Secondary infertility occurs when a man who previously fathered a child is now unable to conceive. This condition can result from several physical, hormonal, and lifestyle changes.
Poor-Quality Semen
A decline in semen quality—low count, poor motility, or abnormal sperm shape—can develop over time due to aging, illness, or environmental factors. Sperm problems are a leading cause of secondary infertility and may appear even if previous conceptions were easy.
Testicular Varicocele
Varicocele refers to enlarged veins in the scrotum, impairing testicular function and sperm production. This is the most correctable surgical cause and is more commonly seen in men with secondary infertility.
Prostate Enlargement or Removal
An enlarged prostate can affect sperm count and restrict ejaculation. Surgical removal of the prostate (usually for cancer) can also reduce or eliminate sperm in the ejaculate.
Reduced Testosterone Levels
Lower testosterone production, whether due to age, obesity, chronic illness, or hormonal disorders, can decrease sperm production and quality.
Vasectomy
A vasectomy—performed as a means of permanent contraception—blocks sperm transport and results in infertility unless surgically reversed.
Other Factors
Additional causes include:
- Medical conditions (diabetes, hypertension)
- Medications affecting sperm production
- Chronic stress
- Weight gain, alcohol abuse, or smoking
- Genitourinary infections or surgery
Conclusion
Secondary infertility in men may develop from sperm quality issues, anatomical problems like varicocele or prostate surgeries, hormonal decline, or lifestyle changes. Prompt evaluation by a fertility specialist can help determine the cause and explore treatment options for couples hoping to conceive again.