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About 9% of men and 11% of women in the U.S. have faced fertility issues. These challenges may feel overwhelming, but there are a variety of treatment options for both male and female infertility to support your family building journey.

Here’s an overview of the causes and symptoms of male and female infertility and common fertility treatments.

Infertility, Explained

About 9% of men and 11% of women in the U.S. have faced fertility issues. These challenges may feel overwhelming, but there are a variety of treatment options for both male and female infertility to support your family building journey.

Here’s an overview of the causes and symptoms of male and female infertility and common fertility treatments.

Infertility, defined as the inability to get pregnant after twelve months or more of unprotected sex, is a health condition that affects both men and women. Approximately one-third of infertility cases stem from a female reproductive factor, one-third stem from a male reproductive factor, and one-third stem from a combination of both or unknown causes.

These are some common causes of female infertility.

The majority of female infertility cases are caused by problems with ovulation, the release of a mature egg from the ovaries. There are several causes of ovulation disorders, including the following.

Polycystic ovary syndrome (PCOS), a condition characterized by a hormone imbalance that impacts ovulation. It is the leading cause of female infertility.

Excessive exercise, eating disorders, or stress, each of which can result in hormonal imbalances

Primary ovarian insufficiency, sometimes referred to as premature ovarian failure

Fallopian tube damage or blockage can prevent sperm from reaching an egg, or fertilized eggs from attaching to the uterus. Common causes of fallopian tube damage or blockage include pelvic inflammatory disease — an infection of the uterus and fallopian tubes from chlamydia, gonorrhea, or other sexually transmitted infections — or a prior surgery in the abdomen or pelvis, including surgery for ectopic pregnancy.

Uterine or cervical issues such as the following can disrupt the implantation of an egg into the uterus or increase a woman’s risk for miscarriage.

Benign polyps or fibroids may block fallopian tubes or interfere with the implantation of an embryo. However, many women with these growths are able to conceive.

Structural issues with the uterus that are present at birth

Cervical stenosis, a narrowing of the cervix

Endometriosis is a condition in which tissue that should only grow in the uterus implants and grows elsewhere. The abnormal tissue growth — as well as surgical procedures to remove it — can block the fallopian tubes, preventing the fertilization of an egg. In some cases, endometriosis may interfere with implantation of the fertilized egg, or embryo.

Male infertility is most often an issue of sperm production — including the quantity and quality of sperm produced — or of sperm mobility, which affects the sperm’s ability to find and fertilize an egg. A blockage in the testicle or damage to the reproductive organs can also contribute to male infertility.

Age is a factor in both male and female fertility issues. The quality and quantity of a woman’s eggs begin to decline as she enters her mid-thirties, and age factors into the success rates of in vitro fertilization (IVF).

Many individuals and couples first learn of a fertility issue after trying to conceive without success, and the primary symptom of infertility is the inability to get pregnant. There aren’t always noticeable symptoms, but the following may indicate an underlying fertility problem.

A menstrual cycle that’s irregular, absent, longer than 35 days, or less than 21 days

Unusually light or heavy bleeding during menstrual cycles

Erectile dysfunction or low sex drive in men

The timeline for seeking fertility treatment depends on your age. If you are under the age of 35, most health experts suggest consulting a reproductive specialist after a year of trying to conceive. If you are between 35 and 40, you may want to pursue testing or treatment after six months of trying to become pregnant. And if you are over 40, you may want to pursue testing or treatment before you start trying to conceive.

An evaluation for fertility issues and potential treatment begins with a conversation about your health history. Several tests may be used during the diagnostic process, including the following.

An hysterosalpingogram (HSG), an x-ray taken to examine issues within the uterus and fallopian tubes

Blood tests to measure hormone levels related to fertility and reproduction

Ovarian reserve testing, which evaluates the number of viable eggs in your ovarian reserve. These are typically used for women over 35 or those at risk of a low egg count for other reasons.

A semen test is used to diagnose most cases of male infertility. This identifies how many sperm you produce and whether the sperm are normal in shape and movement — healthy sperm have an oval head and long tail. In some cases, additional blood tests and/or genital ultrasounds may be used to rule out other health conditions.

Fertility problems do not mean that you won’t be able to have children biologically. There are many treatment options that can help increase your chances of conception. The most effective course of treatment depends on the underlying cause of your or your partner’s fertility issues. These are among the most common fertility treatments.

