Male Infertility – Causes , Diagnosis and Treatment

Infertility is no longer a silent struggle—it affects nearly 1 in 6 couples worldwide, cutting across geographies, lifestyles, and social backgrounds. Yet, when it comes to identifying the cause, male infertility is often overlooked. The truth? In nearly half of all infertility cases worldwide, the male partner is either the only reason or a contributing factor to the couple’s difficulty in conceiving.

In India, cultural stigmas often place the burden of childlessness on women, delaying timely diagnosis and treatment for men. However, science tells a different story. Studies reveal that 1 in 10 Indian men may suffer from abnormal semen parameters, ranging from low sperm count and poor motility to complete absence of sperm (azoospermia).

With rising stress levels, unhealthy diets, smoking, and environmental toxins, the prevalence of male infertility is increasing steadily, particularly among urban Indian populations. According to the Indian Society for Assisted Reproduction, infertility affects approximately 15% of Indian couples, and the number is expected to rise.

This blog will walk you through the causes, diagnosis, and treatment options for male infertility, backed by science and guided by compassion, so you and your partner can make informed choices confidently.

What is Male Infertility?

Male infertility refers to a man’s inability to cause pregnancy in a fertile female partner, despite having regular, unprotected intercourse for a year or longer. It’s more common than many realise—around 7% of all men worldwide are affected by infertility, according to the World Health Organisation. Yet, the condition often goes undiagnosed due to stigma and a lack of awareness.

Unlike erectile dysfunction, male infertility is usually linked to issues with sperm production, quality, or delivery. Problems like low sperm count, poor motility, abnormal sperm shape, or blockages in the reproductive tract are common culprits. WHO data shows that up to 50% of male infertility cases are due to abnormalities in semen quality.

While the symptoms may not always be visible, the impact is real, both physically and emotionally. Understanding what male infertility means is the first step towards finding a solution, and at Imprimis IVF, we’re here to help every step of the way.

Causes of Male Infertility

Did you know that nearly 40%–50% of all infertility cases involve a male factor? Despite this, male infertility often remains undiscussed, delaying diagnosis and treatment. Understanding the root causes is crucial, as male infertility can result from a wide range of biological, lifestyle, and environmental factors.

1. Sperm Abnormalities

Sperm Abnormalities are one of the leading reasons behind male infertility. Experts say that for sperm to be considered healthy, there should be at least 15 million sperm present in every millilitre of semen. However, studies show that 30–40% of Indian men have sperm counts below this threshold. Sperm may also be poorly motile (unable to swim properly) or abnormally shaped, making fertilisation difficult.

• Oligospermia: Low sperm count
• Asthenozoospermia: Poor sperm motility
• Teratozoospermia: Abnormal sperm shape
• Azoospermia: No sperm in the semen

2. Varicocele

A varicocele is an enlargement of veins in the scrotum, affecting 15% of all men, but up to 40% of men with infertility. It increases testicular temperature, which can damage sperm production and function. The good news? It’s often treatable through a simple surgical procedure.

3. Hormonal Imbalances

Hormones play a key role in sperm production. Imbalances in FSH (Follicle-Stimulating Hormone), LH (Luteinizing Hormone), and testosterone can lead to reduced sperm count or quality.

4. Infections and Blockages

Infections like mumps orchitis, prostatitis, or sexually transmitted infections (STIs) can damage sperm-producing organs or block sperm delivery. Sometimes, men may have congenital blockages like congenital bilateral absence of the vas deferens (CBAVD), often linked to cystic fibrosis gene mutations.

5. Lifestyle and Environmental Factors

Modern lifestyle choices are having a growing impact on male fertility:

• Smoking can lower the number of sperm in a man’s body by nearly one-fourth.
• Obesity lowers testosterone and increases estrogen levels.
• Alcohol & drug use interfere with sperm production.
• Prolonged exposure to heat, such as from saunas, laptops, or tight underwear, can impair sperm health.
• Pesticides, heavy metals, and air pollution are linked to declining sperm quality in urban men.

6. Genetic Factors

Genetic problems are found in about 10 to 15 out of every 100 men who have severe infertility issues. Klinefelter syndrome (47, XXY), Y-chromosome microdeletions, and other chromosomal abnormalities can significantly reduce or eliminate sperm production.

Diagnosis of Male Infertility

When a couple struggles to conceive, it’s essential that both partners undergo a thorough fertility evaluation—yet many men delay or avoid it. At Imprimis IVF, we emphasise early diagnosis because over 30% of male infertility cases can be identified through simple tests and medical history.

1. Detailed Medical History & Physical Examination

Diagnosis begins with a comprehensive understanding of the man’s health, lifestyle, and reproductive history. Doctors assess:

• Duration of infertility
• History of infections (like mumps or STIs)
• Lifestyle factors (smoking, alcohol, stress, diet)
• History of surgeries (hernia repair, testicular trauma, vasectomy)
• Libido, sexual performance, and ejaculation issues

During the physical exam, the urologist checks for:

• Testicular size and texture (small or soft testicles may indicate hormonal issues)
• Presence of varicocele (a common and treatable cause)
• Signs of hormonal deficiency (e.g., reduced body hair or breast enlargement)

2. Semen Analysis

This is the cornerstone of male infertility diagnosis. According to WHO standards, a normal semen sample should contain:

• Volume: 5 mL or more
  
• Sperm concentration: 15 million/mL or more
  
• Motility: 40% or more active swimmers
  
• Morphology: At least 4% normal-shaped sperm
  

3. Hormonal Testing

Doctors recommend blood tests to measure the levels of key hormones related to sperm production and overall reproductive health.

