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Among reproductive-age couples, up to 15 percent will have difficulties conceiving within the first year. This means as many as 6 million Americans annually struggle with infertility; you’re not alone.

Forty percent of the time, male factors are part of the problem. About 20 percent of the time, it’s caused by only male factors. And 20 percent of the time it’s a combination of male and female factors. Men should be evaluated by a urologist, which can help ensure they’re up to date on other men’s health issues. This is important because fertility issues are sometimes linked to other medical disorders such as diabetes or heart disease. Because there are many male fertility issues that can’t be found through analysis of semen or specific hormones, it’s important to consult a urologist who is a fertility specialist.

Causes of Men’s Fertility Problems

Male fertility problems can be caused by a large variety of issues, including:

  • Past medical problems or surgeries (undescended testicles, genitourinary infections, cancer/chemotherapy/radiation, groin surgeries)
  • Medications
  • Lifestyle factors (age, smoking, alcohol, drugs)
  • Erection or ejaculation difficulties (like retrograde ejaculation)
  • Sperm abnormalities (count, motility, morphology, DNA)
  • Hormonal imbalances
  • Genetic disorders (like Klinefelter’s syndrome)
  • Congenital absence of the vas deferens
  • Varicoceles

Sometimes fertility challenges are linked to other medical disorders, so it’s important to see a urologist who is up to date on men’s health issues. For instance, erectile dysfunction can be a sign of diabetes, heart disease or other medical problems.

Initial fertility screening gives our fertility specialists data on reasons men have trouble conceiving. These could include very low sperm counts (oligospermia), zero sperm (azoospermia), sperm morphology or hormonal imbalances.

Sometimes recommendations to improve semen parameters are successful, like taking specific vitamins to produce healthier sperm, pursuing a healthier diet or lifestyle and avoiding hot temperatures to the scrotum. Even placing your laptop computer on your lap or keeping your cellphone in your pocket can sometimes affect sperm counts.

When required, we also offer genetic testing and imaging services (ultrasound, CT scans or MRI) to help diagnose the cause of more complicated male fertility issues.

Anatomical Problems that Contribute to Male Fertility Issues

Male fertility problems can also be caused by anatomical problems like congenital bilateral absence of the vas deferens, Peyronie's disease (an abnormal bend in the penis that occurs during erection) or, more commonly, varicoceles. Varicoceles are elongated, dilated and twisted veins in the scrotum. Varicoceles are common (about 15 percent of men have them), and may be the result of malfunctioning valves that increase pressure in the veins. It’s not known exactly what the mechanism is, but varicoceles can have a negative effect on sperm production and sperm morphology. The best treatment for most varicoceles is a type of microscopic surgery our team has sub-specialized in.

Fertility After Cancer

The Tallwood Institute’s Fertility and Urology Oncology teams are also part of the Hartford HealthCare Cancer Institute, a charter member of the Memorial Sloane Kettering Cancer Alliance. We are the leaders in treating urologic cancers in Connecticut, and our rare sub-specialty training in fertility helps to ensure the best reproductive outcomes for men with urologic cancers.

More about Fertility & Cancer Treatment

Help for Younger Men with Urologic Cancer

When treating reproductive-aged men diagnosed with urologic cancer, we help them address fertility issues before undergoing chemotherapy, radiation or surgery that could impact their reproductive abilities.

Urologic Cancer

Fertility Team

Our Fertility team is led by Jared Bieniek, MD, treating patients with problems like low sperm counts, sperm morphology issues, hormonal imbalances, and anatomical issues like varicoseals. A differentiating factor in our Fertility program is the close link with the Hartford HealthCare Cancer Institute, as men of reproductive age diagnosed with cancer have options to pursue in advance of chemotherapy, radiation or surgery. We are one of the few places in Connecticut to have physicians who are fellowship trained in Male Reproductive Medicine.

Meet our Male Infertility Specialists:

David Rosenberg



Medical Group Tallwood Urology & Kidney Institute
Manchester, CT 06040
Anthony DiStefano



Medical Group Tallwood Urology & Kidney Institute
Manchester, CT 06040
Jared Bieniek



Medical Group Tallwood Men's Health
Farmington, CT 06032
More Locations
Glastonbury, CT 06033
Fairfield, CT 06824

Tallwood Urology & Kidney Institute