A Natural Medicine Approach to Male Factor Infertility

My Personal Fertility Journey

Male factor infertility is a sensitive topic for many patients. I know this because I had my own concerns about fertility before having my daughter due to preexisting urological conditions. Luckily, I was able to conceive naturally, which I believe was made more likely due to the modalities that I accessed during the conception period. If you are a patient with male factor infertility or just someone who is trying to improve their fertility, physicians like me are here to support. With that said, it would be my honor to teach you about male factor infertility and how natural medicine can help.

What is Male Factor Infertility and How Is It Diagnosed?

You may be wondering what male factor infertility is and how it is treated. Generally, a diagnosis of male factor infertility is made through a combination of sexual history, physical examination, and two separate semen analyses demonstrating abnormal semen parameters. Hormone testing and scrotal ultrasound may also be considered to get more information. Male factor infertility is a substantially present issue in many infertility cases, contributing to 50% of all infertility cases.¹

What Causes Male Factor Infertility?

Reduced Testosterone: Older men trying to become fathers may have already begun to experience hormonal changes in their older age, a process which may eventually manifest as andropause(ADD LINK TO ANDROPAUSE BLOG). Reduced testosterone and andropause are multifactorial processes. Lifestyle factors such as obesity, physical activity, alcohol, and recreational drug use can also contribute to the manifestation of reduced testosterone.²
StructuralAbnormalities: It is often true that the cause of male factor infertility is due to structural abnormalities in the urinary or genital regions; which may be either acquired or congenital. There are many abnormalities that can occur, with one of the most common conditions being a varicocele, aka an enlarged distended vein in the scrotum. Oftentimes these abnormalities are addressed surgically, however, there may also be natural medicine approaches to managing them.¹
Other Causes: Other causes of male factor infertility may include exposure to environmental toxins, genetic conditions, medications, malignancy, sexual dysfunction, infection, and immunological conditions. Sometimes male factor infertility can be idiopathic with no clear cause.¹

How is Male Factor Infertility Treated?

First line treatments for male factor infertility include lifestyle modifications (e.g. alcohol / recreational drug cessation, improved diet, increased exercise, improved sleep hygiene, etc. When lifestyle modifications are ineffective, medications may be utilized.However, hormone replacement therapywith testosterone may worsen infertility; as it generally decreases one’s own natural production of testosterone and decreases sperm production. Therefore, medications (e.g. clomiphene citrate, tamoxifen, anastrozole) to treat male factor infertility are designed to decrease the effects of estrogen while increasing the production of testosterone.¹

When Medications Aren’t Enough

When medications are not enough to resolve male factor infertility, surgical intervention may be required. One of the most common conditions that contribute to male factor infertility are varicoceles. 15% of men have varicoceles. Most of the time varicoceles are benign as around 80% of men diagnosed with them maintain completely normal fertility and testicular function.³ However for some men it can be a significant contributor to male factor infertility, as around 40% of infertile men have also been diagnosed with a varicocele. It is thought that this is because varicoceles increase scrotal temperature which negatively impacts spermatogenesis. For infertile men with varicoceles, surgical resection is a consideration; generally improving fertility rates in men after the procedure.⁴ In some cases, assisted reproductive technology may be utilized. Sperm extraction or donor sperm paired with in vitro fertilization may also be considered.¹

Natural Medicine for Male FactorInfertility

Regardless of how people choose to treat male factor infertility, natural medicine can have a place in assisting patients in their goals to have children. Lifestyle modifications can be monumental at improving male fertilityand testosterone levels. Nutrition, exercise, sleep hygiene, and substance cessation / moderation can make a significant difference. I know it made a big difference for me.Supplements, botanicals, and even hydrotherapy may also be utilized to improve male factor infertility. Below are examples of options a naturopath may consider when treating this condition, some of which I have tried myself.

Pycnogenol: Pycnogenol is a powerful antioxidant which is derived from pinus pinaster (French maritime pine) bark. Animal studies have shown that pycnogenol can increase antioxidants in testicular and epididymal tissues. Animal studies have also shown improvements in fertility with administration of pycnogenol, increasing sperm count and motility.⁵ Human studies have also shown promise with pycnogenol. One cohort study showed that pycnogenol improved sperm morphology by 38%, while another double-blind placebo study showed that pycnogenol / L-arginine combination significantly increased semen volume, concentration, motility, and improved morphology.⁶^,⁷ For those seeking to boost fertility and decrease exposure to oxidative stress, pycnogenol may be a good consideration.

Myo-inositol: Myo-inositol is an important constituent utilized for both calcium and insulin signaling in the body. Myo-inositol is generally used for patients with female factor infertility as well as poly cystic ovarian syndrome to improve ovarian function and insulin sensitivity. For females, myo-inositol has shown to significantly increase fertility parameters in infertile females.⁸^,⁹However, recent studies have also suggested that myo-inositol may be a good option for treating male factor infertility. One randomized control trial with 37 infertile males showed that those who received myo-inositol had a significant increase in sperm motility; and an 18% increased chance of successful conception.¹⁰ Although research is still ongoing, myo-inositol may be a good option for both men and woman seeking to improve fertility.

Zinc: Zinc is a widely known mineral that has various functions in the body. However zinc has a particular function in sperm. Human trials have demonstrated the efficacy of zinc supplementation in improving fertility in men. One study found that seminal zinc levels were significantly correlated with higher sperm count, sperm concentration, motility, and normal morphology; demonstrating that zinc content in men with normal semen quality was significantly higher compared to men with lowered semen quality.¹¹ A 2025 meta-analysis found a greater number of studies that report lower levels of seminal zinc in cases of sub-fertile males than in fertile controls; concluding that zinclikely influence semen parameters and testosterone levels. The meta-analysis also concluded that testing zinc levels in infertile men may provide valuable information when managing male factor infertility.¹² With this is in mind, supplementation with zinc and or high zinc foods (e.g. pumpkin seeds, oysters) may also be a natural medicine consideration for male factor infertility.

Keeping It Chill with Scrotal Cooling:

Scrotal cooling is an interesting and low-cost option that may give significant benefit to men suffering from male factor infertility. Heat exposure is a risk factor for male factor infertility as demonstrated by one meta-analysis.¹³ Several randomized trials have also shown decreases in sperm function and significant increases in sperm death with heat exposure.¹³^,¹⁴^,¹⁵ One cohort study also demonstrated that infertile men had significant increases in sperm motility with cessation from external heat.¹⁵ Several clinical studies have also shown that scrotal cooling (e.g. ice pack, air circulation devices, etc) demonstrate significant improvements in sperm parameters.¹⁶^.¹⁷^.¹⁸ However, the effects of scrotal cooling currently remain inconclusive yet show promising benefit.¹⁷ It has also been shown that scrotal cooling devices may be hard to comply with due to lack of comfort and difficulty of usage.¹⁹ Therefore, it may be more feasible to utilize modalities such as cold immersion therapy, which have been shown to increase energy expenditure and improve metabolism.²⁰ Ultimately, scrotal cooling is an affordable and accessible modality with low invasiveness; assisting patients with male factor infertility when scrotal heating is a significant concern (e.g. hot tub use, varicoceles, etc).

Attain Virility

If you’re ready to explore how naturopathic medicine can help you with male factor infertility, we’re here to support you. Schedule a visit with a Heart Spring Health provider to take the first step.

To schedule an appointment, call 503-956-9396 or contact us now to schedule an appointment today.