Male Infertility Treatment Hospital in India

Overview of Male Infertility

Infertility can affect both men and women. Male infertility refers to a condition in which a man's reproductive system reduces or prevents his ability to help achieve pregnancy with a female partner. If you have male infertility, it means that despite having regular, unprotected sexual intercourse for at least one year, your female partner has not become pregnant.

Infertility affects about 186 million people worldwide and male partners contribute to approximately half of all infertility cases.

Causes of male infertility

Obstructions causing infertility in men: Sperm are produced in the testicles, mature in the epididymis and travel through the vas deferens to mix with fluids from the prostate and seminal vesicles to form semen. Blockage or absence of these tubes can prevent sperm from reaching semen and may cause infertility; this can be due to birth defects, injury or vasectomy.

Sperm problems: Abnormal sperm number or quality, often linked to genetic factors, can cause male infertility. These include:

Azoospermia: No sperm present in semen due to blocked tubes or reduced sperm production
Oligospermia: Low sperm count, reducing the chance of fertilisation
Abnormal sperm shape: Sperm may have difficulty reaching or fertilising the egg
Poor motility: Reduced sperm movement, affecting the ability to reach the egg

Functional problems: Certain problems with sexual function or the reproductive organs can affect a man's ability to cause pregnancy. These include:

Erectile problems (Impotence): Difficulty getting or maintaining an erection that is firm enough for sexual intercourse
Ejaculation problems: This may include retrograde ejaculation, where semen moves into the bladder instead of leaving through the penis or premature ejaculation
Testicular problems: Injury, infections, or treatments such as chemotherapy can affect testicle function and sperm production
Prostate surgery (Prostatectomy): Removal of the prostate gland may sometimes lead to fertility problems, erectile difficulties or urinary problems.
Certain medical conditions: Diseases such as multiple sclerosis, diabetes and other disorders can affect erection or ejaculation
Antibodies against sperm: In some men, the immune system produces antibodies that affect sperm movement or prevent sperm from attaching to the egg

Hormonal problems: Male fertility depends on a balance of hormones that control sperm production. The brain contains glands called the hypothalamus and pituitary gland, which regulate hormone production in the testicles. In some men, infertility may occur because the body does not produce enough hormones called gonadotrophins, which are needed for normal sperm production.

Signs and symptoms

The main sign of male infertility is difficulty achieving a biological pregnancy. It may also cause emotional and psychological effects, including feelings of sadness, loss, grief, inadequacy, and failure.

Risk factors

Smoking, alcohol use, or use of certain recreational drugs
Being overweight
Previous or current infections
Exposure to harmful toxins or chemicals
Excessive heat exposure to the testicles
Injury or trauma to the testicles
Previous vasectomy or major abdominal/pelvic surgery
A history of undescended testicles
Genetic fertility problems or a family history of fertility disorders
Certain medical conditions, including tumours and chronic illnesses such as sickle cell disease
Certain medications or treatments, including surgery and radiation therapy for cancer

Diagnosis

Diagnosis usually includes:

Physical examination and medical history: The doctor checks the genitals and reviews any health conditions, injuries, surgeries, family history and sexual history that may affect fertility
Semen analysis: A semen sample is tested to assess sperm count, shape, movement and signs of infection. Multiple tests may be needed for accurate results
Scrotal ultrasound: Uses sound waves to check for problems in the testicles, such as varicocele or other abnormalities
Transrectal ultrasound: Evaluates the prostate and checks for blockages in the tubes that carry semen
Hormone testing: Blood tests measure hormone levels involved in sperm production and sexual function
Post-ejaculation urine test: Checks for sperm in urine, which may indicate backward flow of semen into the bladder
Genetic testing: Identifies genetic changes that may contribute to very low sperm counts or infertility
Testicular biopsy: Examines sperm production in the testicles and helps identify blockages or production problems
Specialised sperm tests: Assess sperm function, including survival, movement and ability to fertilise an egg

