When Should a Man See a Fertility Specialist?
See a specialist if you and your partner have been trying to conceive for 12 months without success. See one sooner if:
- your partner is 35 or older (after 6 months of trying)
- you have had undescended testes, testicular injury, surgery in the groin or scrotum, or mumps affecting the testes
- you have had cancer treatment (chemotherapy or radiotherapy)
- you have swelling, pain or a lump in the scrotum, or a known varicocele
- you have problems with erections or ejaculation
- a previous semen analysis was abnormal
- you take, or have taken, testosterone or anabolic steroids
What Causes Male Infertility?
Causes usually fall into a few groups:
Sperm production problems
- Low sperm count (oligospermia)
- low sperm motility
- abnormal sperm shape
- small testes
- past infection or injury
Blockages: sperm are made but cannot reach the semen. This is often after infection, vasectomy, or being born without the sperm-carrying tubes.
Hormone problems: low testosterone or low levels of the brain hormones (FSH and LH) that drive sperm production.
Veins and fluid around the testis:
- varicocele, enlarged veins in the scrotum
- hydrocele, fluid around the testis
Genetic causes: chromosome changes such as Klinefelter syndrome, Y-chromosome microdeletions, or cystic fibrosis gene changes.
Infection: semen infections and past sexually transmitted infections.
Sperm DNA damage: a high DNA fragmentation index (DFI).
Medicines and lifestyle:
- smoking, heavy alcohol use, obesity, and frequent heat exposure
- some medicines
- testosterone or anabolic steroid use. Testosterone taken from outside the body can switch off sperm production, so never start it for low energy or muscle building while trying to conceive.
In some men, no clear cause is found even after full testing.
Sexual and Ejaculation Problems
Sometimes sperm are healthy, but problems with sex make conception difficult. These include:
- erectile dysfunction
- premature ejaculation
- low libido
- difficulty ejaculating
These are common, treatable, and nothing to be embarrassed about. Tell your doctor, because they change which treatment makes sense.
How Male Infertility Is Diagnosed: Step by Step
Step 1: History and Examination
Your doctor asks about:
- how long you have been trying to conceive
- past illnesses, surgery and medicines
- work and lifestyle
A physical examination checks testis size and the sperm-carrying tubes, and looks for a varicocele.
Step 2: Semen Analysis
This is the most important first test. You provide a sample after 2 to 7 days without ejaculation. If the result is abnormal, it is usually repeated, because results naturally vary from one sample to the next. See Male Semen Analysis and our guide on how to read a semen analysis report.
Step 3: Further Tests if Needed
Depending on your result, your doctor may suggest:
- Hormone tests: FSH, LH, testosterone, and sometimes prolactin
- Scrotal ultrasound: to check for varicocele, blockage or other changes
- Genetic tests: karyotype, Y-chromosome microdeletion, and CFTR testing, for very low or zero sperm counts. See Advanced Tests for Azoospermia.
- Semen infection tests: Semen Culture and Semen Infection Testing
- Specialised sperm tests:
- Sperm DNA Fragmentation Test
- Sperm Vitality
- HOS Test
- Advanced Sperm Morphology
- Trial Sperm Wash, to see how many good sperm can be prepared for IUI or IVF
Not every man needs every test. Your doctor will choose based on your results.
Reports to Bring to Your First Visit
- all previous semen analysis reports, with dates
- any hormone, ultrasound or genetic reports
- details of past surgery, illness or cancer treatment
- a list of current medicines and supplements
- your partner’s fertility reports, if available
Understanding Your Semen Analysis Results
The WHO (2021) gives lower reference limits based on men who fathered a child within a year. Results below these values do not mean you cannot father a child, and results above them do not guarantee fertility.
|
Measure |
WHO 2021 lower reference limit |
|
Semen volume |
1.4 mL |
|
Sperm concentration |
16 million per mL |
|
Total sperm number |
39 million per ejaculate |
|
Total motility |
42% |
|
Progressive motility |
30% |
|
Normal forms (morphology) |
4% |
|
Vitality |
54% |
What matters most is how your results fit with your partner’s age and fertility. That is why both partners are assessed together.
