Male Infertility: Tests, Evaluation and Treatment

Male infertility is defined as a health problem that affects an estimated 15% to 30% of the reproductive-aged population. Do you know that 40% of all infertility cases result from male infertility? Yes, it is true. A man’s body produces sperm with the help of testicles. 

Male infertility is a primary concern for millions of men and their partners. Many male infertility cases are treatable and can be successfully resolved with the proper treatment. However, some cases can’t be helped, such as when the cause is related to genetic problems. This article will provide you with important information about male infertility and what you can do if you are concerned about this issue. 

What Do You Mean By Male Infertility

Man’s body produces tiny cells called sperm. The male reproductive system produces, stores, and transports sperm. Sperm and male sex hormone (testosterone) production occur in the two testicles (a skin sack below the penis). 

When the sperm leaves the testicles, they proceed into a tube behind each testicle called the epididymis. Before ejaculation, the sperm move from the epididymis into another set of tubes called the vas deferens. Each vas deferens goes from the epididymis to behind a man’s bladder in the pelvis, where per vas deferens joins the ejaculatory duct from the seminal vesicle. When a man ejaculates, the sperm combines with fluid from the prostate and seminal vesicles and forms semen. During sex, this semen then transits through the urethra and out of the penis into the woman’s body. Male fertility relies on a man’s body making normal sperm and delivering them. The sperm travels through a woman’s cervix into her uterus and fallopian tubes. There, if sperm and egg meet, fertilization happens. So a man is called infertile when for any reason:

  • He is unable to produce healthy sperm. 
  • Lack of sperm into the semen.
  • His sperm is unable to fertilize the female egg.
  • His sperms are not functional, and unable to move because if the motility or function of his sperm is abnormal, then the sperm may be unable to reach or penetrate his partner’s egg.

Male Infertility Causes

There are several causes for male infertility, which includes:

Varicocele: A varicocele is a swelling of the veins in the scrotum that drain the testicles. It is the most found cause of male infertility and could be easily reversed. Although the exact reason behind varicoceles causing infertility is still unknown, abnormal blood flow may cause it. It leads to decreased sperm quantity and quality.

Infection: Some infections can interrupt sperm production or sperm health or cause scarring that blocks the passage of sperm. These include inflammation of the epididymis or testicles and some sexually transmitted infections, including gonorrhoea or HIV. Although some conditions can result in permanent testicular damage, doctors can often still retrieve the sperm.

Ejaculation Issues: Retrograde ejaculation happens when semen goes backwards in the man’s body. The semen goes into the bladder during orgasm instead of ejaculating out the tip of the penis. Many health conditions can cause retrograde ejaculation, like diabetes, spinal injuries, medications, and bladder, prostate, or urethra surgery.

Antibodies that attack sperm: Sometimes, a man’s body makes antibodies that identify sperm as harmful invaders by mistake and then attempts to eliminate them.

Tumours: Cancers and nonmalignant tumours can directly affect the male reproductive organs via the glands that discharge hormones related to reproduction, such as the pituitary gland, or via unknown causes. In some cases, radiation, surgery, or chemotherapy to treat tumours can affect male fertility.

Undescended testicles: Some males have decreased fertility because, during fetal development, one or both testicles fail to drop from the abdomen into the sac that usually contains the testicles (scrotum).

Hormone imbalances: Infertility is sometimes the result of disorders of the testicles themselves or an abnormality affecting other hormonal systems, including the hypothalamus, pituitary, thyroid, and adrenal glands. 

Defects of tubules that transport sperm: Multiple tubes carry sperm. Conditions like inadvertent injury from surgery, prior infections, trauma, or abnormal development, such as cystic fibrosis or similar inherited disorders, can block that sperm from leaving the body. Blockage can occur at any level, within the testicle, in tubes, epididymis, near the ejaculatory ducts, in the vas deferens, or the urethra.

Chromosome defects: Inherited disorders like cystic fibrosis, Kallmann’s syndrome, and Klinefelter’s can cause male infertility. Klinefelter’s is a syndrome in which a male is born with two X chromosomes and one Y chromosome, rendering abnormal development of the male reproductive organs.

Problems with sexual intercourse: When a male has trouble maintaining an erection adequate for sex, premature ejaculation, painful intercourse, anatomical abnormalities, or psychological or relationship problems that interfere with sex can also be a reason a man can not get his partner pregnant.

Celiac disease: Celiac disease can also contribute to male infertility. It is a digestive disorder caused by sensitivity to a protein found in wheat called gluten. Fertility may improve after dropping gluten from the diet.

Certain medications: Some medications can impair sperm production and decrease male fertility, such as testosterone replacement therapy, long-term anabolic steroid use, cancer medications, some ulcer drugs, some arthritis drugs, and certain other medications.

Prior surgeries: Certain surgeries may stop you from having sperm in your semen, such as vasectomy, scrotal or testicular surgeries, prostate surgeries, and extensive abdominal surgeries performed for testicular and rectal cancers.

Lifestyle: Drug use, alcohol, smoking, and obesity could also cause male infertility.

Male Infertility Symptoms

There are a few low sperm count signs that can help us determine male infertility. The most significant sign is the inability to conceive a child. Some of the other symptoms you may witness include:

  • Issues with sexual function include complications with ejaculation or small volumes of fluid ejaculated, diminished sexual desire, or problems maintaining an erection.
  • Swelling, discomfort, or a lump in the testicle area
  • Perennial respiratory infections
  • Incapability to smell
  • Lesser or no facial or body hair or other signs of a chromosomal or hormonal abnormality
  • A lower than average sperm count (fewer than 15 million sperm per milliliter of semen)

Here are the best food items that will help you increase sperm count at home. 

