Male Infertility: Why It Is More Common Than You Think, and What Can Be Done
October 31, 2026 · 7 min read
Written & medically reviewed by Dr. Shaivalini Kamarapu
MBBS · MS (Obstetrics & Gynaecology) · Fellowship in Reproductive Medicine · 20+ years of clinical experience
Half of the picture is often never checked
When a couple struggles to conceive, the focus in India almost always falls on the woman. Tests, treatments and appointments are arranged for the female partner, while male infertility stays an uncomfortable, rarely discussed subject. Yet in about 40–50% of couples with infertility, the male partner is the main cause or a contributing factor.
Dr. Shaivalini Kamarapu regularly sees couples who have spent months or years on investigations for the woman without the man ever being tested. A simple semen analysis could have found the problem much sooner.
What is male infertility?
Male infertility means a man is unable to make a fertile female partner pregnant after 12 months of regular, unprotected intercourse. It is usually caused by problems with the sperm: their number, quality or movement.
It has nothing to do with masculinity, sexual performance or general health. Many men with infertility have no symptoms at all and feel completely healthy. The only way to find a problem is a semen analysis.
Common causes of male infertility
- Low sperm count (oligospermia): fewer than 15 million sperm per millilitre of semen
- No sperm in the semen (azoospermia), caused either by a blockage or by a production problem
- Poor sperm motility (asthenospermia): sperm that can't swim well enough to reach the egg
- Abnormal sperm shape (teratospermia)
- Varicocele: enlarged veins in the scrotum that overheat the testes and reduce sperm quality
- Hormone problems, such as low testosterone or high prolactin
- Past infections, such as sexually transmitted infections or mumps affecting the testes
- Genetic conditions, such as Klinefelter syndrome or Y-chromosome microdeletions
- Lifestyle factors: smoking, alcohol, heat exposure, obesity and stress
- Sperm DNA fragmentation: damage to the genetic material in sperm
How is male infertility diagnosed?
The first and most important test is a semen analysis, which checks sperm count, movement, shape and semen volume. It is non-invasive and quick. If the first result is abnormal, the test is usually repeated after a few weeks to confirm it.
Depending on the results, further tests may include hormone blood tests (FSH, LH, testosterone, prolactin), a scrotal ultrasound to look for a varicocele, genetic tests, and sperm DNA fragmentation testing.
Treatment options
Treatment depends on the cause and how severe the problem is:
- Lifestyle changes: losing weight, stopping smoking and alcohol, and avoiding heat, which can improve sperm within 3–6 months
- Medicines: hormone treatment for hormone problems, and antioxidants to support sperm quality
- Varicocele repair: surgical or microsurgical correction to improve sperm count and quality
- IUI (intrauterine insemination): prepared sperm are placed directly in the uterus; suitable for mild male-factor infertility
- IVF with ICSI: a single healthy sperm is injected into each egg; the most effective treatment for severe male infertility
- Surgical sperm retrieval (TESA/PESA): for men with azoospermia, sperm can often be taken directly from the testis or epididymis and used for ICSI
Improving sperm health naturally
- Keep to a healthy weight; obesity lowers testosterone and sperm count
- Stop smoking, which damages sperm DNA and reduces motility
- Limit alcohol
- Avoid tight underwear, hot baths and long periods with a laptop on your lap
- Eat foods rich in antioxidants, zinc, selenium and vitamins C and E
- Manage stress and exercise moderately
- Repeat the semen analysis about 3 months after making changes, since sperm take around 72 days to develop
See a doctor promptly if you notice these
- Pain, swelling or a lump in the testicle area
- A history of mumps as an adult
- Previous chemotherapy or radiotherapy
- No sperm in the semen
- More than 12 months of trying to conceive without success; both partners should be tested together
Fertility is a shared journey
Male infertility is far more common than people admit, and far more treatable than most couples realise. A semen analysis is the starting point. Whether the answer is a lifestyle change, medicine, IUI or ICSI, there are effective options for almost every situation.
At AMVI Hospitals, Dr. Shaivalini Kamarapu evaluates both partners together. Book a consultation at our Puppalaguda branch (+91 91000 09669) or Attapur branch (+91 80088 42200).
Frequently asked questions
Often, yes. Even when there are no sperm in the semen, sperm can often be retrieved surgically from the testis (TESA) or epididymis (PESA) and used for ICSI. Success depends on whether sperm are being produced in the testicular tissue, which is assessed during evaluation.
No. Male infertility is separate from erectile dysfunction or low libido. Most men with infertility have completely normal sexual function; the problem is with the sperm, not with sexual performance.
Sperm take about 72–90 days to develop, so improvements from stopping smoking, losing weight or other changes usually show in a semen analysis done about 3 months later.
ICSI is the most effective treatment for severe male infertility, but it isn't always the only option. Milder problems may respond to IUI with sperm preparation, hormone treatment or varicocele repair. Your doctor will recommend the least invasive treatment that is likely to work for you.
Have questions about this?
Talk it through with our team at Puppalaguda or Attapur.