Many couples begin fertility testing after trying to conceive for some time. In some cases, the first concern is found through a semen analysis.
The report may show low sperm count, poor sperm movement, abnormal sperm shape, very low semen volume, or no sperm seen in the sample. These results can feel worrying, but they do not always mean pregnancy is impossible.
Male fertility problems need to be assessed carefully. A fertility clinic will usually review the semen analysis along with medical history, hormone levels, previous surgery, infections, lifestyle factors, and the female partner’s fertility assessment.
At Janini IVF, Delhi, male infertility is assessed as part of a complete fertility evaluation. This helps the clinical team understand whether treatment may involve monitoring, medicines, IUI, IVF with ICSI, or sperm retrieval procedures such as TESA or micro-TESE.
Male infertility means that a sperm-related concern may be affecting the chance of pregnancy.
This may happen because of:
low sperm count
poor sperm movement
abnormal sperm shape
no sperm seen in the semen sample
very low semen volume
blockage in the sperm passage
hormone-related concerns
problems with sperm production
Male infertility is common, and it is not always visible through symptoms. This is why semen analysis is usually one of the first tests advised during fertility evaluation.
A semen analysis is a test used to check sperm health.
It looks at the semen sample to understand:
how much semen is present
how many sperm are present
how well the sperm are moving
what shape the sperm are
whether there are signs of infection or other concerns
If the semen analysis is abnormal, the test may need to be repeated. Sperm results can change from one sample to another.
A fertility clinic will not usually make treatment decisions from one number alone. The result is reviewed with the full fertility picture.
Low sperm count means that the semen sample has fewer sperm than expected.
This can reduce the chance of sperm reaching and fertilising the egg naturally. The effect depends on how low the count is, how well the sperm are moving, and whether there are other fertility factors.
Low sperm count may be linked to hormone issues, infection, varicocele, previous surgery, medicines, smoking, alcohol, heat exposure, or genetic factors.
In some cases, treatment or lifestyle changes may help. In other cases, fertility treatment may be needed.
Low sperm count can sometimes be improved, depending on the cause.
A fertility specialist may advise further tests to check hormones, infection, varicocele, medical history, or lifestyle factors. If a treatable cause is found, medical treatment or lifestyle changes may be discussed.
However, if the sperm count is very low, or if there are other sperm-related concerns, IVF with ICSI may be considered. ICSI can help because a single sperm is used to fertilise an egg in the laboratory.
No sperm count usually means that no sperm were seen in the semen sample. The medical term for this is azoospermia.
This can be very difficult to hear, but it does not always mean that sperm are absent from the body.
In some cases, sperm may still be produced in the testicles but may not be reaching the semen because of a blockage. In other cases, sperm production may be very low.
Further testing is needed to understand the reason.
In some cases, yes.
If no sperm are seen in the semen sample, the next step is to understand why. A fertility clinic may advise repeat semen analysis, hormone tests, examination, ultrasound, or genetic testing in selected cases.
If sperm are being produced but not reaching the semen, sperm retrieval may be possible. If sperm are retrieved, IVF with ICSI may be used to support fertilisation.
The treatment plan depends on whether sperm production is happening, whether there is a blockage, and what the couple’s full fertility assessment shows.
Azoospermia means that no sperm are found in the semen sample.
There are two broad types of azoospermia:
Obstructive azoospermia, where sperm production may be happening, but a blockage prevents sperm from reaching the semen
Non-obstructive azoospermia, where sperm production in the testicles may be very low or affected
Azoospermia needs careful assessment because the treatment pathway depends on the cause. Some patients may need further testing, while others may be advised to consider sperm retrieval and IVF with ICSI.
Sperm retrieval is a procedure used to collect sperm directly from the male reproductive system.
It may be considered when sperm are not found in the semen sample, when sperm count is extremely low, or when there may be a blockage preventing sperm from reaching the semen.
Sperm retrieval may be discussed in cases of:
azoospermia
very low sperm count
suspected blockage
previous vasectomy
severe male factor infertility
cases where sperm are needed for IVF with ICSI
If sperm are retrieved, they are often used in IVF with ICSI.
TESA stands for testicular sperm aspiration.
It is a sperm retrieval procedure where sperm are collected directly from the testicle using a needle.
TESA may be considered when sperm are not available in the semen sample but sperm production may still be happening in the testicle.
The retrieved sperm may then be used during IVF with ICSI.
Micro-TESE stands for microsurgical testicular sperm extraction.
It may be considered when no sperm are found in the semen sample and sperm production in the testicle may be very low.
During micro-TESE, the testicular tissue is examined carefully under magnification to look for areas where sperm may be present.
Micro-TESE is usually discussed in selected cases of non-obstructive azoospermia. It is not needed for every patient with male infertility.
TESA and micro-TESE are both sperm retrieval procedures, but they are used in different situations.
TESA is usually a needle-based procedure. It may be considered when sperm production is likely to be present but sperm are not coming out in the semen.
Micro-TESE is a microsurgical procedure. It may be considered when sperm production is very low and sperm are harder to find.
The choice depends on the type of azoospermia, hormone results, testicular assessment, medical history and treatment plan.
IVF with ICSI may be advised when sperm-related concerns make fertilisation more difficult.
ICSI is used during IVF. In ICSI, a single sperm is injected directly into an egg in the laboratory.
IVF with ICSI may be discussed when there is:
very low sperm count
poor sperm movement
abnormal sperm shape
no sperm in the semen sample
sperm retrieved through TESA or micro-TESE
previous fertilisation failure
severe male factor infertility
ICSI is not separate from IVF. It is a method used within IVF when fertilisation needs extra support.
No, male infertility does not always mean IVF is needed.
Some mild sperm-related concerns may be treated or monitored. In some cases, medicines, infection treatment, lifestyle changes, or further evaluation may be advised.
However, IVF with ICSI may be discussed sooner when the sperm count is very low, sperm movement is poor, no sperm are seen in the sample, or sperm need to be retrieved surgically.
The right treatment depends on the cause and severity of the male fertility concern, as well as the female partner’s fertility assessment.
Men should consider visiting a fertility clinic if a semen analysis shows low sperm count, poor sperm movement, abnormal sperm shape, no sperm count, or very low semen volume.
A consultation may also be useful if there has been previous testicular surgery, previous vasectomy, a history of infection, hormone-related concerns, or repeated difficulty conceiving despite regular attempts.
Male fertility testing is an important part of fertility care. It helps avoid delay and allows the couple’s treatment plan to be based on both partners’ results.
At Janini IVF, Delhi, male infertility is assessed as part of a complete fertility evaluation.
If you have been told you have low sperm count, no sperm count, azoospermia, or may need sperm retrieval, it is natural to have questions about what this means.
A structured consultation at Janini IVF can help review semen analysis, sperm health, hormone findings and the couple’s overall fertility history.
Based on the findings, the fertility clinic can guide whether monitoring, medical treatment, IUI, IVF with ICSI, TESA or micro-TESE may be suitable for your situation.
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