Infertility is a growing concern worldwide, affecting roughly 1 in 6 couples according to the World Health Organization (WHO), with male factors contributing to around 50% of these cases. While the focus often falls on women's health, a significant portion of infertility cases involve male factors. Beyond celebrating the incredible strides in assisted reproduction, World IVF Day, marked annually on July 25th, serves as a vital reminder that male fertility is just as crucial for conception as female fertility. Often, the conversation surrounding infertility focuses on women's health. However, this day brings the spotlight to the significant role men play in family planning. On World IVF Day, Dr. Kshitiz Murdia, CEO and co-founder of Indira IVF and Dr Priyank Kothari, consultant andrologist and assistant professor at B.Y.L Nair Ch Hospital, Mumbai delve into fertility challenges faced by men, and the benefits of assisted reproductive technology.

Prevalence and causes of male infertility in India

“We are facing a pandemic of non-communicable diseases in India, with a manifold rise in diabetes, hypertension dyslipidemia and other environmental and lifestyle-related illnesses. Infertility is among these and it is estimated that 15 to 20 per cent of couples in India suffer from infertility. Infertility in a couple can be due to either male factors, female factors or both. Male infertility contributes to 40 to 50 per cent of all cases. Exposure to environmental toxins such as lead and mercury, age, lifestyle factors such as smoking, obesity, drug and alcohol abuse and lifestyle stresses are the main causes of decline in male fertility over the past decade,” explains Dr Priyank Kothari.

Comprehensive diagnosis and understanding of male infertility

Unfortunately, despite the high prevalence of male infertility in India, there is still a lack of awareness about the condition and its causes. “The 1st step in evaluating a couple for infertility should be a Semen Analysis and any couple unable to conceive after 12 months of unprotected intercourse can be labelled infertile and needs to consult an expert for evaluation,” poses Kothari.

He elaborated, “The diagnosis of the male factor contributing to infertility is confirmed by a semen analysis done after 2 to 3 days of abstinence. At least 2 semen samples a month apart are usually required for an accurate estimation as there is considerable physiological variation in the semen parameters of a normal male. There can be a decrease in count, Concentration (Oligozoospermia), motility (Asthenozoospermia), quality of sperms (Teratozoospermia), or a combination of factors. The cause can be due to hormonal deficiency, testicular dysfunction, or external factors. Varicocele can be a very common cause of poor counts and motility (dilated veins above the testis signifying poor blood flow) and is a surgically correctable cause of male infertility.  In 10 % of men with sub fertility there can be a complete absence of sperms in the ejaculate (Azoospermia).”

Murdia adds, “ART employs a range of diagnostic tools, including semen analysis, DNA fragmentation testing, hormonal evaluations, and genetic screening. These tests provide comprehensive insights into sperm quality, quantity, and genetic integrity, as well as potential structural or hormonal issues. This thorough approach enables fertility specialists to develop tailored treatment plans and select the most appropriate ART techniques for each case, maximising the chances of successful outcomes.”