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Male Infertility Treatment in Ahmedabad | Causes & Diagnosis | Wellspring IVF

Male Infertility Causes & Diagnosis in Ahmedabad

50% of the Equation. 100% of Our Attention.
Male infertility causes 50% of conception failures. Dr. Pranay Shah diagnoses the real reason — low count, zero sperm, poor motility — and builds a personalised treatment plan. Semen analysis & consultation in Ahmedabad.
✓ Medically reviewed by Dr. Pranay Shah, MS (ObGy)

Male Infertility Treatment in Ahmedabad — 50% of the Equation. 100% of Our Attention.

When a couple cannot conceive, the conversation almost always starts with the woman. Tests are arranged for her. Specialist appointments are made for her. She carries the emotional weight of investigation while the man waits.

This is medically wrong. Male factor infertility is the sole or contributing cause in approximately 50% of all infertility cases. And yet, in many couples we see at Wellspring IVF, the man has never had a single test done.

The semen analysis — a painless, 30-minute test — is one of the most informative and most underutilised investigations in fertility medicine. It gives us a complete picture of sperm count, motility, morphology, and DNA health. And critically: a low result is not a reflection of masculinity. It is a medical variable. Nothing more, nothing less.

At Wellspring IVF & Women’s Hospital, Dr. Pranay Shah treats the man as a patient — with his own diagnosis, his own treatment plan, and his own clinical pathway. Not as an afterthought. Not as just a sample provider. As half of the equation.

A Number Is Not Your Identity

A sperm count of 3 million/mL does not say anything about who you are as a man.It says something about a biological variable that, in most cases, we can treat. The men who come to us are not less. They are proactive.

The 50% Statistic — Why Male Testing Is Non-Negotiable

When couples struggle to conceive, fertility investigation is often framed as a 'female problem.' Clinical evidence tells a very different story:

~30%

Male factor only

~20%

Both male + female

~50%

Total cases with male contribution
This is why at Wellspring IVF, we investigate both partners simultaneously from Day 1. We do not spend months treating only the female partner before discovering a male factor that changes the entire treatment strategy. It wastes time, money, and emotional reserves that couples cannot afford to lose.

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The Semen Analysis — What It Measures & What Normal Looks Like

The semen analysis is the first and most important test in male fertility evaluation. The man produces a sample in a private room at our clinic, and our in-house andrology lab returns a complete report within 45–60 minutes. Here is what it measures:
Parameter WHO 2021 Normal Fertility Impact If Abnormal
Count ≥ 16 million / mL Primary — enough sperm to reach the egg Oligospermia → see child page
Total Motility ≥ 42% (all moving) Sperm must swim to reach the egg Asthenospermia — treated with meds/ICSI
Progressive Motility (PR) ≥ 30% Forward swimmers — critical for fertilisation Key indicator for IUI vs ICSI decision
Morphology ≥ 4% (Kruger Strict) Shape determines egg-penetration ability Teratospermia — ICSI bypasses this
Volume ≥ 1.4 mL Low volume may indicate blocked ducts Investigate accessory glands
pH ≥ 7.2 Acidity damages sperm Investigate infection / obstruction
WBC < 1 million / mL High WBC = infection causing sperm damage Treat infection first
DNA Fragmentation (DFI) < 15% ideal Damaged DNA = fertilisation failure / miscarriage Advanced ICSI / lifestyle change

 

The Test That Many Men Skip — Sperm DNA Fragmentation (DFI)

A standard semen analysis tells us count, motility, and morphology. But it does NOT tell us about sperm DNA quality. A man can have a perfectly normal semen analysis and still have high DNA fragmentation — meaning his sperm appear fine but carry damaged genetic instructions.

High DFI (above 25%) is associated with:

  • Repeated IUI failures despite reasonable sperm count
  • Repeated IVF failures despite fertilisation occurring
  • Recurrent early miscarriage where female factors have been ruled out

Dr. Shah recommends DFI testing in cases of unexplained infertility, recurrent IUI/IVF failure, and recurrent miscarriage. Available in-house at Wellspring IVF. Call 9099946050 to arrange.

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Male Infertility Conditions — Your Complete Guide

Select the condition most relevant to your semen analysis report. Each page contains full clinical detail, treatment options, and Dr. Shah's approach:

Azoospermia — Zero Sperm Count

No sperm detected in ejaculate. Obstructive vs. Non-Obstructive. TESA/PESA surgical retrieval + ICSI — biological fatherhood is often still possible. TESA cost: ₹25,000.

Oligospermia — Low Sperm Count

Sperm count below 16 million/mL. Lifestyle-first approach — varicocele, hormonal correction, supplements. IUI for mild cases. ICSI for severe. Most treatable male infertility diagnosis.