Treatment

Lifestyle changes

Healthy lifestyle habits may improve sperm production and quality, including:

Maintaining a healthy weight
Eating a balanced diet rich in fruits and vegetables
Exercising regularly, such as walking, jogging, cycling, dancing or strength training
Managing stress
Avoiding smoking, alcohol and recreational drugs
Avoiding the use of sexual lubricants during intercourse, as some may affect sperm movement

Medications

Hormonal treatments can help correct hormone imbalances that affect sperm production. Some medications that may reduce sperm quality may need to be stopped or replaced under medical guidance, including certain antidepressants, calcium channel blockers and anti-androgens.

Surgery

Surgical options may help treat blockages or improve sperm availability, including:

Vasectomy reversal: Reconnects the sperm pathway after a previous vasectomy

Vasoepididymostomy: Removes blockages in the epididymis to allow sperm to enter semen

Sperm retrieval: Collects sperm directly from the testicles or epididymis

Varicocelectomy: Removes enlarged veins in the scrotum that may affect sperm quality

Assisted reproductive technology (ART): ART techniques help achieve pregnancy by combining sperm and eggs in a laboratory, including:

Artificial insemination: In this procedure, the man's semen is collected, processed to concentrate healthy sperm and then placed directly into the woman’s uterus through the cervix. It may be considered when:
Sperm count is low
The man has sexual or functional problems, such as erectile difficulties
Antibodies in semen affect sperm function
The woman’s cervical mucus prevents sperm from moving properly
In-vitro fertilization (IVF): In IVF, sperm is collected and combined with eggs collected from the woman’s ovaries in a laboratory. The woman receives hormone injections to help mature multiple eggs. After fertilisation, the embryos are placed into the uterus through the cervix to achieve pregnancy.
Intracytoplasmic sperm injection (ICSI): ICSI is used when sperm count or quality is too low for regular IVF. A single sperm is directly injected into an egg using a fine needle. The fertilised egg develops into an embryo, which is then transferred into the uterus.

Planning for emotional challenges

Set limits: Discuss with your partner the number and type of fertility treatments you are comfortable with emotionally and financially. Decide on a clear limit, as treatments can be costly and may not always be covered by insurance.
Explore other options: Consider alternatives such as adoption or donor sperm/egg early in the process to reduce stress and prepare for different outcomes.
Seek emotional support: Talk openly about your feelings and consider support groups or counseling to help manage the emotional challenges during and after treatment.

Prevention of male infertility

Male infertility cannot always be prevented, but certain lifestyle choices may help reduce the risk:

Avoid smoking and recreational drugs
Limit or avoid alcohol consumption
Maintain a healthy body weight
Avoid unnecessary vasectomy if future fertility is desired
Prevent prolonged exposure to heat around the testicles
Manage stress effectively
Limit exposure to pesticides, heavy metals and other harmful toxins

Myths and Facts

Myth

It’s only the woman’s health that matters when it comes to having a baby.

Fact

This is not true. Several factors can negatively affect sperm production, including:

Smoking
Excessive alcohol consumption
Sexually transmitted infections (STIs)
Heat exposure from wearing tight-fitting underwear
Misuse of steroids
Exposure to harmful chemical

Myth

Testosterone supplements are good for fertility.

Fact

Several products are marketed as ways to increase testosterone levels. Many over-the-counter testosterone boosters also claim to improve low sex drive, but these products are not FDA-approved for this purpose. Testosterone injections, supplements and steroid use can significantly harm fertility and may result in a complete absence of sperm. Under the guidance of a healthcare provider, certain treatments that naturally support testosterone production may be considered when preserving fertility is important.

Myth

Nothing can be done to improve sperm counts.

Fact

Natural approaches may provide minor improvements in sperm quality, while hormonal treatments or surgery can increase testosterone levels and improve semen parameters, including sperm count, shape and movement.