Forms of assisted reproductive technology (ART) including in vitro fertilization (IVF), a process in which eggs and sperm are fertilized in a laboratory and then placed into the uterus with the potential outcome of a pregnancy. In addition to treating female infertility, IVF can also be used when male infertility is a factor.

Intrauterine insemination (IUI), a type of artificial insemination in which sperm that have been washed and concentrated are placed directly into a woman’s uterus during ovulation.

Injectable fertility medications including gonadotropins and oral fertility medications such as Clomid® and Femara® can treat fertility-related hormonal imbalances.

Your doctor may also recommend lifestyle changes or treating a related health condition.

A fertility pharmacy partner you can rely on

Since 2016, Alto has supported more than 50,000 fertility journeys. We understand that fertility treatment is a significant investment — physically, emotionally, and financially — and we see ourselves as a partner in your health.

We offer free, same-day delivery seven days a week and temperature controlled packaging to ensure that your fertility medications always arrive in the right condition. And our fertility-trained pharmacists are available until 9 pm PST (12 midnight EST) on weeknights to offer any support you need.

Reach out any time via phone at 1-800-874-5881, or in-app messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

While fertility preservation treatments like egg freezing and IVF are significant investments of time and resources, there are many ways to lower or manage the costs of treatment. As you prepare for the financial aspects of treatment, be sure to explore all of your options for financial assistance and savings, including patient assistance programs from fertility medication manufacturers.

A Guide to Ferring Pharmaceuticals’ Fertility Medication Savings Programs

If Alto is your fertility pharmacy, your fertility medication protocol may include medications manufactured by Ferring Pharmaceuticals, which has several financial assistance programs that offset the cost of fertility medications. Here’s more on eligibility for these programs and how to apply.

The OneHeart program provides a $200 rebate for out-of-pocket costs for select Ferring fertility medications. Eligibility is for those with no insurance coverage or commercial health insurance plans. In addition, you must have started your ovarian stimulation cycle between June 1, 2020 and June 30, 2022, with all medications purchased by June 30, 2022.

Learn more about program terms and conditions and the application process.

The HeartFelt program helps individuals whose cycles were canceled due to COVID-19 or a natural disaster resume fertility treatment. It offers medication replacement for up to 15 vials of Menopur® and up to five syringes of Fyremadel™ (ganirelix acetate) depending on the amount of medication used in the canceled cycle. Eligibility is for those with no insurance coverage or commercial insurance coverage.

To learn more about program terms and conditions and the application process, download the HeartFelt brochure on Ferring’s patient resources page.

The HeartTomorrow program provides Menopur® at $68 per vial for those undergoing an elective egg freezing cycle. To be eligible, you must be paying cash for your fertility medications and purchase a minimum of 20 vials in your first fill.

The Heart for Heroes program provides IVF medications at no cost to eligible military veterans who have experienced infertility due to a service-related injury or who do not have insurance coverage for fertility medications. To learn more about terms and conditions and the application process, call 1-800-515-3784.

The HeartBeat program provides select fertility medications at no cost for cancer patients. To be eligible, you must be a female U.S. citizen or permanent resident with a cancer diagnosis who has not received chemotherapy within the previous six months. To learn more about terms and conditions and the application process, call 1-888-347-3415. (Residents of Arkansas, Massachusetts, or New Jersey can call 1-877-252-0553.)

If your fertility medications are manufactured by EMD Serono, read our previous post for an overview of EMD Serono’s patient assistance programs. You can also read our previous posts on managing the costs of fertility treatment to learn about additional financial resources, including Alto’s financial support for fertility medications:

Managing the Costs of Fertility Treatment

A Financial Planning Guide for Egg Freezing

We’re here for you during fertility treatment

At Alto, we understand that fertility treatment is a physical, emotional, and financial investment, and we offer support with all aspects of your fertility journey.

We prioritize your financial wellness, working with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make your medications as affordable as possible. In addition to automatically applying any coupon savings, we’ll connect you with any outside programs that require you to apply directly.

We’re here to help with the rest of the process, too, with free same-day delivery of your medications, temperature controlled packaging, and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

To get a price quote specific to your fertility medication protocol, complete our online form.

Since certain types of cancer treatments and procedures can temporarily or permanently impact both male and female fertility, it’s important to have a discussion about fertility with your oncologist as soon as possible. Read on to learn more about fertility preservation options and financial resources for those recently diagnosed with cancer.

