Overview
Most male fertility problems can be helped. Depending on the cause, treatment ranges from lifestyle changes and medicines to IUI, ICSI and, when there are no sperm in the semen, surgical sperm retrieval.
Common causes of male infertility
- Low sperm count (oligozoospermia), or no sperm in the semen (azoospermia)
- Poor motility, where sperm do not swim well enough to reach the egg
- Abnormal shape (morphology) that makes fertilisation harder
- Varicocele, enlarged veins in the scrotum that can raise testicular temperature
- Hormone problems affecting testosterone, FSH, LH or prolactin
- Blockages after infection, surgery or from birth
- Genetic causes, such as Y-chromosome microdeletions or Klinefelter syndrome
- Lifestyle factors: smoking, alcohol, obesity, heat exposure, some medicines and anabolic steroids
How male fertility is tested
- Semen analysis
The first and most important test. It measures volume, count, motility and shape. A sample is usually given after 2 to 7 days without ejaculation, and an abnormal result is repeated to confirm it. - Hormone blood tests
FSH, LH, testosterone and prolactin help show whether the problem lies in sperm production or in the hormones that control it. - Scrotal ultrasound
Checks for a varicocele, blockages or other changes in the testes. - Further tests where needed
Sperm DNA fragmentation, genetic tests and urine tests after ejaculation, chosen according to the semen result.
Treatment options
The right treatment depends on the cause and on the female partner's fertility. Your plan is made for you as a couple.
- Lifestyle changes and medicines to improve sperm production where a cause is found. Sperm take about three months to develop, so changes need time to show.
- Varicocele treatment with a urologist, for selected men with a significant varicocele.
- IUI for a mild reduction in count or motility: washed, concentrated sperm are placed in the uterus at ovulation.
- ICSI for moderate to severe problems: the embryologist injects a single healthy sperm into each egg.
- Surgical sperm retrieval (such as TESA or TESE) when there are no sperm in the semen, followed by ICSI.
- Donor sperm, discussed with care, when no sperm can be found.
Why couples choose Ishwa IVF
- Semen analysis and sperm preparation in our own laboratory
- A chief embryologist experienced in ICSI and handling low sperm numbers
- Both partners assessed together, so time is not lost treating one side only
- Private, respectful consultations
Questions about male infertility
Can a man with a low sperm count still become a father?
Yes, in most cases. Mild problems may respond to lifestyle changes, medicines or IUI. Even with very low numbers, ICSI needs only one healthy sperm for each egg.
What does it mean if there are no sperm in the semen?
This is called azoospermia. It can be caused by a blockage or by a problem with sperm production. Hormone tests and an examination help find the cause, and in many men sperm can still be retrieved surgically from the testis for ICSI.
How should I prepare for a semen analysis?
Avoid ejaculation for 2 to 7 days before the test, and give the sample at the clinic if possible, or bring it within an hour, kept at body temperature. A single abnormal result is usually repeated before drawing conclusions.
Can lifestyle changes improve sperm quality?
They can help. Stopping smoking, cutting down alcohol, reaching a healthy weight, avoiding heat to the groin and reviewing medicines all support sperm production. Because sperm take about three months to mature, improvements take time.
Is male infertility treatment painful?
Most tests involve a semen sample and a blood test. Surgical sperm retrieval, when needed, is done under anaesthesia and most men go home the same day.
