Male Infertility

Causes of Male Infertility

Male factors contribute to nearly half of all infertility cases - yet they're often the last thing examined.

At Dr. Rama Sofat Hospital, a simple semen analysis is just the beginning. We identify the cause - structural, hormonal, genetic, or lifestyle - and map a clear path forward.

40-50% of infertility cases involve a male factor - alone or in combination
30% of male infertility is caused by varicocele - one of the most treatable conditions
1 test a semen analysis is the starting point - non-invasive, quick, and highly informative

The Causes

01

Semen analysis

Low Sperm Count

Fewer than 15 million sperm per millilitre is considered low (oligospermia). It's one of the most common reasons conception is delayed.

  • Hormonal imbalances (low testosterone, FSH/LH)
  • Varicocele — enlarged veins in the scrotum
  • Genetic conditions like Klinefelter syndrome
  • Prior infections affecting the testes
  • Heat or radiation exposure
02

Often reversible

Poor Sperm Motility

Sperm must swim actively to reach the egg. When movement is impaired (asthenozoospermia), even a healthy count may not be enough.

  • Smoking, alcohol, and recreational drug use
  • Zinc or antioxidant deficiencies
  • Heat exposure — laptops, saunas, tight clothing
  • Reproductive tract infections
03

ICSI can help

Abnormal Sperm Shape

Sperm with structural defects (teratozoospermia) may struggle to penetrate the egg — even when count and motility look normal.

  • Genetic or chromosomal defects
  • Exposure to toxins or environmental pollutants
  • Chemotherapy or radiation treatment
  • Oxidative stress from poor diet or chronic illness
04

Surgically correctable

Varicocele

Enlarged veins in the scrotum raise testicular temperature, directly harming sperm production. Found in roughly 30% of men evaluated for infertility — yet often causes no symptoms.

  • Often silent — detected only during evaluation
  • Corrected through a minor surgical procedure
  • Sperm quality typically improves within 3–6 months
05

Blood tests

Hormonal Imbalances

Sperm production is regulated by a hormone chain from the brain to the testes. A disruption at any point can reduce sperm count significantly.

  • Low testosterone
  • FSH and LH deficiency from pituitary disorders
  • Thyroid abnormalities (both hypo and hyper)
  • Anabolic steroid use suppresses natural production
06

Sperm retrieval possible

Ejaculation Disorders

Some men produce healthy sperm but face problems with delivery — due to a blockage or nerve-related issue. Sperm can often still be retrieved for IVF or ICSI.

  • Retrograde ejaculation — sperm enters the bladder
  • Blocked ejaculatory ducts
  • Nerve damage from diabetes or spinal injury
  • Anejaculation — no ejaculation at all
07

Genetic testing

Genetic causes

Certain genetic conditions affect sperm production at its core — often with no outward signs. These are identified through specialised testing when no obvious cause is found.

  • Klinefelter syndrome (XXY) — impairs testicular function
  • Y-chromosome microdeletions
  • Cystic fibrosis gene mutations — can cause absent vas deferens
08

First step: lifestyle

Lifestyle & environmental factors

Daily habits have a measurable impact on sperm health — and many of these causes are reversible with the right guidance.

  • Smoking, alcohol, and recreational drugs
  • Obesity and poor metabolic health
  • Chronic stress and sleep deprivation
  • Saunas, hot baths, or tight underwear
  • Pesticides or chemical exposure
09

Advanced semen analysis

Unexplained male infertility

When standard tests look normal but pregnancy doesn't happen, the issue may be invisible in a routine semen analysis. Deeper investigation often finds an answer.

  • DNA fragmentation — damaged genetic material in sperm
  • Oxidative stress in the semen environment
  • Sperm-egg binding failure at fertilisation

Have concerns about your fertility?

Our male fertility specialists run a thorough evaluation - from basic semen analysis to advanced genetic and hormonal testing - and give you clear answers, not guesswork. Led by Dr. Rama Sofat, Dr. Amit Sofat and Dr. Ruchika Sofat — Dr. Rama Sofat Hospital, Ludhiana.