Fertility Preservation Options After a Cancer Diagnosis

A cancer diagnosis can bring much uncertainty. If you are considering having children in the future, you may be wondering how your options for cancer treatment will affect your reproductive health. Fertility preservation treatments like egg or sperm freezing can bring peace of mind during this potentially overwhelming time, allowing you to leave open the possibility of starting a family after cancer treatment.

There are several ways that cancer treatments can affect your fertility, including the following:

Surgery to treat cancer of a reproductive organ — such as in the prostate, testes, ovaries, or cervix — may lead to infertility.

Chemotherapy-induced changes in hormone levels can lead to early menopause for women and decrease sperm production in men.

Radiation therapy near the reproductive organs, abdomen, pelvis, or spine may damage eggs or sperm cells depending on the dose and level of radiation.

Hormone therapy used in the treatment of breast cancer and other types of cancer may affect fertility, though these effects are often temporary.

The extent to which these cancer treatments may impact your fertility depends on your personal health history — including your age and baseline fertility — and the duration and dosage of treatment. Your care team can provide a clearer sense of what to expect based on your health and treatment plan.

Many individuals of reproductive age choose to freeze their sperm or eggs for future use before beginning cancer treatment.

Sperm freezing is a fairly simple process in which a person’s sperm is collected, analyzed by a doctor, and, if viable, frozen in vials with cryoprotectant agents and stored for future use.

In the egg freezing process, fertility medications stimulate egg production and maturity. The eggs are retrieved in a minimally invasive procedure and then frozen and stored for future use. There is also the option of freezing embryos, which are eggs that have been fertilized with sperm.

There are several ways that you can use your frozen sperm, eggs, or embryos to have children biologically in the future after cancer treatment. Intrauterine insemination (IUI) is a process that allows you to use your frozen sperm and have it placed into your partner’s or a surrogate’s uterus.

In vitro fertilization (IVF) is a process in which eggs and sperm are fertilized and then placed into the uterus with the potential outcome of a pregnancy. Women who have previously undergone cancer treatment might use this process to have their frozen eggs or embryos implanted into their own uterus. If using eggs rather than embryos, there will be the additional step of fertilizing the eggs with a partner or donor’s sperm. If you had a hysterectomy to remove all or part of your uterus during cancer treatment, you can have your embryos implanted into a gestational carrier’s uterus.

Given the urgency of cancer treatment and the important timing of fertility medications during an egg freezing cycle, you will likely have to make quick decisions about fertility preservation, often within a few days of receiving a diagnosis. Your oncologist may refer you to a fertility specialist called a reproductive endocrinologist who can answer questions about cancer treatment and fertility and help you understand your fertility preservation options. It isn’t uncommon to begin taking fertility medications the same day as your consultation with a reproductive endocrinologist. 

If your oncology team does not know that fertility preservation is a priority for you, do not be afraid to take the initiative in starting the conversation. Be sure to get clarity on how moving forward with the fertility preservation process might impact the timing of your cancer treatment and what your oncologist recommends. Depending on your treatment plan, you may also want to ask about radiation shielding, which can be used during cancer treatment to protect the ovaries or testicles and limit how much radiation they are exposed to.

It’s important to take the financial aspects of fertility preservation treatments into account when planning for the future. While these treatments are significant financial investments, there are resources that can alleviate some of the costs of treatment, including programs designed specifically for those in cancer treatment and survivors.

If Alto is your fertility pharmacy, your fertility medication protocol likely includes medications manufactured by EMD Serono or Ferring Pharmaceuticals. Both companies offer financial assistance for individuals whose fertility has been affected by cancer treatment.

EMD Serono donates fertility medications to eligible cancer survivors diagnosed during their reproductive years through the Livestrong Fertility Discount program. Start the application process on Livestrong’s website to learn if you are eligible.

Ferring Pharmaceuticals provides some fertility medications at no cost for individuals pursuing fertility preservation before cancer treatment. To be eligible, you must be a female U.S. citizen or permanent resident with a cancer diagnosis who has not received chemotherapy within the previous six months. To apply, learn more about Ferring’s Heartbeat program online, or call 1-888-347-3415. (Residents of Arkansas, Massachusetts, or New Jersey can call 1-877-252-0553.)

Read our previous post on financial planning for egg freezing.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881. You can also request a price quote online.

