Male Infertility

In simple terms, male infertility means that a male factor is making it difficult for a couple to achieve pregnancy. This could be because there are too few sperm, the sperm are not moving effectively, their shape is abnormal, or sperm are unable to reach the semen because of an obstruction. Problems with ejaculation and certain hormonal or genetic conditions can also play a role.

One important point to remember is that fertility cannot always be judged from symptoms alone. Many men with sperm-related concerns feel completely well and may only discover the issue after undergoing a fertility evaluation.

Types of Male Infertility

There are different ways to classify types of male infertility. Some terms describe a person’s reproductive history, while others explain where the actual problem may be occurring.

Primary Male Infertility

Primary male infertility generally refers to difficulty achieving a pregnancy when no previous pregnancy has been achieved.

Secondary Male Infertility

Secondary male infertility refers to difficulty achieving a pregnancy after a previous pregnancy has already occurred. Fertility can change over time, so having conceived in the past does not always guarantee that fertility will remain unchanged.

Obstructive Male Infertility

In obstructive male infertility, sperm may be produced but are unable to travel normally because of a blockage in the reproductive tract. Previous infections, injuries, surgery or congenital conditions can sometimes be responsible.

Non-Obstructive Male Infertility

Here, the main issue is usually with sperm production itself. The testes may be producing very few sperm or none that can be detected in the semen. Hormonal, genetic and testicular factors may need to be investigated further.

There is usually no single test that gives every answer. A male fertility evaluation often starts with a detailed medical history, followed by a physical examination and one or more semen analyses. The doctor may ask about previous pregnancies, childhood illnesses, infections, surgeries, medications and lifestyle habits. Information about erection or ejaculation problems may also be relevant.

A semen report is often the starting point, but it should not be viewed in isolation. Semen parameters can vary, and an abnormal result does not automatically mean that a man is infertile. Depending on the findings, repeat testing or further investigations may be recommended.

Tests for Male Infertility

Not everyone needs an extensive list of investigations. Tests for male infertility are usually selected based on the semen analysis, medical history and clinical findings.

Semen Analysis

For most men, this is where the evaluation begins. A semen analysis looks at several aspects of semen and sperm, including sperm concentration, movement and shape.

A low sperm count is medically referred to as oligospermia. However, sperm count is only one part of the picture. Sperm Motility and morphology can also provide useful information.

Hormonal Tests

If there is a concern about sperm production, blood tests may be used to assess reproductive hormones. These can help the specialist understand whether a hormonal issue could be contributing to the problem.

Ultrasound

A scrotal ultrasound may be advised when the doctor needs to look more closely at the testes and surrounding structures. It can be useful in identifying conditions such as a varicocele.

Genetic and Advanced Tests

Certain men, particularly those with very low or absent sperm counts, may be advised to undergo genetic testing. Other specialised tests, such as sperm DNA fragmentation testing, may be considered in selected situations rather than as a routine test for everyone.

Male fertility is not always only about the numbers mentioned in a semen report. A few other conditions may also need attention.

Varicocele

A varicocele involves enlarged veins in the scrotum. It is a condition that may be found during a male fertility evaluation and, in some men, may affect sperm production or quality. Whether it needs treatment depends on the individual’s clinical situation.

Erectile Dysfunction

Erectile dysfunction refers to ongoing difficulty in getting or maintaining an erection suitable for intercourse. It does not necessarily mean there is a problem with sperm, but if intercourse is difficult or infrequent, it can obviously affect the chances of conception.

Ejaculatory Disorders

Some men experience problems with ejaculation, including absent, delayed or retrograde ejaculation. In such cases, the focus is on identifying the reason and deciding whether medical treatment or other fertility options may be appropriate.

When Should You See a Fertility Specialist for Male Infertility?

If pregnancy has not happened despite regular unprotected intercourse, it may be time for both partners to undergo a fertility assessment. It is also worth seeking advice earlier if there is already a known low sperm count, a history of testicular surgery or injury, a varicocele, previous cancer treatment, or ongoing problems with erection or ejaculation.

The main advantage of an early evaluation is clarity. Instead of spending months trying different supplements or relying on assumptions, you can understand whether there is a specific issue that needs attention.

There is no standard male infertility treatment that works for everyone. The treatment depends on what is causing the problem and may include:

Treating underlying conditions

Hormonal or other medical conditions may be treated to address their impact on fertility if they are the reason behind the infertility issue.

Lifestyle changes

Incorporating some healthy lifestyle changes, such as quitting smoking, reducing excessive alcohol use, and addressing obesity, may support reproductive health.

Surgical treatment

Surgery is not applicable in all cases. It is usually considered for certain cases of varicocele or blockages that affect sperm transport.

Assisted reproductive techniques

Advanced fertility procedures like IUI, IVF or ICSI may be recommended when sperm-related concerns make natural conception difficult.

Sperm retrieval

In some cases where sperm are not found in the semen, sperm retrieval procedures may be considered. These can be needle aspiration (PESA/TESA) or tissue extraction (TESE/Micro-TESE). The right treatment starts with understanding the cause and then choosing the most suitable option.

The male infertility treatment cost in India can vary because the treatment itself can be very different from one person to another. Someone who only needs diagnostic tests will have a very different cost from someone requiring varicocele surgery, sperm retrieval or IVF with ICSI.

