New Delhi: Infertility affects about 10-20% of couples of reproductive age, with male factors contributing to approximately one-third of cases. Male infertility can arise from issues such as low sperm count, poor motility, abnormal sperm morphology, or genetic factors. A comprehensive semen analysis evaluates these parameters and examines genetic and lifestyle influences, helping to identify specific issues, such as infections or hormonal imbalances. Additional diagnostic steps, including hormone tests and scrotal ultrasounds, may be recommended based on initial findings to provide a clearer understanding of the underlying causes. On International Men’s Day, leading doctors in IVF and male infertility spoke about the steps that can be taken to reduce the risk of failure.
Dr. A.S. Arati Adhe, Consultant – IVF, Obstetrics and Gynecology at PD Hinduja Hospital & MRC, Khar, Mumbai, said, “For any pregnancy to happen three factors have to be normal on an average, and these are good quality egg, potent sperm and the uterine factor. Whenever a male is not able to impregnate a woman after unprotected intercourse it’s called male factor infertility. In the natural process of conception, the male has to have normal production of sperm, normal erection during sexual intercourse, and normal ejaculation.”
Any deviation in this process may lead to a difficult sexual life and infertility. The gametes after ejaculation (sperm) have to have a normal structure( head, body, tail), normal function ( sperm motility and a normal genetic pool to impregnate/fertilize an egg.
The factors interfering with the sexual or fertilization process are:
- Congenital defects in the structure or childhood illnesses e.g. mumps
- Injuries or surgery of genital organs
- Lifestyle-induced comorbidities e.g. Diabetes, hypertension
- Addictions ( tobacco/smoking/ alcohol/ anabolic steroids
- Other systemic disorders make the sexual act difficult
In cases of male factor infertility where sperm production is normal, intrauterine insemination(IUI) or in vitro fertilization (IVF) can be the choice of treatment.
Dr. Supriya Puranik, Director – Obstetrics – Gynaecology and IVF, Sahyadri Hospitals MomStory, Shivajinagar, Pune, spoke about the diagnostic approaches that can help.
Male infertility plays a big role in nearly 40-50% of infertility cases, making it an important factor to understand when trying to start a family. It can happen due to issues such as poor sperm parameters, blocked reproductive tracts, or hormonal imbalances in the reproductive system. Regular habits such as smoking, drinking alcohol, inadequate sleep, lack of exercise, poor dietary choices, stress, and exposure to harmful substances can significantly worsen the problem. Identifying the cause is the first step toward finding the right treatment and moving closer to parenthood.
Comprehensive Diagnostic Approaches
Diagnosing male infertility starts with a semen analysis, which checks the number of sperm, how well they move, their shape, and DNA fragmentation, which refers to damage in the sperm’s DNA that can affect fertility. Hormonal tests, including measurements of FSH, prolactin, and testosterone, are conducted to assess levels of key hormones that play a crucial role in supporting sperm production. Genetic tests can find problems like missing parts of the Y chromosome or conditions like Klinefelter’s syndrome, which affect fertility. In some cases, advanced imaging is used to look for physical problems, such as blockages or enlarged veins (varicoceles), to make sure every possible cause is considered.
Tailored Treatment Options
Treatment for male infertility depends on what is causing the problem. For mild cases, simple lifestyle changes, like eating a healthy diet, exercising regularly, reducing stress, and quitting smoking, can improve fertility. If the issue is due to hormonal problems, medicines can help balance the hormones. In some cases, surgeries, such as fixing varicoceles (swollen veins in the scrotum) or removing blockages, can help sperm move properly. For more serious cases, advanced methods like IVF offer a clear and effective way to help couples become parents.
IVF – Hope for Male Infertility
In cases of severe male infertility, In-Vitro Fertilization (IVF) combined with advanced methods like Intracytoplasmic Sperm Injection (ICSI) can provide effective solutions. With ICSI, a single sperm is directly injected into an egg, making it possible to overcome problems like low sperm count or poor sperm movement. If no sperm is found in the semen (a condition called azoospermia), procedures like Testicular Sperm Extraction (TESE) can collect sperm directly from the testes for use with ICSI. Additionally, Preimplantation Genetic Testing (PGT) helps ensure that only healthy embryos are selected for transfer, which is especially helpful when genetic issues are a concern.
Sperm Preservation and Advanced Techniques
Sperm preservation, or freezing, gives men the option to store their sperm for use in the future. This can be especially helpful for planning treatments or preserving fertility. New advancements, like using artificial intelligence (AI), are also making IVF more successful. AI helps in selecting the healthiest embryos for transfer, giving couples a better chance of having a successful pregnancy. Male infertility is no longer an impossible challenge to overcome. With advanced diagnostic tests, personalized treatments, and modern IVF techniques, many couples can achieve their dream of having a family.
Talking about the treatment options, Dr. S. Shashant, IVF Specialist, Ferty9 Fertility Center, Hyderabad, said,” Treatments for male infertility range from lifestyle adjustments and medical interventions to surgical options and assisted reproductive technologies (ART) like IVF and ICSI. ICSI, in particular, is beneficial for cases with severe male infertility, as it allows a single sperm to be injected directly into an egg, increasing the chances of fertilization. Beyond medical treatments, lifestyle modifications—like reducing alcohol intake, quitting smoking, and improving diet—can have a positive impact on sperm health and, ultimately, treatment success.”
For couples pursuing IVF, the quality of the sperm affects not only fertilization but also embryo development. Providing emotional support and education on male infertility empowers couples to make informed decisions about their reproductive health. These approaches offer hope and potential pathways to parenthood for many aspiring families.
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