There’s a lot to cover during a consultation, so you may find it helpful to prepare a list of questions in advance. Our fertility pharmacy experts offer some suggestions to get you started below.

Top Questions to Ask Your Fertility Clinic

Fertility treatment is a significant investment of emotions, resources, and time, and there are many factors to consider as you plan your journey. One of the most important decisions to make is your choice of fertility clinic, which will shape your overall experience during treatment and impact your out-of-pocket costs.

There’s no right or wrong choice — only the choice that’s best for your reproductive goals and health needs. To make an informed decision about which clinic to use for your fertility treatment, take time researching the different options. In addition to exploring a clinic’s website or reading patient reviews on FertilityIQ, scheduling a consultation can provide a sense of what your experience would be like as a patient.

The cost of an initial consultation typically ranges from $250-500, and clinics typically list these fees on their website or can provide consultation pricing information over the phone. If you are attending your consultation in person and want your partner or spouse to attend with you, we recommend confirming with the clinic in advance as some practices have policies limiting attendance. Many clinics also give you the option to do this initial consultation virtually.

Your clinic’s overall approach to care, including their communications channels, frequency of communication, and experience working with diverse populations, will influence your experience of fertility treatment.

Ask questions that give you a sense of the clinic’s overall responsiveness and who you’ll regularly interact with. And if you are building a family as an LGBTQ+ couple or individual, use your consultation to learn more about your clinic’s experience with LGBTQ+ family building and their commitment to diversity and inclusion.

How is your clinical team structured? Are your doctors on teams with specific nurses and clinical staff, and will I be working with someone familiar with my treatment plan and clinical history?

How often will I be able to see my actual doctor when I come in for appointments?

Will my partner/spouse be able to accompany me to my appointments?

What communication channels are available to me?

What are your holiday and weekend hours? Who can I call for emergencies or after-hour questions?

How will you develop my individual treatment plan?

Do you have experience treating LGBTQ+ patients? (if relevant)

Do you have experience treating older patients? (if relevant)

Do you have experience treating patients with my condition or a health history similar to mine (examples: polycystic ovary syndrome (PCOS), a diminished ovarian reserve (DOR), endometriosis, or recurrent pregnancy loss)?

Your choice of clinic will impact the total cost of your fertility treatment. While it’s important to get a clear understanding of how much each type of fertility treatment costs at a clinic, remember that there are additional expenses beyond the treatment itself. If you have insurance, ask how it will apply to diagnostic tests and fertility medications in addition to the treatment itself.

Do you accept insurance? If so, which plans?

Do you accept fertility benefits from Maven, Progyny, or other fertility benefit providers?

What are the prices of different types of fertility treatments, and what do they include or exclude?

What is the cost of fertility medication?

Do you offer treatment packages that include fertility medication?

Do you offer payment plans or other forms of financial support?

Can I use a loan to pay for my fertility treatment? Do you work with fertility financing programs (e.g. CapEx, Lending Club, Origin) (if relevant)

Do you offer a full or partial IVF refund program if the treatment is not successful?

What are the fees for freezing and storing eggs or embryos? Will my eggs or embryos be stored at the clinic, or do you use a third party?

There are a variety of fertility treatments, and some clinics have expertise with specific procedures. Use part of your consultation to understand which procedures your clinic can perform and what the process typically looks like, while understanding that specific details will depend on your health history and reproductive goals.

Are there any requirements for treatment such as age or FSH levels?

What treatment do you recommend for my health needs and reproductive goals?

What specific tests do you recommend for me or my partner?

Will you accept blood work or test results that I’ve done previously?

What procedures are possible at the clinic? IVF? IUI?

How many times do you typically try IUI or timed intercourse before recommending IVF?

What is the typical IVF timeline from start to finish? How much prep work is involved, and what are your pre-cycle requirements?

Do you have any age requirements for using my eggs for IVF versus a donor’s?

Do you offer freezing of eggs, sperm, and embryos?

Are donor and surrogacy options available? If so, do you coordinate surrogacy?

Do you have your own egg donor program? Are they fresh or frozen?

Read ‘IVF and Egg Freezing: What to Expect and How to Prepare’ and ‘Fertility Medications 101’ for more information on fertility treatment.

You probably have questions about your clinic’s success rate. Some clinics are more transparent about these numbers than others. You can definitely ask your clinic to share their success rate during your consultation, and you should also be able to find it on the Society of Assisted Reproductive Technology (SART)’s website.