Treatment or Procedure	Approximate Cost in India*
Semen analysis	₹500–₹2,000
Hormonal tests	₹1,500–₹5,000+
Varicocele treatment	₹40,000–₹1,50,000+
IUI	₹10,000–₹25,000 per cycle
IVF	₹1,00,000–₹2,50,000+ per cycle
Surgical sperm retrieval	₹30,000–₹1,00,000+

 

*These are broad estimated ranges and may vary based on the city, hospital, treatment plan, medications, and additional procedures. The actual cost can only be estimated accurately after the diagnosis and treatment plan are clear.

Medicines and surgery can help treat many causes of male infertility, but they may not work for everyone. When these treatments are not enough, assisted reproductive treatments can help you and your partner try for a baby using sperm when the sperm count is very low or sperm needs to be collected through a procedure.

The three main options are IUI, IVF and ICSI. Before choosing a treatment, your fertility specialist will look at your sperm health and your partner’s fertility as well. For more information on how male infertility is diagnosed, you can also read our guide to the causes of male infertility.

How Is the Right Treatment Chosen?

There is no single treatment that works best for every case of male infertility. Your specialist will usually consider three main factors:

• Sperm count: This tells you how many sperm are present in a given amount of semen. A low sperm count is known as oligospermia.
• Sperm movement and shape: Sperm motility shows how well sperm move, while sperm shape can also affect their ability to fertilise an egg.
• Your partner’s fertility: Her age, ovulation, and fallopian tube health can also influence which treatment is most suitable.

A semen analysis is usually one of the first tests used to understand sperm health. Your partner may also need a fertility assessment. Looking at both partners helps your specialist recommend the treatment that gives you the best chance of success.

IUI for Mild Sperm Problems

IUI, or intrauterine insemination, is often considered when sperm problems are mild. During the procedure, the semen sample is prepared in the laboratory to select the healthier, more active sperm. These sperm are then placed directly into the uterus around the time of ovulation.

How does it help? By placing sperm closer to the egg, IUI reduces the distance they need to travel and bypasses the cervix.

When may it be suitable? IUI may be considered when sperm count and motility are only mildly affected, your partner is ovulating, and her fallopian tubes are open.

IUI usually takes only a few minutes and does not generally require anaesthesia. You can usually return home the same day. Your specialist will advise whether IUI is worth trying based on your sperm results and other fertility factors. You can also learn more about our IUI specialists and IUI costs.

IVF for Male Infertility

With IVF, eggs are collected from your partner’s ovaries and fertilised with sperm in a laboratory. Once an embryo develops, it can be transferred to the uterus.

How does it help? IVF brings the egg and sperm together in the laboratory, so sperm do not have to travel through the entire reproductive tract to reach the egg.

When may it be suitable? IVF may be recommended when sperm problems are more significant, IUI has not worked, or your partner has other fertility concerns that also need to be addressed.

Your IVF specialists can explain the different stages of treatment, including the full IVF process and expected IVF cost, before you begin.

ICSI for Severe Sperm Problems

ICSI is a specialised form of IVF that can be useful when sperm-related problems are more severe. Instead of allowing sperm and egg to fertilise together in the laboratory, an embryologist selects a sperm and injects it directly into the egg.

How does it help? ICSI gives a single sperm the opportunity to fertilise the egg, which can be helpful when there are very few sperm or when sperm have difficulty moving or fertilising an egg on their own.

When may it be recommended?

• The sperm count is very low, or no sperm are found in the semen. See our guide to azoospermia treatment.
• Sperm movement or shape is significantly affected.
• Fertilisation did not occur in a previous IVF cycle.
• Sperm has been collected through a surgical procedure.
• A blockage is preventing sperm from reaching the semen.

Your ICSI specialists can help determine whether ICSI is more appropriate than conventional IVF based on your sperm results and treatment history. You can also learn more about ICSI costs.

When Can Sperm Freezing Help?

Sperm freezing can be useful if your sperm count varies, you are undergoing treatment that may affect fertility, or you want to keep sperm available for future fertility treatment.

For example, men who are about to undergo chemotherapy may be advised to consider sperm freezing before treatment begins. Freezing sperm can also provide a backup if producing a sample on the day of treatment may be difficult. Our fertility preservation services can help you understand your options and plan ahead.

What If No Sperm Can Be Retrieved?

In some cases, sperm may not be found even after a sperm retrieval procedure such as micro-TESE. When this happens, donor sperm may be an option for some couples.

This is an important decision, and your specialist can explain how donor sperm programmes work, the screening involved, and the applicable legal requirements in India. You can then make a decision that feels right for you and your partner, without feeling rushed.

Should the Causes Be Treated Too?

Assisted reproductive treatments can help overcome certain fertility problems, but they do not always treat the cause. If there is a condition that can be treated, addressing it may be an important part of your overall fertility plan. For example:

• A varicocele may sometimes be treated with surgery. Our varicocele surgery guide explains what the procedure involves.
• A hormonal imbalance may be treated with medicines, depending on its cause. A hormone specialist can guide you through the evaluation.
• Conditions such as retrograde ejaculation and some erection difficulties can also be evaluated and treated.

Male infertility can be complex, and a single test result may not always explain the complete picture. At Birla Fertility & IVF, the focus is on understanding the possible cause and guiding patients towards the appropriate next steps.

• Detailed fertility evaluation to understand factors that may be affecting sperm health and conception
• Personalised treatment plans based on the individual’s diagnosis and the couple’s overall fertility assessment
• Advanced investigations, when required, to look beyond a routine semen analysis
• Multiple treatment options, including medical management, surgical procedures and assisted reproductive techniques
• Expert guidance at every step, helping couples understand their diagnosis and the options available to them