Various medical issues can contribute to male fertility problems, including:
- A problem in the hypothalamus or the pituitary gland — parts of the brain that signal the testicles to produce testosterone and sperm (secondary hypogonadism)
- Testicular disease
- Sperm transport disorders
Age also can play a role. The ability of sperm to move and the number of typical sperm tend to decrease with age, affecting fertility, especially after age 50.