Poor Sperm Motility — Asthenospermia

Sperm count is adequate but sperm cannot swim properly. Progressive motility below 30%. Causes: oxidative stress, varicocele, infection. Treated with lifestyle changes, antioxidants, or ICSI.

Common Causes of Male Infertility — What Dr. Shah Investigates

Unlike female infertility — where a scan can immediately reveal fibroids, cysts, or blocked tubes — male infertility is invisible to the naked eye. It requires systematic lab and imaging investigation. Here is our complete approach:

Varicocele — Present in 35–40% of Infertile Men

What it is: Enlarged varicose veins inside the scrotum that raise testicular temperature by 1–2°C. Sperm production requires temperature precisely 2–3°C below body temperature. Even a small rise causes measurable damage to count, motility, and DNA.

Why it matters most: Varicocele is the single most common reversible cause of male infertility. Found in 35% of men with primary infertility and up to 80% of men with secondary infertility.

Diagnosis: Scrotal Doppler ultrasound — this cannot be reliably detected on physical examination alone. Dr. Shah arranges a Doppler scan for all men with abnormal semen parameters.

Treatment: Microsurgical or laparoscopic varicocelectomy. In 60–70% of cases, sperm parameters improve significantly within 3–6 months — sometimes enough to convert an ICSI case into a natural conception or IUI case.

 Hormonal Imbalance — The Often-Missed Cause

Primary hypogonadism: Testes fail to produce adequate testosterone despite normal pituitary signals. FSH is elevated. Sperm production is impaired. May require HCG injections.

Secondary (hypogonadotropic) hypogonadism: The pituitary gland is not signalling the testes adequately. FSH and LH are low. Testes may respond to hormone stimulation with Clomiphene, Letrozole, or HCG.

Hyperprolactinaemia: Elevated prolactin from a pituitary adenoma suppresses testosterone. Treatable with Cabergoline. Sperm production typically recovers within 3 months.

Thyroid dysfunction: Both hypo- and hyperthyroidism impair sperm quality. A simple TSH blood test identifies this — and treatment is straightforward.

Diagnosis: Fasting blood test: FSH, LH, Total Testosterone, Prolactin, TSH, SHBG, Oestradiol.

Genetic Causes — Known Before Starting Treatment

Y-chromosome microdeletion (YCM): Deletions in the AZFa, AZFb, or AZFc regions of the Y chromosome directly impair spermatogenesis. AZFc deletions still allow TESA sperm retrieval; AZFa/b deletions typically do not. Testing before surgery is non-negotiable.

Klinefelter syndrome (47,XXY): Extra X chromosome causes primary testicular failure. Most common sex chromosome abnormality. Azoospermia is typical but Micro-TESE may find sperm in focal areas.

CFTR gene mutation: Causes Congenital Bilateral Absence of the Vas Deferens (CBAVD) — a physical obstruction. Sperm production is normal; the exit path is absent. PESA retrieves sperm from the epididymis.

Why genetic testing matters: If a Y microdeletion is passed to a son born through ICSI, he will inherit the same fertility issue. Pre-implantation genetic testing (PGT) can screen embryos before transfer. Couples are counselled on this before proceeding.

Lifestyle & Environmental Factors — Reversible With Action

Oxidative stress: The primary mechanism by which lifestyle factors damage sperm. Free radicals attack sperm membranes and DNA. Antioxidant supplementation (CoQ10, Zinc, Selenium, Vitamin C+E) significantly reduces oxidative damage.

Smoking: Reduces sperm count by up to 22%, motility by 13%, and significantly increases DNA fragmentation. Effects partially reverse within 3 months of stopping.

Alcohol: More than 5 units/week suppresses testosterone and damages sperm morphology. The effect is dose-dependent and reversible.

Obesity (BMI > 30): Increases scrotal temperature and converts testosterone to oestrogen via adipose tissue aromatisation. Losing 10% body weight can meaningfully improve sperm parameters.

Anabolic steroids / testosterone therapy: Exogenous testosterone completely shuts down the pituitary-gonadal axis. Men on testosterone therapy often have zero sperm count. Recovery after stopping can take 12–24 months and is not guaranteed.

Heat exposure: Prolonged laptop use on the lap, hot baths, saunas, and tight underwear all impair spermatogenesis. Simple behavioural changes — cooling the scrotal environment — are part of the treatment protocol.

Infection & Obstruction — The Plumbing Problem

Sexually transmitted infections (STIs): Chlamydia and gonorrhoea are the most common infectious causes of epididymal and vas deferens blockage in India. Often silent — the infection resolved years ago but left scarring.

Tuberculosis (TB): Genital TB is significantly more prevalent in India than globally. It scars the epididymis and vas deferens, causing obstructive azoospermia. Diagnosed with culture, PCR, and sometimes surgical biopsy.

