Male infertility generally occurs as a result of abnormalities affecting the amount of sperm (concentration), motility of the sperm, or the shape of the sperm (morphology). There are several factors that can affect the quality and quantity of sperm, including hormonal, genetic, anatomic, and age-related factors. Lifestyle factors such as smoking, drug or alcohol use, obesity, and exposure to environmental toxins can also contribute to male infertility. 

In many cases, there may be no obvious symptoms of male infertility. However, some potential signs include difficulty achieving or maintaining an erection, pain or swelling in the testicles, or a decrease in sexual desire. It's important to note that these symptoms can also be related to other health issues, so it's always best to seek the advice of a healthcare professional.

A man should seek a fertility evaluation if he and his partner have been trying to conceive for over a year without success. Additionally, if there are any concerns about sperm health or infertility, a male fertility evaluation is recommended. This evaluation may include a physical exam, semen analysis, and blood tests to evaluate hormone levels and genetic factors. Imaging studies such as ultrasounds or MRI may also be used to evaluate the reproductive system.

Treatment options for male infertility will depend on the underlying cause of the condition. For example, lifestyle modifications such as smoking cessation or weight loss may be recommended. Other treatment options may include medications or supplements to improve sperm production and quality, surgical procedures to correct blockages or abnormalities in the reproductive system or assisted reproductive technologies such as in vitro fertilization (IVF). Your healthcare provider can help you determine which treatment options are right for you. 

Male fertility evaluations are generally effective in identifying potential causes of infertility. The semen analysis is a particularly useful tool for evaluating male fertility, as it provides information about sperm count, motility, and morphology. However, it's important to note that there may be cases where no specific cause of male infertility can be identified. Additionally, the cause of infertility may be multifactorial or related to factors such as age. 

Yes, there are several lifestyle changes that can help improve male fertility. For example, maintaining a healthy weight, avoiding products containing nicotine/tobacco, reducing alcohol consumption, and avoiding exposure to environmental toxins can all improve sperm health. Your healthcare provider can provide additional guidance on lifestyle changes that may be beneficial for you.