Male factor is diagnosed in roughly 30% of infertility cases, and in another 20% the factor is combined. It breaks down into four types, identified through the semen analysis. Treatment ranges from correcting reversible causes, targeted supplementation and lifestyle changes to assisted reproduction (IUI, IVF, ICSI) in more severe cases.
| Diagnosis | What it means | Related WHO reference value |
|---|---|---|
| Oligospermia | Low sperm concentration | Concentration ≥ 16 million/mL |
| Asthenospermia | Low motility | Progressive motility ≥ 30% |
| Teratospermia | A high proportion of abnormally shaped sperm | Normal morphology ≥ 4% |
| Azoospermia | No sperm in the ejaculate | Not applicable |
Reference values: WHO laboratory manual for the examination and processing of human semen, 6th ed., 2021.
For the result to mean something, the test has to be done correctly: 3 to 5 days of sexual abstinence beforehand, no fever in the past 2 weeks, no recent antibiotics, collection at the lab and no lubricants.
If a result comes back below the reference, do not assume “male infertility”. Sperm production varies month to month. The clinical standard is to repeat the test in 4 to 12 weeks before drawing conclusions and, in parallel, to change habits. Many men with a bad first test come back normal after 3 to 6 months of adjustments.
Unlike eggs, which are finite, sperm is produced continuously, and habit changes show a measurable effect in about 90 days. The treatment options the book lists:
If the semen analysis is abnormal on two evaluations 4 to 12 weeks apart, or if there are specific risk factors, the couple needs to see a urologist, ideally one who specializes in reproduction. The risk factors the book lists:
Male factor and a female diagnosis can also exist at the same time: PCOS plus male factor is the book's example. That is why the book puts the semen analysis in the very first month of the workup, alongside your own tests.
Male factor is diagnosis number 3 in Chapter 33 of Map to the Positive, in Station IV (Signs). His side of the map is covered in full in Station III (Optimization): how to do the semen analysis correctly, the WHO reference values, the 10 habits with proven impact in 90 days and the male supplement stack. Station IV adds the red flags in his history and when to see a urologist.
Take 30 days. If it does not give you more clarity than everything you have read for free so far, ask for a refund and you get every cent back. We cannot promise you a pregnancy. We can promise you will not be guessing.
References: WHO laboratory manual for the examination and processing of human semen, 6th ed., 2021.