Expert-verified information on male fertility, sperm health, conception and reproductive options for SA men.
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Male factors contribute to approximately 50% of all infertility cases — early assessment matters. 💡 A semen analysis is non-invasive, quick and provides critical information. Don't wait — male fertility declines with age too, and many causes of male infertility are highly treatable when identified early.
Trying to conceive for 12+ months
If you and your partner have been trying to conceive without success for a year (or 6 months if she is over 35), a male fertility assessment is strongly recommended.
Pain or swelling in the testes
Testicular pain, swelling or a feeling of heaviness can indicate varicocele, infection or other conditions that affect fertility — see a urologist.
Sexual dysfunction
Erectile difficulties or ejaculation problems (retrograde ejaculation, anejaculation) can directly impact fertility and warrant specialist evaluation.
History of cancer treatment
Chemotherapy and radiation can significantly affect sperm production. Men who have undergone cancer treatment should have a semen analysis before trying to conceive.
Known hormonal imbalance
Low testosterone, high prolactin or thyroid dysfunction can reduce sperm production — hormonal assessment is part of a complete fertility workup.
Previous infections or surgery
STIs such as chlamydia or gonorrhoea, mumps orchitis, or prior groin/hernia surgery can cause blockages or scarring that impairs fertility.
Connect with HPCSA-registered fertility specialists, urologists and reproductive experts across South Africa.
Fertility Specialists
Male fertility diagnosis & treatment
Urologists
Reproductive system, varicocele & surgery
Endocrinologists
Hormonal causes of male infertility
Embryologists
IVF, ICSI & advanced assisted reproduction
Andrologists
Male reproductive medicine specialists
Genetic Counsellors
Genetic causes of infertility & planning
Psychologists
Emotional support through fertility challenges
Men's Health GPs
Initial assessment & referral pathway
Male fertility is a subject that is often overlooked in conversations about family planning — yet male factors are involved in approximately 50% of all cases of infertility. In South Africa, where access to specialist reproductive care varies significantly across provinces, understanding your fertility health and knowing when and how to seek help is more important than ever.
A semen analysis is the cornerstone of male fertility assessment, evaluating sperm count (concentration), motility (movement), morphology (shape) and volume. Normal sperm counts are defined by the World Health Organization as greater than 16 million sperm per millilitre, with at least 42% motility and 4% normal morphology. Results below these thresholds — oligospermia (low count), asthenospermia (poor motility) or teratospermia (abnormal morphology) — warrant further investigation. Hormone testing (FSH, LH, testosterone, prolactin) and genetic testing may follow depending on initial results.
The most common causes of male infertility include varicocele (enlarged veins in the scrotum, affecting 40% of infertile men), hormonal imbalances, obstructive causes (previous vasectomy, infections or congenital absence of the vas deferens), genetic conditions (Klinefelter syndrome, Y chromosome microdeletions), and lifestyle factors including smoking, alcohol, obesity, anabolic steroid use and exposure to heat or toxins. Many of these causes are correctable — varicocele repair, for example, can significantly improve sperm parameters and natural conception rates. Assisted reproductive technologies including IUI, IVF with ICSI (intracytoplasmic sperm injection) are available at fertility centres across South Africa’s major cities.
Male involvement in family planning extends far beyond fertility treatment. Vasectomy — a safe, effective and permanent form of contraception — is the most common surgical procedure for male contraception and has a very high success rate with low complication risk. Vasectomy reversal (vasovasostomy) is possible, with success rates that decline over time since the original procedure. For men who have not yet completed their families, sperm banking before vasectomy, cancer treatment or high-risk occupation provides a fertility safeguard. HealthLab can connect you with reproductive urologists and fertility specialists across South Africa.
