For many couples facing difficulty conceiving, the male partner is rarely the first focus — yet his evaluation is often the fastest and least invasive way to understand what’s happening. Male infertility is common, frequently treatable, and in many cases the diagnosis points directly toward an effective solution. Understanding the cause is the essential first step, and it begins with a thorough evaluation and a semen analysis.
Dr. Justin Houman is a board-certified urologist, Fellow of the American College of Surgeons, and fellowship-trained microsurgeon in Male Reproductive Medicine and Surgery, training he completed at UCLA Medical Center. As an Assistant Professor of Urology at Cedars-Sinai Medical Center, he has built a Los Angeles practice focused specifically on male reproductive health — pairing advanced diagnostics with microsurgical expertise that few urologists possess. His approach treats male fertility not as a single test result, but as a window into a man’s overall health.
I was sent to Dr. Houman from another Urologist that was pretty confused about my situation. Dr. Houman’s team scheduled me quickly, and once we met, Dr. Houman took action immediately. He has a great team that is very nice. He is very personable, listens, jumps right into the trenches, explains everything, and is very responsive. I love working with Dr. Houman, definitely the best Doctor I’ve had!
What Is Male Infertility?
Male infertility refers to a man’s reduced ability to achieve a pregnancy with a fertile partner, typically after a year of regular, unprotected intercourse. It is far more common than many people realize. According to the American Urological Association and the American Society for Reproductive Medicine, male factors contribute to roughly half of all infertility cases — acting as the sole cause in 20 to 30 percent of couples and a contributing factor in another 20 to 30 percent. Because male infertility often produces no obvious symptoms, many men discover it only when they begin trying to conceive.
What to Expect From a Fertility Evaluation
A male fertility evaluation begins with a detailed medical history and physical examination, followed by a semen analysis and, when appropriate, hormone testing or imaging to pinpoint the underlying cause. From there, Dr. Houman builds a plan tailored to the findings rather than to assumptions. Depending on the diagnosis, the path forward may include:
- Microsurgical correction of a varicocele to improve sperm quality
- Hormonal or medical therapy to support healthy sperm production
- Surgical sperm retrieval when no sperm are present in the ejaculate
- Coordination with IVF or ICSI when assisted reproduction offers the most direct route
Common Causes of Male Infertility
Male fertility depends on a precise sequence of hormonal, structural, and cellular factors, and a problem at any point can affect the result. The most common contributors include:
Sperm Disorders
Low sperm count, reduced motility, or abnormal shape can lower the chance of conception.
Varicoceles
Enlarged veins in the scrotum can raise testicular temperature and impair sperm production.
Hormonal Imbalances
Low testosterone or other endocrine issues can disrupt healthy sperm development.
Structural Blockages
Obstructions along the reproductive tract can prevent sperm from reaching the ejaculate.
Genetic Conditions
Inherited factors, including chromosomal differences, may affect how sperm are produced.
Lifestyle and Medical Factors
Tobacco use, certain medications, prior infections, and injury can each play a role.
Frequently Asked Questions About Male Fertility
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Yes — male factors contribute to roughly half of infertility cases, which is why evaluating the male partner early matters so much. A straightforward semen analysis is often the first and most informative step.
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It typically begins with a medical history, physical exam, and semen analysis, with hormone testing or imaging added when needed to identify the underlying cause.
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In many cases, yes. Treatable causes such as varicoceles or hormonal imbalances often respond well to therapy, and procedures like microsurgical varicocelectomy can meaningfully improve sperm quality.
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A complete absence of sperm, known as azoospermia, does not necessarily mean fatherhood is impossible. Learn more about azoospermia and microsurgical sperm retrieval, which can recover sperm for use with IVF or ICSI.
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Yes — factors such as smoking, excess heat exposure, certain medications, and weight can influence sperm health, and addressing them is often part of a comprehensive plan.
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Because sperm take roughly three months to mature, the effects of treatment or lifestyle changes are usually reassessed after about 90 days.
Why Patients Choose Dr. Houman for Male Fertility Care
- Subspecialty Microsurgical Training: Fellowship training in male reproductive surgery supports precise, effective procedures.
- Academic Expertise: As an Assistant Professor at Cedars-Sinai, Dr. Houman practices and teaches current, evidence-based techniques.
- Comprehensive Evaluation: Each plan is built on thorough diagnostics that identify causes other practices may overlook.
- Collaborative Care: Dr. Houman coordinates closely with reproductive endocrinologists to support the couple’s shared goals.
Meet Dr. Houman
Expert in Men’s Health with Tower Urology and Cedars Sinai
Dr. Justin Houman, MD, FACS is a board-certified urologist and fellowship-trained microsurgeon at Tower Urology, Cedars-Sinai Medical Center in Los Angeles. His subspecialty training in male reproductive medicine and microsurgery is held by fewer than 2% of practicing urologists in the United States.
His clinical focus is narrow by design. Varicoceles, chronic testicular pain, male infertility, vasectomy, testosterone optimization, erectile dysfunction, penile implant surgery, and Peyronie’s disease are not add-on services here. They are the practice. Patients travel from across the country and internationally for procedures, particularly microsurgical varicocelectomy, spermatic cord denervation, and inflatable penile implant surgery, that require a level of subspecialty training and surgical volume most urology practices do not have.
Schedule a Male Fertility Consultation in Los Angeles
Difficulty conceiving can feel isolating, but it is rarely the end of the road — and understanding the cause is often simpler than men expect. Dr. Houman provides thorough, discreet male fertility evaluations for patients across Los Angeles and Southern California, with a clear, individualized plan built around your goals. Contact the Los Angeles office to request a consultation and take the first confident step toward building your family.
