Yes, in most cases you can still get pregnant even if your boyfriend has been diagnosed as infertile. Male infertility is a spectrum, not an on/off switch. The majority of men labeled “infertile” still produce some sperm, and even men with zero sperm in their ejaculate may have sperm that can be surgically retrieved and used to conceive. The path to pregnancy depends on what’s causing his infertility and how severe it is.
Infertile Rarely Means Sterile
When a doctor tells a man he’s infertile, it usually means his sperm count, movement, or shape falls below the threshold needed for natural conception. It does not typically mean he produces no sperm at all. A man with a low sperm count of, say, 5 million per milliliter (normal is 15 million or more) will have a harder time conceiving naturally, but it’s far from impossible. Some couples with low counts conceive on their own with enough time.
True sterility, where no sperm are produced at all, is relatively uncommon. Even among men diagnosed with azoospermia (no sperm detected in their semen), the cause is sometimes a blockage rather than a production failure. And even when the problem is production, small pockets of sperm-making tissue may still exist inside the testicles. The American Urological Association notes that in men with non-obstructive azoospermia, microscopic examination of testicular tissue can reveal these hidden pockets of sperm production despite none appearing in the ejaculate.
What the Diagnosis Tells You
The most important thing is understanding the specific diagnosis. Male infertility falls into a few broad categories, and each one carries a very different outlook for pregnancy.
Low sperm count or poor motility: This is the most common scenario. Sperm are present but in lower numbers or they don’t swim well. Natural conception is harder but not ruled out, and treatments like intrauterine insemination (IUI) or in vitro fertilization (IVF) can significantly improve your chances by concentrating the best sperm and placing them closer to the egg.
Obstructive azoospermia: The testicles make sperm normally, but a blockage prevents it from reaching the ejaculate. This can result from a prior vasectomy, infection, or a congenital issue. Sperm retrieval is extremely successful here, with rates approaching 95 to 100% when doctors extract sperm directly from the epididymis or testicle.
Non-obstructive azoospermia: The testicles aren’t producing sperm efficiently, so none shows up in the semen. This is the most challenging diagnosis, but it’s not a dead end. Using a technique called micro-TESE, where a surgeon examines testicular tissue under a microscope to find sperm, retrieval succeeds in about 52% of cases. When sperm is found, pregnancy rates with IVF are comparable to those seen with obstructive cases, around 40 to 44%.
How Sperm Can Be Retrieved Surgically
If your boyfriend has no sperm in his ejaculate, surgical retrieval paired with IVF is the primary route to a biological pregnancy. The specific procedure depends on the cause.
For blockages, doctors can aspirate sperm from the epididymis (the coiled tube where sperm matures) or extract it directly from testicular tissue. Both approaches have very high success rates. For production problems, micro-TESE is the preferred method because it allows the surgeon to identify and target areas of the testicle that are still producing sperm. An NHS evidence review found micro-TESE was 1.5 times more likely to successfully retrieve sperm compared to conventional extraction in men with non-obstructive azoospermia.
Once sperm is retrieved, it’s used with a specialized form of IVF called ICSI, where a single sperm is injected directly into an egg. This bypasses virtually every barrier that low count or poor motility would normally create. Even sperm that could never fertilize an egg on their own can result in a healthy pregnancy through ICSI.
When the Cause Is Treatable
Some causes of male infertility can be directly corrected, potentially restoring natural fertility or improving the odds with assisted reproduction.
Varicocele, a swelling of veins in the scrotum that overheats the testicles, is one of the most common treatable causes. A meta-analysis of prospective trials found that varicocele repair improved sperm concentration by an average of about 12 million sperm per milliliter compared to no treatment. It also improved pregnancy rates, with treated men about 1.3 times more likely to achieve a pregnancy than those who were simply observed. The benefit was most pronounced in men who already had abnormal semen results.
Hormonal imbalances can also suppress sperm production. Low testosterone caused by a pituitary issue, for instance, may respond to medication that stimulates the body’s own hormone production. Infections that damage the reproductive tract can sometimes be treated with antibiotics, though the degree of recovery depends on how much damage occurred before treatment.
Lifestyle Changes That Can Help
If your boyfriend’s infertility is on the milder end, lifestyle modifications can meaningfully shift the numbers. New sperm take about 64 days to fully develop and become ready for ejaculation, so any changes he makes today won’t show up in a semen analysis for roughly two to three months.
Weight is one of the biggest modifiable factors. Higher BMI is linked to lower sperm counts and reduced sperm motility. Smoking damages sperm DNA and reduces count. Alcohol can impair the hormones needed for healthy sperm production. Heat exposure matters too: frequent hot tub use, laptops placed directly on the lap, or tight underwear can raise scrotal temperature enough to temporarily suppress production. Even chronic stress can interfere with the hormonal signals that drive sperm development.
These changes won’t cure a structural blockage or severe production failure, but for a man whose count is borderline or whose motility is sluggish, they can be the difference between needing IVF and conceiving with less invasive help.
What Natural Conception Looks Like With Low Counts
If your boyfriend has low sperm count rather than zero sperm, natural pregnancy remains possible. It typically just takes longer. Couples without any fertility issues have about a 20 to 25% chance of conceiving in any given cycle. With a reduced sperm count, that per-cycle probability drops, but it doesn’t vanish. Many couples with mild male factor infertility conceive within 12 to 24 months of trying, especially if the female partner has no fertility issues of her own.
Timing intercourse around ovulation becomes more important when sperm numbers are lower, because you want to maximize the chance that the available sperm meet the egg during its short window of fertility. Ovulation predictor kits or tracking basal body temperature can help pinpoint that window more precisely.
Your Own Fertility Matters Too
Pregnancy is always a two-person equation. Even with excellent medical interventions on his side, your own reproductive health plays an equal role. Age is the single biggest factor for female fertility: egg quality and quantity decline gradually after 30 and more steeply after 35. If you’re younger, you generally have more time to explore options. If you’re in your mid-thirties or older, moving more quickly toward evaluation and treatment tends to improve outcomes.
A fertility specialist will typically evaluate both partners at the same time. For you, that usually involves bloodwork to check hormone levels and an imaging test to confirm your fallopian tubes are open. Getting the full picture from both sides is what allows a doctor to recommend the most effective and least invasive path forward for your specific situation.