Male Infertility Treatment in Ahmedabad | Causes & Diagnosis | Wellspring IVF
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
~30%
~20%
~50%
Watch Our ICSI for Male Infertility Treatment Video
Learn about the common causes of male infertility and the treatment options available including ICSI to improve pregnancy chances.
The Semen Analysis — What It Measures & What Normal Looks Like
| 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 sperm 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.
What Our Patients Say
A special thank you to Dr. Pranay Shah for his confidence, guidance, and the way he explained everything so patiently. His positive approach gave me so much strength, and today I am blessed with my baby.
Thank you to each and every member of the hospital for taking such great care of me and supporting me throughout this journey. Forever grateful. 💕
He is, without a doubt, the most patient doctor I have ever met. Of course, treatment can be done by many. What truly sets him apart is his maturity, the way he pauses, explains, comforts, and most importantly, seeks your permission before moving forward. You never feel rushed. You never feel unheard. You feel respected.
And the staff deserves equal appreciation. They handle even the most anxious and impatient moments with such calm grace and dignity that you slowly find your own heartbeat settling down. It feels less like a clinic and more like a safe space.
I wholeheartedly recommend him to anyone who overthinks, seeks reassurance, or simply needs a doctor who believes comfort is the first step of healing. With him, care begins long before the treatment does.
Highly recommend for their expertise, kindness and dedication. "Turned out dream into reality"
Our gratitude also extends to everyone in your clinic who offered a smile, reassurance, technical support, or a listening ear along the way. We feel incredibly blessed to have chosen your practice for our journey, and we will always cherish the precious gift you helped us receive.
Thank you, from the bottom of our hearts, for making our dream a reality.
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Male Infertility Conditions — Your Complete Guide
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.
Book a Private Semen Analysis — Results Same Day
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
Step-by-Step Male Fertility Evaluation at Wellspring IVF
- 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.
- 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.
- Hormonal Blood Panel: FSH, LH, Total Testosterone, Prolactin, TSH, Oestradiol. Day 2 fasting sample. Identifies pituitary and gonadal hormone deficiencies.
- Scrotal Doppler Ultrasound: Checks for varicocele (Grades 1–3), testicular volume, epididymal fullness (suggestive of obstruction), and any masses.
- Genetic Testing (if indicated): Y-chromosome microdeletion panel + Karyotype for Azoospermia or severe Oligospermia. CFTR gene mutation if CBAVD suspected.
- Semen Culture: Checks for bacterial infection causing sperm agglutination (clumping) and DNA damage. Important in cases with elevated WBC on semen analysis.
Your Fertility Consultant
Our fertility specialists are committed to providing personalized, compassionate care with
the latest reproductive medicine techniques.
Dr. Pranay Shah
Divyesh Bhalodia
Urmi Chauhan
Treatment Options — Matched to Your Specific 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
Frequently Asked Questions
Should the male partner be tested at the same time as the female?
Absolutely yes. This is our standard protocol at Wellspring IVF. We investigate both partners simultaneously from the first consultation. This prevents the all-too-common scenario where months of female treatment proceed before a simple semen analysis reveals the primary issue is male. A semen analysis costs a fraction of any female fertility investigation — there is no clinical or financial reason to delay it.What is the cost of a semen analysis in Ahmedabad?
At Wellspring IVF & Women’s Hospital, a comprehensive WHO-standard semen analysis is available in our in-house andrology lab. The test is affordable and results are available within 45–60 minutes. Dr. Shah personally reviews all reports and explains findings in detail at your consultation. Call 9099946050 for current pricing and to book.Is male infertility inherited? Will my son have the same problem?
It depends on the cause. Most lifestyle, hormonal, and varicocele-related causes are not inherited. However, genetic causes — particularly Y-chromosome microdeletions — can be passed to a son born through ICSI. Dr. Shah discusses Preimplantation Genetic Testing (PGT) in these cases, which can screen embryos before transfer to select those unaffected by the deletion.Can a man with zero sperm count (Azoospermia) have a biological child?
In most cases of Obstructive Azoospermia — yes. We can retrieve sperm directly from the testes (TESA) or epididymis (PESA) and use it for ICSI. Even in Non-Obstructive Azoospermia, Micro-TESE finds sperm in 50–60% of cases. Read the complete guide: Azoospermia Treatment at Wellspring IVF.My count is low but I had a child 3 years ago. What changed?
This is secondary infertility from a male perspective, and it is more common than most people realise. Sperm parameters naturally decline with age and are highly sensitive to lifestyle changes — weight gain, increased alcohol use, a new varicocele developing, or chronic stress can all reduce count significantly over 2–3 years. A varicocele, in particular, is known to develop and worsen progressively over time. A repeat semen analysis is the essential first step.How long does the male infertility evaluation take at Wellspring IVF?
A complete initial evaluation — semen analysis, consultation with Dr. Shah, and a hormonal blood test — can be done in a single morning visit. The semen analysis result is available the same day. Blood test results return within 24–48 hours. Dr. Shah then presents a clear diagnosis and treatment plan at a follow-up consultation.Is it possible to have a normal semen analysis but still be infertile?
Yes — through high sperm DNA fragmentation (DFI). A man’s semen analysis can show normal count, normal motility, and normal morphology, yet his sperm carry damaged DNA that prevents fertilisation or leads to early miscarriage. DFI testing is separate from standard semen analysis and is recommended for couples with unexplained infertility, recurrent IVF failure, or recurrent miscarriage.
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