Male infertility is more common than most people realise. It contributes to approximately 40–50% of all infertility cases, yet it often goes undiagnosed because the focus tends to be on the female partner. Understanding the causes and available treatments is essential for couples seeking to start a family.
Male infertility expertise with Dr. Arun Muthuvel in Chennai
Dr. Arun Muthuvel is an MCh-qualified reproductive medicine and surgery specialist in Chennai who evaluates and treats the full range of male infertility, from mildly abnormal semen parameters to azoospermia requiring surgical sperm retrieval.
Male factor contributes to around half of all infertility, yet the man is often assessed superficially or not at all. A proper male evaluation can reveal a treatable hormone disorder, a varicocele, an obstruction, an infection, or occasionally a serious underlying illness that would otherwise be missed.
Common Causes
- Low sperm count (Oligospermia): Fewer than 15 million sperm per millilitre of semen.
- Poor sperm motility (Asthenospermia): Sperm that cannot swim effectively toward the egg.
- Abnormal sperm morphology (Teratospermia): High percentage of abnormally shaped sperm.
- Varicocele: Enlarged veins in the scrotum that raise testicular temperature and impair sperm production.
- Hormonal imbalances: Low testosterone or elevated prolactin levels.
- Obstructive azoospermia: Blockages preventing sperm from reaching the ejaculate.
- Non-obstructive azoospermia: The testes fail to produce adequate sperm.
- Genetic factors: Conditions like Klinefelter syndrome or Y-chromosome microdeletions.
- Lifestyle factors: Smoking, excessive alcohol, obesity, and exposure to environmental toxins.
Diagnosis
The evaluation of male infertility typically begins with a detailed medical history and a semen analysis. If the semen analysis is abnormal, further testing may include hormonal blood tests (FSH, LH, testosterone, prolactin), scrotal ultrasound, genetic testing (karyotype and Y-chromosome microdeletion analysis), and in some cases, a testicular biopsy.
Treatment Options
- Lifestyle modifications: Weight loss, quitting smoking, reducing alcohol, and improving diet can improve sperm parameters in many men.
- Medications: Hormonal therapy to correct imbalances or antioxidant supplements to reduce oxidative damage.
- Varicocele repair: Surgical correction of varicocele can improve sperm count and quality.
- IUI (Intrauterine Insemination): Suitable for mild male factor infertility with adequate sperm counts.
- IVF with ICSI: Intracytoplasmic sperm injection is the gold standard for moderate to severe male infertility, requiring only a single viable sperm per egg.
- Surgical sperm retrieval (TESA/TESE/Micro-TESE): For men with azoospermia, sperm can be surgically retrieved directly from the testes for use in IVF-ICSI.
The Main Categories of Male Infertility
| Category | Examples | Typical treatment direction |
|---|---|---|
| Pre-testicular | Low gonadotrophins, high prolactin, thyroid or pituitary disorders | Medical treatment often restores sperm production |
| Testicular | Varicocele, undescended testis, genetic causes, infection, chemotherapy | Varies from surgery to ICSI or sperm retrieval |
| Post-testicular | Vasal obstruction, absent vas deferens, ejaculatory duct obstruction | Reconstruction or sperm retrieval with ICSI |
| Functional | Erectile or ejaculatory dysfunction, retrograde ejaculation | Medical treatment, sperm recovery, IUI or IVF |
What a Complete Male Evaluation Includes
- History: duration of infertility, childhood surgery or undescended testis, mumps, infections, injuries, medications, anabolic steroid or testosterone use, occupational heat and toxin exposure, smoking and alcohol.
- Examination: testicular size and consistency, presence of the vas deferens on both sides, epididymal fullness and varicocele assessment.
- Two semen analyses performed to WHO standards several weeks apart, with examination of the centrifuged pellet if no sperm are seen.
- Hormone profile: FSH, LH, testosterone and prolactin, with thyroid function and blood sugar where indicated.
- Scrotal ultrasound and, where ejaculatory obstruction is suspected, transrectal imaging.
- Genetic testing in severe oligospermia and azoospermia: karyotype, Y-chromosome microdeletion, and CFTR testing when the vas is absent.
- Specialised tests such as DNA fragmentation or post-ejaculatory urine analysis when the clinical picture calls for them.
Treatment Pathways
Medical treatment corrects hormonal causes and infections. Surgery repairs a varicocele or an obstruction. Where sperm are absent from the ejaculate, retrieval procedures such as TESA, TESE and micro-TESE can obtain sperm directly from the testicle for ICSI.
Assisted reproduction is chosen according to severity: IUI for mild abnormalities with good total motile count, conventional IVF for moderate problems, and ICSI for severe male factor. A full overview is available in our male infertility treatment guide for Chennai.
Why Male Health Matters Beyond Fertility
Infertile men have a higher prevalence of undiagnosed diabetes, hypertension, thyroid disease and, rarely, testicular cancer. A fertility assessment is often a man’s first thorough medical review in years, and abnormal findings should be investigated rather than treated only as a fertility issue.
Frequently Asked Questions
Is infertility more often a male or female problem?
Neither dominates. A male factor is present in around half of couples, alone in about 20 to 30 percent and combined with a female factor in the rest. Both partners should always be assessed together.
How long does male fertility treatment take to work?
Sperm production takes about three months, so medical and surgical treatments are reassessed at three to six months. Assisted reproduction can proceed sooner where time matters.
Can men with no sperm in the ejaculate have biological children?
Often yes. In obstructive azoospermia sperm are almost always retrievable, and in non-obstructive azoospermia micro-TESE finds sperm in a substantial proportion of men.
Does age affect male fertility?
Yes, though more gradually than in women. From the mid-forties, semen parameters decline and DNA fragmentation rises, with modest increases in miscarriage risk and time to conception.
Why consult Dr. Arun Muthuvel for male infertility in Chennai?
His MCh qualification in reproductive medicine and surgery covers diagnosis, hormonal treatment, microsurgery, sperm retrieval and IVF-ICSI, so the couple is managed by one specialist throughout.
The Bottom Line
Male infertility is common, frequently treatable, and always worth investigating properly rather than moving straight to IVF. Dr. Arun Muthuvel provides complete male infertility diagnosis and treatment in Chennai, from hormonal and surgical correction to ICSI and surgical sperm retrieval.
This article provides general medical information and does not replace individual diagnosis or treatment advice. Outcomes vary with age, diagnosis, test results and clinical circumstances.