proactive option gaining traction. Fertility preservation is an investment in your future,” says Shimange-Matsose.
“It allows men to protect their reproductive potential, especially if they face high-risk lifestyles or medical conditions.”
