Why the man should be tested early
Infertility is not only a woman's problem. Sperm problems are a common cause on their own or alongside a female factor.
Testing the man is quick, simple and inexpensive. Doing it at the start avoids months of treatment aimed at the wrong cause.
Many men feel uneasy about being tested. A semen report is a routine medical test, like a blood count, and it is kept confidential. Knowing the result early helps the couple plan together.
Common causes of male infertility
Often more than one factor is involved, and sometimes no clear cause is found. The main groups are:
- Varicocele: enlarged veins in the scrotum that can raise testicular temperature
- Hormone problems: low testosterone, high prolactin or thyroid disorders
- Infections: past mumps affecting the testes, or infections of the reproductive tract
- Blockages: in the tubes that carry sperm, from infection, surgery or birth
- Genetic causes: such as Y chromosome changes or Klinefelter syndrome
- Lifestyle factors: smoking, heavy alcohol, obesity, anabolic steroids and heat exposure
- Medicines and treatments: chemotherapy, radiation and some long-term drugs
- Ejaculation or erection problems that prevent sperm reaching the egg
Semen analysis: the first test
A semen analysis checks the number, movement and shape of sperm. Abstain from ejaculation for 2 to 5 days before the test, and give the sample at the lab if possible.
| What is checked | What it tells the doctor |
|---|---|
| Volume | Low volume may point to a blockage or collection problem |
| Sperm count (concentration) | How many sperm are present per millilitre |
| Motility | How many sperm move, and how well they move forward |
| Morphology | How many sperm have a normal shape |
| Vitality and white cells | Whether non-moving sperm are alive, and signs of infection |
Sperm results vary from sample to sample. One abnormal report is usually repeated after a few weeks before any decision is made.
Depending on the result, the doctor may suggest hormone tests, a scrotal ultrasound, a sperm DNA fragmentation test or genetic tests.
Terms you may see on a report
Oligospermia means a low count. Asthenospermia means poor movement. Teratospermia means many abnormally shaped sperm. Azoospermia means no sperm were seen in the sample.
Treatment options
The right treatment depends on the cause, how severe it is, and the female partner's age and test results. Options usually move from simple to advanced.
Lifestyle changes
Stopping smoking, cutting down alcohol and losing excess weight can improve sperm over time. Avoiding hot baths, saunas and laptops on the lap also helps. Sperm take about three months to develop, so changes need time to show.
Medicines
Hormone imbalances can sometimes be treated with medicines. Infections are treated with antibiotics. Supplements are used in some cases, but they are not a cure for every sperm problem.
Varicocele treatment
A large varicocele with abnormal semen may benefit from surgery. When needed, we refer you to a urologist or andrologist for this. Not every varicocele needs an operation.
IUI
With a mild drop in count or movement, washed sperm can be placed in the uterus. This is simpler than IVF. Read more on our IUI treatment page.
IVF with ICSI
For a moderate or severe sperm problem, ICSI is often the most effective route. A single sperm is injected into each mature egg, so very few healthy sperm are needed.
TESA and PESA
When no sperm appear in the semen, sperm may still be present in the testis or epididymis. TESA takes sperm from the testis with a fine needle. PESA takes it from the epididymis.
These are short procedures under local or short anaesthesia. The sperm found are used for ICSI. Surgical sperm retrieval costs ₹30,000 – ₹60,000.
When donor sperm is considered
Donor sperm may be discussed when no sperm can be found even after surgical retrieval. It may also be considered when there is a serious genetic condition the man does not want to pass on.
Under the ART (Regulation) Act, 2021, donor sperm can only come from a registered ART bank, and the donor stays anonymous. The decision is personal, and the doctor gives you time and counselling before you choose.
Matching the treatment to the semen result
The table below gives a general picture of how test results guide the choice. Your own plan also depends on the female partner's age and reports.
| Semen result | Options usually discussed |
|---|---|
| Normal or near normal | Look for female factors; timed intercourse or IUI if needed |
| Mildly low count or motility | Lifestyle changes, medicines if a cause is found, then IUI |
| Moderately or severely low | IVF with ICSI |
| No sperm (azoospermia) | Hormone and genetic tests, then TESA or PESA with ICSI |
| No sperm found even after retrieval | Counselling about donor sperm from a registered ART bank |
Treating a reversible cause first can sometimes avoid IVF altogether. But if the female partner is older, the doctor may advise moving faster to protect her chances.
What affects the chance of success
The outcome depends mainly on the female partner's age and egg reserve, the sperm quality and the embryo quality. The cause of the sperm problem also matters.
After both partners' tests, the doctor explains realistic chances for each option. Our blog on low sperm count treatment options has more detail.
Testing from your own city
The semen analysis and hormone tests can be done in your own city. Send the reports on WhatsApp for the doctor to review. You then travel to our Delhi clinic only when treatment needs it.
You receive a written, itemised estimate before any treatment begins.