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A detailed Guide To Male Infertility – The Missing Part Of The Equation

Asian Institute of Nephrology and Urology | October 3, 2022



In 2019, a study revealed that in around 50% of infertility cases in India, male infertility is the reason. The prevalence of male infertility in India is 23%, according to WHO.

We cannot deny that these are startling statistics. They point at health and lifestyle problems that need immediate attention. To help you understand male infertility better, we have created this detailed guide for you.

What causes infertility in males?

Infertility in men could be the congenital, acquired and idiopathic. Congenital causes undescended testis, chromosomal abnormalities like Klinefelter syndrome, Kallman syndrome, congenital bilateral absence of vas and Y chromosome microdeletion. Acquired causes are testicular injury, torsion, tumours, infections, erectile dysfunction, surgeries, radiation, chemotherapy etc. Idiopathic causes are smoking, alcohol, chronic health problems, varicocele and dietary habits.

Evaluation of Male Infertility?

Evaluation starts with proper history (infertility, sexual, medical surgical, family) and physical examination. Investigations CBC, RFT, Glycemic profile, Lipid profile, hormonal profile (testosterone, LH, FSH, TSH, prolactin) and semen analysis. Imaging includes scrotal doppler USG and transrectal USG/MRI pelvis. Special investigations are post ejaculatory urine analysis, antisperm antibodies, sperm DNA fragmentation, Karyotyping and genetic testing.

How to prevent infertility in males

If the reason is congenital, it can be hard to prevent infertility, but if the reason is lifestyle, illness, or injury, there are a few steps you can take:

  • Maintain healthy BMI
  • Avoid unhealthy indulgences such as alcohol and tobacco
  • Avoid wearing tight undergarments
  • Eat healthy, balanced, and nutritious food
  • Ensure that your immunity is high by exercising and maintaining a fit lifestyle
  • Adequate sleep

Which doctor to consult for male infertility?

You should first visit an Andrologist/Urologist for comprehensive evaluation. Although in most cases, the male abnormalities are detected during evaluation of the partner by the gynaecologist, male partners should be referred to the specialists when there is.

  • Abnormality identified in basic evaluation (Semen analysis / Hormonal)
  • Couples with unexplained infertility (male and female investigations normal)
  • Couples failing to conceive despite successful treatment of female factor
  • Patients about to undergo gonadotoxic treatment (chemotherapy/radiotherapy) who might desire future fertility

Treatment of male infertility

Depending on the cause, the andrology doctor may suggest any of the following treatments:

  • Antibiotics : Antibiotics are prescribed if there’s an infection in the reproductive tract.
  • Counselling and medication : This course of treatment is suggested to help with erectile dysfunction, sexual dysfunction, and premature ejaculation.
  • Hormonal replacement : Abnormal levels of certain hormones can cause infertility. To tackle that, the doctor may suggest hormone replacement therapy or medications.
  • ART : Assisted Reproductive Technology is used for in vitro fertilization. Surgical extraction of the sperm (TESA, m-TESE, MESE) may be carried out in this process if normal ejaculation is difficult.
  • Surgery : A conditions where obstruction is diagnosed may require surgery, such as vasovasostomy, vasoepididymostomy, TURED and microsurgical varicocele repair.


Counselling and medication

Hormonal replacement




At AINU, we have world-class Andrologist/ Urologists in hyderabad who will help you overcome these problems by recommending the best form of treatment.