But keep in mind that various factors can influence a clinic’s success rate numbers, including decisions about treatment options and which patients they treat. In addition to asking about the specific numbers, we suggest also asking how your clinic measures success.

Choose a flexible and reliable fertility pharmacy partner

At Alto, we’re here for you at every step of your fertility journey, and we’re committed to both your financial well-being and your physical health. We offer free same-day delivery of your medications, with discreet packaging, fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists, and support with insurance and savings opportunities.

If you’re interested in learning more about how Alto can support your fertility treatment, you can request a price quote online.

If you are considering freezing your eggs, it’s important to take the financial aspects of treatment into account. Here are our top financial planning tips and resources to support your egg freezing journey.

Egg freezing — a fertility preservation treatment that allows you to freeze unfertilized eggs and store them for later use — has allowed millions of individuals to leave open the possibility of having children in the future and experience more flexibility in their family-planning timelines.

If you are considering freezing your eggs, it’s important to take the financial aspects of treatment into account. While it’s true that egg freezing is a significant investment of time and resources, there are many options for managing or lowering the costs of treatment so that you can move forward with the process. Here are our top financial planning tips and resources to support your egg freezing journey.

Before you can determine how to pay for egg freezing, it’s important to have a sense of the total cost. Keep in mind that egg freezing expenses are ongoing. In the short term, you are accounting for fertility medications and the egg freezing cycle (or cycles). These costs vary from one individual to another, as your reproductive health — including the number of eggs in your ovarian reserve — will inform your individual medication protocol and the number of cycles needed to retrieve your target number of eggs.

Long-term egg freezing expenses include the cost of storing your eggs and in vitro fertilization (IVF) — the process of thawing your eggs, fertilizing them with sperm, and having them placed into your uterus through a non-surgical procedure — if you decide to use them in the future. The length of time that you store your eggs will impact the overall cost. 

You may not be able to accurately predict all of these variables in advance, but identifying your longer-term reproductive goals and mapping out a vision can help you prepare as much as possible for the total investment. Setting up a consultation with a fertility clinic can be a good first step toward getting the information you need about your reproductive health to plan accordingly. The cost of a consultation typically ranges from $250-500, and clinics typically list these fees on their website or can provide specific information over the phone.

Savings and support from family and friends

Depending on your individual circumstances, you may have money in a savings account that you can use for part of your egg freezing expenses. If you have questions about getting started with a savings account, a financial planner or a budgeting tool like NerdWallet, Mint or Savology can help you determine how much money you may need to seek through grants, loans, and other resources.

You may also have family or friends who are able to contribute. If you are comfortable sharing your egg freezing experience with others, consider using fundraising websites like GoFundMe to reach out to your extended network for donations.

Health insurance coverage and workplace benefits

Some health insurance plans offer partial or full coverage of egg freezing-related costs including medications and IVF. Note that most insurance plans have separate medical and pharmacy benefits. In most cases, professional services provided by your doctor or clinic will fall under medical benefits. Fertility medications will likely fall under pharmacy benefits, though in some cases they may fall under your medical benefits.

If you have a health savings account (HSA) or a flexible spending account (FSA) — two types of pre-tax accounts you can use for healthcare expenses — consider planning ahead to use these accounts to reduce the total cost of your fertility treatments and your taxable income.

In addition, some employers offer egg freezing coverage as part of their employee benefits, separate from your health insurance plan. Do not be discouraged if you learn that your employer doesn’t currently cover egg freezing: employers who offer fertility coverage often do so in response to an employee’s request. RESOLVE: The National Infertility Association, a nonprofit that supports individuals and couples affected by infertility, has resources to help you start a conversation with your employer about fertility coverage benefits.

Your total egg freezing expenses also depend on your choice of fertility clinic. Most clinics can share the total out of pocket costs for egg freezing if you do not have any insurance coverage. As you explore your options, call various clinics to ask about costs with a list of questions prepared in advance. Here are examples of questions to ask:

Based on my specific treatment plan, what is the typical all-inclusive cost?

What is included in the treatment cost and what is not?

Can you provide a detailed list of procedures and costs?

What is the typical cost of fertility medications for my treatment plan?

You may also want to ask if they will store eggs for up to a year as part of the cost of an IVF cycle, which is a common practice at many clinics.

In addition, some fertility clinics offer no- or low-interest payment plans. During your search, ask various clinics about any available financial assistance.