Treatment Options: Matched to Your Diagnosis
Treatment depends on the cause, the severity, and your partner’s fertility.
|
What the tests show |
Usual next step |
|
Mild changes, lifestyle factors |
Lifestyle changes, then repeat the semen test after about 3 months |
|
Hormone deficiency (low FSH and LH) |
Hormone injections, which can restore sperm production in many men |
|
Varicocele with abnormal semen results |
Varicocele surgery may be considered |
|
Semen infection |
Treatment of the infection, then retesting |
|
Mild to moderate low count or motility |
|
|
Severe low count, poor motility or shape, or failed IUI |
|
|
Zero sperm due to a blockage |
|
|
Zero sperm due to low production |
Genetic tests, then TESE or Micro-TESE with ICSI |
|
High sperm DNA fragmentation |
Address possible causes, then discuss options with your specialist |
|
No sperm can be retrieved |
Donor sperm from a registered ART bank, after counselling |
Azoospermia (Zero Sperm Count)
A zero sperm count is not always the end of the road. The first question is whether there is a blockage or a production problem. The answer decides whether a simple needle procedure or microsurgery is the right choice. Read more about Azoospermia.
Fertility Preservation for Men
Men about to start cancer treatment, or facing surgery that may affect fertility, can store sperm before treatment. See Sperm Freezing and Testicular Tissue Freezing.
What You Can Do While You Wait for Results
Sperm take about 2 to 3 months to develop, so changes you make today show up in a semen test roughly 3 months later.
- Stop smoking, and limit alcohol.
- Aim for a healthy weight.
- Avoid hot tubs, saunas, and keeping a laptop on your lap for long periods.
- Do not take testosterone, anabolic steroids or “fertility boosters” without your doctor’s advice.
- Ask your doctor before starting supplements. See Nutrition to Improve Sperm Health.
Male Infertility Treatment Cost in Hyderabad
The cost of male infertility treatment at Mamata Fertility Hospital Hyderabad varies depending on factors such as the type of diagnosis, procedures required, and the duration of treatment. We maintain transparency in our pricing and provide affordable solutions without compromising on quality.
Our team helps you understand the treatment process and associated costs in detail during your consultation, ensuring there are no surprises. Additionally, we offer flexible payment options to support your fertility care.
Why Choose Mamata Fertility Hospital for Male Infertility?
- Both partners are assessed together from the first visit
- NABH-accredited hospital, established in 1995
- In-house andrology lab for semen and specialised sperm tests
- Full pathway under one roof: diagnosis, IUI, IVF with ICSI, surgical sperm retrieval and sperm freezing
- [Male fertility specialist name and credentials] [only if on staff]
- Private, discreet consultations
- Counselling Services for men and couples, and support for International Patients
If your partner is also being evaluated, see our Female Fertility Treatment guide. Meet our Fertility Specialists.
FAQ
What is the first test for male infertility?
A semen analysis. It checks sperm count, movement and shape, and guides which other tests, if any, are needed.
Can male infertility be treated?
Many causes can be treated or worked around, with medicine, surgery, IUI, or IVF with ICSI. Not every case can be cured. Even with a zero sperm count, sperm can sometimes be retrieved surgically.
Can a low sperm count improve?
Sometimes, yes, especially when the cause is lifestyle, infection, a hormone problem or a varicocele. Because sperm take about 2 to 3 months to develop, improvement shows on a repeat test after about 3 months.
Does age affect male fertility?
Yes. Men stay fertile longer than women, but sperm quality tends to decline gradually with age, especially after the mid-40s.
How long should we try before seeing a doctor?
After 12 months of trying, or after 6 months if your partner is 35 or older. See a doctor sooner if you have known risk factors, such as past testicular surgery or a known semen problem.
Does taking testosterone help fertility?
No. Testosterone taken as medicine or supplements can reduce or stop sperm production. Stop it only with your doctor’s guidance, and tell your specialist if you have used it.
Is a male fertility consultation confidential?
Yes. Consultations are private, and your reports are discussed only with you and, if you choose, your partner.
While male infertility may not always present noticeable symptoms, certain signs could indicate a fertility issue:
-
- Difficulty in conceiving despite regular unprotected intercourse.
- Reduced desire or issues related to sexual function (such as low libido or erectile dysfunction).
- Swelling, pain, or lumps in the testicular area.
- Low sperm concentration or abnormal appearance of sperm in semen analysis.
- Hormonal symptoms like abnormal breast growth (gynecomastia) or reduced facial/body hair.
If you experience any such symptoms, seeking medical advice is the first step towards finding a solution.
Reviewd By
Dr Aarti Deenadayal Tolani
Clinical Director, Scientific In-Charge & Fertility Consultant
MBBS, MS ( OBGYN), FICOG
Expert in Reproductive Endocrinology, Infertility, Advanced Gynaec Ultrasound, and Faculty at Mamata Fertility Hospital.
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