Male Infertility Treatment Options

Aastha is one of the country’s leading and most trusted infertility clinics. The aastha team takes pride in providing accurate diagnosis and customized treatment protocols for couples seeking infertility treatment to lead to pregnancy successfully.

We offer a range of advanced fertility treatments at Aastha Fertility Care. We have used cutting-edge technology and the most advanced fertility treatments in India to create an environment that’s customized to your needs and lifestyle.

Treatment of male infertility depends on what is causing it. Doctors can treat some of the disorders in the following ways:

Surgery: For example, Doctors can surgically correct a varicocele or an obstructed vas deferens repaired. A man can reverse his prior vasectomies. In cases no sperm is present in the semen, sperm can often be recovered directly from the testicles or epididymis using sperm retrieval techniques.

Ministering infections: Antibiotic treatment might help you cure an infection of the reproductive tract, but it doesn’t need to restore fertility.

Treatments for sexual intercourse problems: In erectile dysfunction or premature ejaculation, medication or counselling can help improve fertility in conditions.

Hormone treatments and medications. When the cause of infertility is high or low levels of certain hormones or problems with the way the body uses hormones, the doctor might recommend hormone replacement or drugs. 

Here are 5 best tips to treat low sperm count or Oligospermia in men. 

Assisted reproductive technology (ART): In ART treatments, the doctors obtain sperm through normal ejaculation, surgical extraction, or donor individuals, depending on the man’s specific case and wishes. Then they insert the sperm into the female genital tract or perform In- Vitro fertilization or Intrauterine Insemination (IUI), Intracytoplasmic sperm injection, or IVF with PGS.

What is Male Infertility Evaluation: What To Expect From Male Fertility Evaluation?

At Aastha Fertility Care, we have the expertise and experience to perform infertility evaluation on men and pinpoint the exact cause of infertility with ease. During our initial consultation, you will be given a thorough examination by one of our doctors, who will conduct basic tests on your sperm cells to check for abnormalities. You might also be asked for a semen analysis, which is to be performed on a sample that you provide.

A male infertility evaluation is an exam and test to find why you and your partner have not gotten pregnant. In male infertility, evaluation doctors analyze a man’s semen sample to determine the reason behind it. In this evaluation, doctors assess the volume (quantity of fluid that comes out), concentration (number of sperm present), motility (sperm movement), and morphology (sperm shape). There is natural variation between analyses, and often the test is repeated to confirm normal or abnormal results. For this evaluation, doctors require:

General physical examination and medical history: Doctors will examine the patient’s genitals and will ask him his medical history, like if he has any inherited conditions, chronic health problems, illnesses, injuries, or surgeries that could affect fertility. The doctor might also ask about sexual habits and sexual development during puberty.

Semen analysis: The patient will have to give his semen for analysis. There are different ways to obtain semen samples. The patient can provide a sample by masturbating and ejaculating into a container at the doctor’s office. In some cases, the patient collects semen using a special condom during intercourse because of religious or cultural beliefs they are not comfortable with masturbating.

Male Infertility Tests

Apart from semen analysis, the doctor might ask the patient to get additional tests to determine the cause of your infertility. These tests include:

Scrotal ultrasound. A scrotal ultrasound allows the doctor to see a varicocele or other issues in the testicles.

Transrectal ultrasound: lets your doctor check your prostate and look for tubes that carry semen blockages.

Hormone testing: A blood test will measure the level of testosterone and other hormones as abnormalities in other hormonal or organ systems might also contribute to infertility.

Post-ejaculation urinalysis: Sperm in your urine can indicate if the patient has retrograde ejaculation or not.

Genetic tests: A blood test can reveal subtle changes in the Y chromosome, which is a sign of a genetic abnormality. The doctor might order genetic testing to diagnose various congenital or inherited syndromes.

Testicular biopsy: helps the doctor determine whether the problem is with sperm production or is likely caused by a blockage or another issue with sperm transport.

Specialized sperm function tests: There are some tests to check how well a patient’s sperm persists after ejaculation, how nicely they can penetrate an egg, and whether there’s any problem attaching to the egg. Doctors often do not suggest these tests as they significantly change treatment recommendations.


Aastha Fertility Care aims at providing you with the highest quality of care in the field of infertility treatment. At Aastha, you are treated by experienced doctors having specialized training in infertility. You can get a personalized evaluation for your infertility problems and get the fertility treatment that suits you best.

With the changing lifestyle of people, male infertility is getting more common these days. But as medical science progresses, the ways of treating infertility are also getting better and more effective. So if you notice that you have an infertility problem, do not panic and consult a doctor.

Picture of Dr Namita Kotia

Dr Namita Kotia

Dr. Namita Kotia (IVF specialist in Jaipur) attained her Master’s in Obstetrics and Gynecology from S.N. Medical College, Jodhpur affiliated to University of Rajasthan in 1997. She has more than 10 years experience in field of Assisted Reproductive Technology (ART).Presently at Aastha Fertility Care Dr. Namita along with her team is providing complete infertility work up and treatment options under one roof. Her aim is to provide proper guidance and treatment to Infertile couples at AFFORDABLE RATES.She is life member of Indian Academy of Human Reproduction (IAHR), Indian Society for Assisted Reproduction (ISAR), Federation of Obstetrics and Gynecology Society of India (FOGSI) and Jaipur Obstetrics Gynecology Society (JOGS). She has a number of publications in various journals and presentations at state and National level conferences to her credit.Dr. Namita is also recipient of best paper presentation viz “Diagnosis of Congenital Mullerian anomalies by three dimensional Transvaginal Sonography” awarded at “Kishori” Conference in Jodhpur (2000).

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