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Iswarya Fertility Centre & Women's Hospital
Comprehensive Guide

Male Infertility

Causes, Diagnosis & Treatment

Male factor infertility contributes to approximately 40% of all infertility cases. With modern diagnostic techniques and advanced treatments, most male fertility issues can be successfully addressed.

40%

Of infertility involves male factors

1 in 20

Men have low sperm count

90%+

Cases treatable with modern medicine

75%

Our success rate with ICSI

Common Male Fertility Conditions

Click on a condition to learn more about causes, symptoms, and treatment

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Azoospermia

Azoospermia — the complete absence of sperm in the ejaculate — affects 1% of men, but surgical sperm retrieval and ICSI can still achieve fatherhood.

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Oligospermia (Low Sperm Count)

Oligospermia is a sperm count below 16 million per mL, reducing the chances of natural conception but treatable with IUI or ICSI-IVF.

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Asthenozoospermia (Poor Sperm Motility)

Asthenozoospermia is when less than 42% of sperm are motile, limiting their ability to reach and fertilise the egg.

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Teratozoospermia (Abnormal Sperm Morphology)

Teratozoospermia means most sperm have abnormal shape, reducing their ability to penetrate and fertilise an egg.

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Varicocele

Varicocele is an enlargement of veins in the scrotum that raises testicular temperature and impairs sperm production and quality.

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Retrograde Ejaculation

Retrograde ejaculation causes semen to enter the bladder instead of exiting through the penis, but sperm can be retrieved from urine for IUI or IVF.

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Male Hormonal Imbalance

Hormonal imbalances in men — including low testosterone or high oestrogen — reduce sperm production and can often be corrected medically.

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Asthenozoospermia

Reduced sperm motility impairs the ability of sperm to reach and fertilise the egg. Defined as <30% progressive motility by WHO 2021 criteria.

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Teratozoospermia

High proportion of abnormally shaped sperm (<4% normal forms by strict Kruger criteria). Affects fertilisation capacity and embryo development.

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Azoospermia — Obstructive

Complete absence of sperm in ejaculate due to a blockage in the ductal system, despite normal sperm production in the testes.

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Azoospermia — Non-obstructive

No sperm in ejaculate due to impaired sperm production. Sperm may still be retrieved from the testis via mTESE in ~50–60% of cases.

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Sperm DNA Fragmentation

High levels of DNA damage in sperm reduce fertilisation rates, impair embryo development, and increase miscarriage risk even with normal semen parameters.

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Antisperm Antibodies

Immune antibodies that bind to sperm surface antigens, causing agglutination and inability to penetrate cervical mucus or zona pellucida.

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Hypogonadotropic Hypogonadism (Male)

Low pituitary gonadotropin secretion results in testosterone deficiency and absent or severely impaired spermatogenesis.

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Cryptorchidism — Undescended Testis

Failure of one or both testes to descend into the scrotum impairs sperm production. Risk of infertility and testicular cancer is increased.

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Erectile Dysfunction and Infertility

Inability to achieve or maintain erection sufficient for intercourse prevents natural conception. Psychogenic and organic causes must be distinguished.

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Male Hypogonadism

Inadequate testosterone production causes androgen deficiency and impaired spermatogenesis leading to infertility.

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Klinefelter Syndrome (47,XXY)

The most common sex chromosome aneuploidy in males. Small testes, azoospermia, and low testosterone are the norm, but focal spermatogenesis allows sperm retrieval via mTESE in ~50% of cases.

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CFTR Mutations and Male Infertility

CFTR mutations cause congenital bilateral absence of the vas deferens (CBAVD), resulting in obstructive azoospermia despite normal spermatogenesis.

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Common Causes of Male Infertility

Understanding the underlying cause is essential for effective treatment

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Sperm Production Issues

Low sperm count, poor motility, or abnormal morphology can significantly reduce the chances of natural conception.

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Hormonal Imbalances

Imbalances in testosterone, FSH, or LH can disrupt sperm production and overall reproductive function.

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Structural Blockages

Obstructions in the vas deferens or epididymis can prevent sperm from being present in the ejaculate.

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Genetic Factors

Chromosomal abnormalities such as Klinefelter syndrome or Y-chromosome microdeletions can affect fertility.

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Lifestyle Factors

Smoking, excessive alcohol, obesity, stress, and environmental toxin exposure can impair sperm quality.

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Medical Conditions

Varicocele, infections, undescended testes, and certain medications can impact male reproductive health.

Diagnostic Tests

Our comprehensive male fertility evaluation includes

1

Semen Analysis

Complete evaluation of sperm count, motility, morphology, volume, and other critical parameters.

2

Hormone Panel

Blood tests measuring testosterone, FSH, LH, prolactin, and thyroid hormones to assess hormonal health.

3

Scrotal Ultrasound

Imaging to detect varicocele, structural abnormalities, or obstructions in the reproductive tract.

4

DNA Fragmentation Test

Advanced test measuring DNA damage in sperm, which can affect fertilisation and embryo development.

5

Genetic Screening

Karyotyping and Y-chromosome microdeletion testing to identify genetic causes of infertility.

6

Post-Ejaculation Urinalysis

Test to check for retrograde ejaculation, where sperm enters the bladder instead of exiting the body.

Treatment Options

Personalised treatment plans based on your specific diagnosis

When Should You See a Specialist?

You should consult a male fertility specialist if:

Unable to conceive after 12 months of trying
Known history of testicular problems
Previous groin or testicular surgery
Low libido or erectile dysfunction
Pain or swelling in the testicular area
History of prostate or sexual health issues
Partner has had recurrent miscarriages
Abnormal semen analysis results

Get a Complete Male Fertility Evaluation

Our specialists provide confidential, comprehensive fertility assessments with advanced diagnostics

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