Many individuals and couples fund a portion of their egg freezing expenses through a personal loan. There are companies that provide loans for fertility treatments, with flexible monthly payment options, including Lending Club and CapExMD. Some lenders focus exclusively on fertility, including Origin Finance, and can lend enough to cover the entire cost of the treatment, with plans starting around $250/ month. (Great news: the Origin application fee is waived for Alto customers!)

Regardless of which lender you choose, verify the interest rate and any other fees. Many of these companies have budgeting tools on their websites so that you can get a sense of what your monthly payments will be before you decide to take out a loan.

In addition, many companies and organizations offer grants that help cover a portion of fertility treatment costs. Some are based on income level and demonstrated financial need while others are designed to support specific groups including members of the LGBTQ+ community and people of color.

Fertility for Colored Girls (FFCG) offers grants for Black women and couples.

Men Having Babies, which supports gay men and couples in starting their families through surrogacy, offers income-based cash grants through the Gay Parenting Assistance Program. (If you are starting a family as a gay man, your path to parenthood will likely include an egg donor and IVF but not necessarily egg freezing.) In addition, Family Equality has a list of family-building grants that help LGBTQ+ families afford fertility treatment.

You can also search for additional grant opportunities through RESOLVE.

In addition to applying the loans or grants mentioned above toward your fertility medication expenses, some fertility medication manufacturers offer patient assistance programs in partnership with fertility clinics to further alleviate these expenses.

If Alto is your fertility pharmacy, your fertility medication protocol likely includes medications manufactured by EMD Serono or Ferring Pharmaceuticals. EMD has several programs that lower the cost of fertility treatment, including the Compassionate Care program, which offers income-based assistance for fertility medications that aren’t covered by insurance, and special opportunities for military veterans and cancer survivors.

Ferring Pharmaceuticals also offers financial assistance programs to offset the cost of fertility medications, including the HeartTomorrow program for individuals who elect to freeze their eggs, and special opportunities for military veterans and cancer patients.

Read our previous blog to learn more about EMD Serono's financial assistance programs and how to apply.

Your choice of fertility pharmacy matters

There’s one more factor that can significantly impact the cost of your fertility medications: your choice of fertility pharmacy partner.

Alto is committed to your financial well-being alongside your physical health. To help you save as much as possible on your fertility medications, we’ll automatically search for and apply any savings, as well as connect you with any outside programs that require you to apply directly.

We know that managing the costs of egg freezing is just one part of your fertility journey, and we’re here to make the process as easy as possible. We offer free same-day delivery of your medications, with discreet packaging, and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

If you’re interested in learning more about how Alto can support your fertility treatment, you can request a price quote online. 

Infertility is often thought of as exclusively a women’s health issue, but the truth is that it can affect anyone regardless of gender. We explain more including male infertility causes, symptoms, and treatment options.

Male Infertility: Causes, Symptoms, and Treatment

Infertility is often thought of as exclusively a women’s health issue, but the truth is that it can affect anyone regardless of gender. About one-third of infertility cases include factors related to male reproductive function.

If you’ve experienced infertility, you’re not alone: about 9% of men and about 11% of women in the U.S. have experienced fertility challenges. And while these challenges may feel overwhelming, they do not necessarily mean that you won’t be able to start a family one day — there are a variety of fertility treatment options for both men and women to support your family building journey.

Below, we explain more about male infertility, including causes, symptoms, and treatment options that can help you build or add to your family.

Male infertility most often stems from issues with sperm production. In some cases, it may be a problem with the quality of your sperm, like how fast or how well your sperm move. In other instances, it’s a matter of sperm quantity: you may not be able to produce any sperm, or you may have a low sperm count (the threshold is typically a sperm count under 15 million sperm per milliliter of semen.)

Sperm production problems may also occur as the result of other health conditions, including hormone, pituitary gland, or immune system problems or genetic conditions like cystic fibrosis, a progressive disease that makes it difficult to breathe, and hemochromatosis, a condition in which you have an excess of iron in your system.

Lifestyle and environmental factors can also play a role: heavy smoking (20 or more cigarettes per day), consistent heavy drinking or binge drinking (for men, five or more drinks in a two-hour timeframe), drug use, and exposure to toxins like endocrine disruptors contained in plastics and pesticides have been linked to male infertility.