Previous surgeries: Inguinal hernia repair, hydrocoele surgery, or orchidopexy can inadvertently damage the vas deferens or epididymis. History-taking is essential.

Retrograde ejaculation: Semen travels backward into the bladder instead of forward through the urethra. Common after prostate surgery, diabetes neuropathy, or certain medications. Sperm can be retrieved from urine for IUI or ICSI.

Talk to Dr. Shah About Cavity Optimisation

Dr. Pranay Shah can advise whether hysteroscopy is likely to change your implantation chances or whether another evaluation pathway is more appropriate first.

Myth vs. Fact — Busting the Stigma Around Male Infertility

The silence around male infertility is not caused by the condition itself — it is caused by misinformation. Here is the truth:

MYTH FACT
“If I can have sex, I must be fertile.” Sexual function and fertility are completely separate. Sperm quality is invisible and undetectable without a test.
“Low sperm count is permanent.” Most causes — varicocele, hormonal imbalance, lifestyle — are treatable. Count frequently improves with targeted management.
“IVF is the only option for male infertility.” Depending on severity, lifestyle changes, IUI, or varicocele surgery may restore natural conception. IVF is not always needed.
“A normal semen analysis means I’m not the problem.” Normal count/motility does NOT rule out high sperm DNA fragmentation — a hidden cause of IVF failure and recurrent miscarriage.
“Male infertility means low testosterone / low sex drive.” Most men with Oligospermia or Azoospermia have completely normal testosterone levels, libido, and erections.
“The problem is always the woman — she just needs to ‘relax’.” Male factor contributes to 50% of all infertility cases. Delaying male investigation wastes critical time.

How We Diagnose Male Infertility at Wellspring IVF

Dr. Pranay Shah's male infertility evaluation is designed to be thorough, fast, and completely private. Everything is done in-house. No referrals. No waiting for external lab reports.

Step-by-Step Male Fertility Evaluation at Wellspring IVF

  1. Semen Analysis (WHO 2021 Standard): Produced privately at our clinic. Processed in our in-house andrology lab. Count, motility, morphology, volume, pH, WBC. Report ready in 45–60 minutes.
  2. Sperm DNA Fragmentation (DFI): For cases of unexplained infertility, recurrent IUI/IVF failure, or recurrent miscarriage. A critical test that standard analysis does not cover.
  3. Hormonal Blood Panel: FSH, LH, Total Testosterone, Prolactin, TSH, Oestradiol. Day 2 fasting sample. Identifies pituitary and gonadal hormone deficiencies.
  4. Scrotal Doppler Ultrasound: Checks for varicocele (Grades 1–3), testicular volume, epididymal fullness (suggestive of obstruction), and any masses.
  5. Genetic Testing (if indicated): Y-chromosome microdeletion panel + Karyotype for Azoospermia or severe Oligospermia. CFTR gene mutation if CBAVD suspected.
  6. Semen Culture: Checks for bacterial infection causing sperm agglutination (clumping) and DNA damage. Important in cases with elevated WBC on semen analysis.

Treatment Options — Matched to Your Specific Diagnosis

Male infertility treatment is never one-size-fits-all. The treatment is entirely determined by the diagnosis:
  • Varicocelectomy: Microsurgical correction of varicose scrotal veins. Improves count and motility in 60–70% of cases within 3–6 months.
  • Hormonal Correction: Clomiphene, Letrozole, HCG, or Cabergoline depending on the hormonal deficiency identified. Prescribed for 3–6 months with repeat semen analysis to assess response.
  • Lifestyle Protocol: Structured 3-month programme covering smoking cessation, BMI correction, heat avoidance, and evidence-based antioxidant supplementation (CoQ10, Zinc, Selenium, Folate, Vitamin D).
  • IUI (Intrauterine Insemination): For mild male factor — TMSC ≥ 5 million after washing. IUI Treatment at Wellspring IVF →
  • ICSI (Intracytoplasmic Sperm Injection): For severe Oligospermia or Azoospermia — even a single viable sperm is sufficient. ICSI Treatment →
  • TESA / PESA Surgical Sperm Retrieval:
  • For Azoospermia — sperm retrieved directly from testes or epididymis under local anaesthesia, used for ICSI. Azoospermia Treatment →

“The semen analysis is the most underused test in fertility medicine. Couples spend months on female investigations — scans, hormones, procedures — before anyone thinks to check the male partner. In 3 out of 10 cases, we find the primary problem on the first male test. Three months of unnecessary female treatment, avoided in a single afternoon.”

— Dr. Pranay Shah, MS (ObGy), Director & Chief Fertility Consultant, Wellspring IVF & Women’s Hospital, Ahmedabad

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The First Step Takes 45 Minutes.

A semen analysis at Wellspring IVF is private, fast, and — most importantly — gives you real answers. Dr. Pranay Shah reviews every result personally and explains exactly what it means for your fertility journey.