Low sperm count
Fewer sperm than the WHO reference. Often has a cause worth treating.
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CONDITIONS · HIS FERTILITY
About half the time, it involves him. It starts with one test.
Male infertility means a problem with how many sperm there are, how they move, their shape, or how they get out. It rarely causes symptoms, so the only way to know is a semen analysis.
- Common, and usually silent
- Found with a semen test
- Tested in the first round
- Many causes are treatable
- Testis — Where sperm is made (low count, no production)
- Epididymis — Where sperm matures (blockage, infection)
- Vas deferens — The tube out (vasectomy, missing vas, hernia repair)
- Ejaculation — How sperm leaves (retrograde, erection problems)
01What is male infertility?
Male infertility is a problem with sperm production, sperm quality or sperm delivery that lowers a couple's chance of pregnancy.
It is not a verdict on his health, his strength or his worth. Most men with a sperm problem feel completely well. Erections, sex drive and the look of the semen are usually normal. That is why it is often found late, and only when someone thinks to test.
02How common is male infertility?
A male factor is part of the reason in about half of couples who struggle to conceive.
Sometimes it is the only reason. More often it sits alongside a female factor. Either way, treating only her while his result is unknown can cost a couple a year. Testing both partners together is the shortest road to a plan.
Honest note
A male factor is solely responsible in about 1 in 5 infertile couples and contributes in another 30 to 40% (AUA/ASRM guideline). Yet many couples arrive having had months of female treatment and no semen test. (What the evidence says)
03What is a male fertility test?
The first male fertility test is a semen analysis: a lab count of sperm number, movement and shape, read against the WHO 2021 reference values.
The sample is produced after 2 to 7 days without ejaculation, collected whole, and tested within an hour. One abnormal result is not a diagnosis. Counts vary a lot from week to week, so an abnormal result is repeated before any plan is made. If it is still abnormal, an examination and hormone blood tests come next.
Semen analysis: how to read your report04What causes male infertility, and what do we do about it?
The main causes are low sperm production, a blockage, a varicocele, hormone problems, genetic causes and ejaculation or erection problems, and the treatment follows the cause.
Some causes are reversible: testosterone or steroid use, a hormone deficiency, infection, thyroid or diabetes control, some medicines. Some need surgery or sperm retrieval. When the cause cannot be fixed, IUI or IVF with ICSI works around it. Examination and surgery are done with andrology support [CONFIRM: in-house or named urologist or andrologist].
05What can he do to improve sperm?
Stopping smoking, cutting alcohol, reaching a healthy weight, keeping the testes cool and stopping any testosterone or steroids are the changes with the clearest evidence.
Sperm takes about 2 to 3 months to make, so changes show in a report after that, not before. Lifestyle helps most when the problem is mild. It cannot fix a blockage or a genetic cause, and no supplement course is a cure.
Honest note
Lifestyle, led by a healthy weight. Then smoking, alcohol, about seven hours of sleep, stress, folic acid, and correcting thyroid, diabetes, blood pressure and vitamin D. (Dr Vani Sundarapandian, Medical Director, on the factor couples can influence most)
Six conditions, one page each.
Start with the one on his report.
Obstructive azoospermia
No sperm in the sample because of a blockage. Production is usually fine.
Non-obstructive azoospermia
The testes make little or no sperm. What can still be checked.
Varicocele
Swollen veins in the scrotum. Repair helps some men, not all.
Ejaculation problems
Premature, delayed, retrograde or none. Common and treatable.
Erectile dysfunction
A health signal, not a verdict on fertility.
Does this sound like you?
Any one of these is a reason to book a semen analysis.
- We've tried for a year and he hasn't been tested
- His report says low count, or no sperm
- He's used testosterone or gym steroids
- He had mumps, a hernia repair or undescended testes
- Erection or ejaculation is difficult
- Her tests are normal and we still aren't pregnant
Just starting to look into it together? Begin with a first consultation for both of you.
What we try, in order.
- 1
Semen analysis, repeated if abnormal
Two results, a few weeks apart, before anything is decided.
- 2
Examination and hormone tests
Testis size, the vas, any varicocele. FSH, LH, testosterone, prolactin. Genetic tests if the count is very low or zero.
- 3
Treat what can be treated
Stop steroids, correct hormones, treat infection, control diabetes or thyroid, repair a varicocele when it is likely to help.
- 4
IUI for a mild problem
When the washed sample is good enough and her tests allow it, with a cycle limit agreed first.
- 5
IVF with ICSI
When the count is very low. One sperm is injected into each egg.
- 6
Sperm retrieval, or donor sperm
When there is no sperm in the sample. If none can be found, we say so.
His first visit
1
Talk
His health, medicines, supplements, gym use, past surgery and any old semen reports.
2
Test
Semen analysis, examination and hormone blood tests. Her tests run in the same round.
3
Plan
What the results mean for both of you, and which step comes first.
4
Treat
Fix what is fixable, then IUI, ICSI or retrieval if needed. No step repeated without a review.
Questions men ask
Still unsure? Ask us on WhatsApp — a real person replies.
Where can I get a male fertility test in Chennai?
Jananam Fertility Centre offers semen analysis and male fertility consultations at Neelankarai, off ECR, and at Thiruporur [CONFIRM]. Message us on WhatsApp and we will give you a time and the collection instructions.
Should the husband be tested first?
He should be tested at the same time as her, in the first round. A semen analysis is simple and quick, and without it no one can plan her treatment properly.
Can I come for a semen test on my own?
Yes, a man can book a semen analysis and a consultation on his own [CONFIRM]. Many men prefer to see the result first and then plan together.
What does a semen analysis check?
A semen analysis checks the volume, sperm count, how many sperm move and how well, their shape, and whether they are alive. The results are read against the WHO 2021 reference values.
Is male infertility treatable?
Often, yes: many causes can be corrected, and when they cannot, IUI, ICSI or sperm retrieval can work around them. When no sperm can be found at all, we say so plainly and talk through donor sperm and other options.
Can I see a male doctor?
. Everything he tells us stays between him, his partner if he wishes, and the doctor.
Do sperm supplements work?
There is no strong evidence that antioxidant or sperm supplements improve the chance of a baby. Tell us what he takes; we would rather spend the time finding a cause that can be treated.
In their words, not ours.
Geetha M.
· Google
She prescribes only the very necessary investigations and medications, maintaining high standards and ethics.
Patient from USA
· Practo
We found Dr Vani to be straightforward about the course of treatment we should take without mincing words or making false promises.
Sources (4)
- World Health Organization: WHO laboratory manual for the examination and processing of human semen, 6th edition (2021)
- AUA / ASRM: Diagnosis and treatment of infertility in men: AUA/ASRM guideline
- European Association of Urology: EAU Guidelines on Sexual and Reproductive Health
- NHS: Infertility: causes
One test answers a lot.
Book his semen analysis and a private consultation. A real person from Dr Vani's team replies on WhatsApp, usually within minutes during clinic hours (Mon to Sat, 9am to 5pm. Sunday closed.).
Chat on WhatsAppCall +91 89399 94244
Sex selection is prohibited in India under the PCPNDT Act, 1994 and the ART Act, 2021.