Male Reproductive System

The Male Reproductive System: How it Works, Fertility Issues & Treatment

In the U.S. alone, it’s estimated that 10-15% of couples are infertile. Of those couples, 50-60% will likely have a male contributing factor. It can be frustrating for couples dealing with fertility issues. However, there are solutions that may be effective if it’s been determined male infertility is likely a contributing factor.



A common cause of male infertility is a problem with one of the male reproductive system structures, which collectively play a role in important urological and reproductive processes.  Below is a description of each of these structures.

Scrotum and Testicles
The scrotum is the sac of skin that contains the testes, the two organs that produce sperm. They are located outside of the body to help maintain an ideal temperature for sperm production. Housed within the scrotum, testicles are oval glands produce the male sex hormone testosterone. They also produce sperm cells.

The penis is the male sex organ that transports urine and deposits seminal fluid into the vagina during intercourse. Tissues within the penis help this structure become erect and transport semen.

Epididymis and Vas Deferens
The epididymis is a long, coiled tube located next to and behind the testes. Its function is to allow sperm to mature fully and send them to the vas deferens. Sperm typically stays within this tube for 2-12 days. The vas deferens is a long tube that extends from the epididymis to the pelvis in the area behind the bladder. It’s a duct that transports sperm from testicles to the tube that exits the body via the penis (urethra).

Other Key Structures
Prostate gland:  A walnut-sized gland that produces essential enzymes and fluid that help semen liquefy prior to ejaculation.

Cowper’s glands:  Nestled behind the prostate, these glands at the base of the penile shaft in urethra provide lubricant for seminal fluid just prior to ejaculation.

Seminal vesicles:  Tubular glands that produce energy in the form of sugar fructose sperm need to travel.

Leydig cells:  These cells play a role in producing testosterone.

Sertoli cells:  These are cells that produce growth factors that provide nourishment for sperm.

Seminiferous tubules:  Sperm starts to mature here as it’s stored for about 3 months.



The main symptom of infertility is an inability of a couple to conceive after at least a year of actively trying to achieve this goal. Roughly 20% of all instances of infertility is solely due to the male partner and an additional 30-40% is due to both the male and female partners. Common male infertility causes include:

  • Sperm abnormalities: Some men have issues with sperm quality or production that affect fertility capabilities.
  • Sperm delivery issues: Premature ejaculation, cystic fibrosis and other genetic diseases, structural blockages, and damage affecting reproductive organs are among the issues that can affect sperm delivery.
  • Environmental factors: Exposure to radiation or certain toxic chemicals like pesticides, cigarette smoking, and excessive alcohol consumption are some of the environmental factors that may contribute to male infertility.

Some men also have fertility problems related to underlying health issues. The side effects of certain medications, high blood pressure, depression, and a poor diet are other factors that could affect the ability to conceive. There’s also evidence frequent exposure to heat around the scrotum and testicles may affect sperm production.



Some men notice improvements after making certain lifestyle changes, such as eating healthier, wearing loose-fitting underwear, and no longer smoking. Medication adjustments may be helpful as well. Depending on the diagnosis, treatment of male infertility can include the following:

  • varicocele correction surgery
  • vas deferens repair surgery
  • vasectomy reversal surgery
  • sperm retrieval techniques
  • hormone treatment that preserves sperm production

Once couples develop a better understanding of the warning signs of infertility issues, it can help to work with a reproductive urologist to determine if there’s a male factor involved. This is a process that allows couples dealing with fertility challenges and inferiority concerns to ask questions, get answers based on reliable results, and make well-informed decisions about what steps to take next.