Beyond issues with sperm production, anything that blocks a reproductive organ can interfere with the flow of semen, including inflammation from a sexually transmitted infection, scar tissue from surgery, or swollen veins in any of your reproductive organs. Additional factors in male infertility include erectile dysfunction, premature ejaculation, liver or kidney disease, and treatment for seizure disorders.

You may have a greater chance of experiencing fertility issues if you have had any of the following:

Inflammation of your prostate or genital infections

Certain prescription medications may also increase your risk of infertility, including:

5-alpha-reductase inhibitors, a medication class used to treat prostate enlargement and hair loss, which includes finasteride (Propecia®) and dutasteride (Avodart®)

Alpha blockers like silodosin (Rapaflo®), tamsulosin (Flomax®), alfuzosin (Uroxatral®), terazosin (Hytrin®), doxazosin (Cardura®), which are used to treat prostate enlargement

Some selective serotonin reuptake inhibitors (SSRIs) used to treat depression and anxiety, including sertraline (Zoloft®) and paroxetine (Paxil®)

Spironolactone, which may be used to treat high blood pressure or acne

Cimetidine, which is used to treat acid reflux and Gastroesophageal reflux disease (GERD) 

If you and your partner are unable to conceive after trying for at least a year, one or both of you may be experiencing infertility. If you have experienced any of the following symptoms, you may wish to consult with your doctor about a potential diagnosis of male infertility:

Problems with ejaculation, including delayed ejaculation

If you have previously had surgery in your genital area, you should also consult with a doctor about potential infertility issues.

To evaluate you for an infertility diagnosis, your doctor will first ask questions about your medical history, including your sexual history and any other factors that may affect your reproductive health and fertility. They may also do a physical exam to check your genitals for any abnormalities.

The next step is typically a semen test, sometimes called a sperm count. Your doctor will ask you for a sample of semen. During their evaluation, they will look at how many sperm you produce and whether the sperm are normal in shape and movement — healthy sperm have an oval head and long tail.

Your doctor may recommend additional tests, including blood tests to evaluate your hormone levels and to rule out other health conditions and genital ultrasounds to identify potential reproductive health issues.

Thanks to the medical community’s advances in fertility treatment and technology, infertility issues do not mean that you won’t be able to build a family. There are a range of treatment options that can help increase your chances of conception. Your doctor will make recommendations for the best course of treatment based on the underlying cause of your fertility issues.

In some cases, hormone imbalances or problems with how your body uses hormones may impact your sperm production. If that’s the case, your doctor may recommend hormone treatments or medications such as gonadotropin therapy or antibiotics to increase the number of sperm in your semen.

Gonadotropin therapy may be used to treat both male and female infertility and is typically administered via injections. Common side effects of gonadotropin therapy for men may include pain, redness, and swelling at the injection site, stomach pain, nausea, and vomiting. In some cases, it may lead to the enlargement of male breast tissue.

Since lifestyle habits like heavy smoking or alcohol use can affect sperm production, you may be able to increase your sperm count with healthy choices like exercising regularly and abstaining from cigarettes, alcohol, and drugs.

There are several fertility treatment options that can increase your chances of conceiving a child, including in vitro fertilization (IVF) using a technique called intracytoplasmic sperm injection (ICSI) and different forms of artificial insemination like intrauterine insemination (IUI).

In intracytoplasmic sperm injection (ICSI) a single sperm can be injected directly into an egg. This procedure is often incorporated into an IVF cycle for many couples affected by male infertility. IVF is a process in which eggs and sperm are fertilized in a laboratory and then placed into the uterus with the potential outcome of a pregnancy. Women trying to conceive may undergo IVF treatment if their partner is experiencing male infertility to increase their chances of conceiving. ICSI can be the fertilization method used in IVF.

In IUI, sperm that have been washed and concentrated are placed directly into your partner’s uterus around the time that they are ovulating, helping your sperm reach an egg more easily.

At Alto, we understand that there are many paths to parenthood, and that each individual or couple’s needs are different. Our team of pharmacists is experienced in male infertility treatment options, and we’ll be here at every step of the way if fertility medications become part of your plan. 

Reach out any time by phone at 1-800-874-5881 or in-app messaging.

For nearly 50 years, RESOLVE — a national patient advocacy organization — has been both a go-to resource for individuals and couples experiencing infertility and a leading advocacy voice.

What to know about RESOLVE: The National Infertility Association

RESOLVE: The National Infertility Association

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