• FSH and LH regulate sperm production
• Testosterone – an important hormone that helps with sex drive and the making of sperm.
• Prolactin and TSH – if a hormonal imbalance is suspected

4. Advanced Diagnostics (if needed)

• Scrotal Ultrasound – to detect varicocele or testicular tumours
• Transrectal Ultrasound – for blockages in the ejaculatory ducts
• Genetic Testing – for men with no sperm (azoospermia) or very low count
• Sperm DNA Fragmentation Test – to assess sperm quality at the molecular level

Treatment for Male Infertility

The good news? Most cases of male infertility are treatable. Whether it’s through lifestyle changes, medication, surgery, or assisted reproductive technologies (ART), advances in fertility care have made fatherhood possible for millions of men. At Imprimis IVF, we offer a full spectrum of treatments based on the root cause of infertility, each tailored to your unique case.

1. Lifestyle Modifications and Medical Management

In many cases, male infertility can be improved simply by addressing lifestyle factors. According to clinical studies, men who quit smoking, reduce alcohol intake, maintain a healthy weight, and manage stress see a 20–30% improvement in sperm quality.

• Nutritional supplements such as zinc, vitamin E, folic acid, CoQ10, and selenium have been shown to improve sperm motility and DNA quality.
• Antioxidants reduce oxidative stress, which is a major contributor to sperm damage.
• Treating underlying infections with antibiotics can restore fertility if infections are interfering with sperm transport.
• Hormonal therapies like Clomiphene Citrate or hCG injections help stimulate sperm production in men with low testosterone or hypogonadism.

2. Surgical Treatments

Surgical intervention is effective in several common male infertility conditions:

• Varicocelectomy: Varicocele (enlarged veins in the scrotum) is found in up to 40% of infertile men. A minimally invasive surgery can significantly improve sperm count and motility. One study reported that 60–80% of men show semen improvement post-surgery, with 30–50% achieving pregnancy
• Vasovasostomy/Vasoepididymostomy: Reverses vasectomy or clears blockages in the sperm duct.

3. Sperm Retrieval Techniques:

• • PESA (Percutaneous Epididymal Sperm Aspiration)
    
  • TESA (Testicular Sperm Aspiration)
    
  • TESE (Testicular Sperm Extraction)
    These procedures are ideal for men with azoospermia (no sperm in ejaculate), allowing sperm to be extracted directly from the testicles for use in IVF/ICSI.

4. Assisted Reproductive Technologies (ART)

When natural or surgical methods are not enough, ART bridges the gap between infertility and parenthood.

A. Intrauterine Insemination (IUI)

IUI is used to treat mild male infertility by placing specially prepared sperm directly into the woman’s uterus to help with fertilisation.

• Requires at least 5 million motile sperm
  
• Success rates: 10–20% per cycle
  

B. In Vitro Fertilisation (IVF)

IVF is the process in which eggs are retrieved from the female partner, fertilised with sperm in a lab, and the resulting embryo is implanted in the uterus.

• Suitable for moderate to severe sperm abnormalities
• Success rate: 30–40% depending on the female partner’s age and embryo quality

C. Intracytoplasmic Sperm Injection (ICSI)

Considered the gold standard for severe male infertility.

• A single healthy sperm is injected directly into the egg
• Ideal for men with very low sperm count or motility, and even for sperm retrieved surgically
• Studies show ICSI has enabled fertilisation even with as few as one viable sperm
  
• For couples younger than 35, each IVF cycle using ICSI results in a live birth about 35 to 45 per cent of the time.

Emotional & Psychological Aspects of Male Infertility

Male infertility doesn’t just affect the body—it takes a significant toll on mental health too. Studies show that nearly 50% of men facing infertility experience emotional distress, including anxiety, depression, and feelings of inadequacy. In cultures like India, where masculinity is often linked with fertility, the emotional burden can be even more intense.

Research published in the Indian Journal of Psychiatry highlights that infertile men are more likely to experience low self-esteem, social withdrawal, and even relationship strain. Many hesitate to talk about their condition due to shame or societal pressure, which only delays support and treatment.

Why Choose Imprimis IVF for Male Infertility?

Choosing the right clinic is important when treating male infertility. At Imprimis IVF, we use modern technology along with caring support to provide high-quality fertility treatment in Odisha.

With nearly 1 in 10 Indian men facing sperm-related issues and over 40% of infertility cases involving male factors, our centre is equipped to diagnose and treat even the most complex cases. From hormonal evaluations, semen analysis, and genetic screening to advanced procedures like TESE, PESA, and ICSI, our andrology unit ensures nothing is left undetected.

What sets us apart?

• A state-of-the-art IVF lab with success rates matching national benchmarks
• Highly skilled fertility specialists and urologists with extensive experience
• Personalised treatment plans tailored to your medical and emotional needs
• On-site access to counselling and mental health support
  
• Transparent care with clear communication at every step

Whether it’s improving sperm health through lifestyle coaching or navigating the most advanced ART procedures, Imprimis IVF is committed to helping every man take confident steps toward fatherhood. Because when it comes to fertility, your journey deserves expertise and empathy.

Conclusion

Male infertility is far more common than most people think. Affecting nearly 1 in 10 men globally and contributing to almost 50% of all infertility cases in couples. Yet, it remains one of the least talked-about health issues, especially in India. The truth is, with the right diagnosis and timely treatment, over 90% of male infertility cases can be improved or successfully managed using modern medical techniques.

Whether it’s a simple lifestyle correction, hormone therapy, surgery, or assisted reproductive technologies like ICSI or sperm retrieval, science today offers a solution for almost every case. What’s critical is taking that first step toward diagnosis.

Don’t let silence delay your dream of parenthood.

If you or your partner has been trying to conceive for over a year without success, book a consultation with our fertility experts today. Let’s take the first step together.