Male Factor Infertility: Semen Analysis and What Couples Should Do Next

By Dr. Prithivi Perum, Obstetrician, Gynecologist, Fertility Expert & Laparoscopic and Robotic Surgeon at Mathrutva Women Healthcare, Manikonda, and Medicover Women & Child Hospitals, Hyderabad.

Quick answer: About half of couples who need help conceiving have a male factor, alone or with a female factor. A semen analysis after two to five days of abstinence looks at sperm count, movement, and shape. One abnormal report is repeated before any big decision.

Fertility is a couple’s question. Starting with only the woman’s scans delays care when sperm parameters are the limiting step. At Mathrutva Women Healthcare in Manikonda, Dr. Prithivi Perum includes the partner’s semen analysis in a fertility consultation from the first visit.

How Common Is a Male Factor?

Clinic series and WHO guidance put a male contribution in roughly half of infertile couples. It may be the only finding, or it may sit beside PCOS, endometriosis, thyroid disease, or age-related decline. Blaming one partner is neither accurate nor useful. Both results belong on the same plan.

What a Semen Analysis Checks

• Volume - how much semen is produced
• Concentration - sperm count per millilitre
• Motility - the share of sperm that move forward
• Morphology - the share with a normal shape
• Other notes - white cells, clumping, or very low volume that may need a urology review

Reference ranges describe a population, not a guarantee of pregnancy. A result just inside the range can still be a problem if the couple has tried for a long time. A result just outside the range is not a diagnosis of sterility. Fever, a recent illness, or a short abstinence gap can temporarily lower the numbers, which is why a repeat test is standard.

Causes Worth Looking For

Varicocele, hormonal imbalance, previous infection, undescended testis, certain medicines, anabolic steroids, heavy smoking, heat exposure, and obesity can all affect sperm. Some men have no clear cause. A fertility history also asks about erection and ejaculation, because those change which treatment is realistic.

Lifestyle changes - stopping tobacco, limiting alcohol, keeping a healthy weight, and avoiding unnecessary heat to the testes - are reasonable while tests are repeated. They are not a substitute for a proper report.

What Happens After an Abnormal Report

Mild reductions may still suit timed intercourse or IUI if the woman’s tubes and ovulation are favourable. Very low count or very poor movement often points toward IVF with ICSI, discussed in when to consider IVF. Azoospermia (no sperm in the ejaculate) needs a hormone panel and a urologist or andrologist before anyone assumes donor sperm is the only path.

“We do not label a man infertile from a single sample. We repeat the test, read it with the woman’s results, and then choose the simplest treatment that still has a real chance.”

- Dr. Prithivi Perum

Couples from Gachibowli, Kondapur, Madhapur, Hitech City, and Manikonda can bring an outside semen report to the visit. If it is more than a few months old, or was done without a standard abstinence window, it is usually worth repeating.

Summary

Male factor infertility is common, testable, and often treatable with the right next step. A semen analysis early in the work-up saves months.

Key Takeaways

• Test both partners before repeating ovulation medicines for the woman alone.
• Repeat an abnormal semen analysis before deciding on IVF.
• Mild changes may suit IUI; severe changes usually do not.
• No sperm in the sample needs specialist andrology review, not guesswork.