Male Factor Infertility and IVF
Approximately half of all infertility involves a male factor — and that is half of our diagnostic and treatment attention. Modern fertility care evaluates and treats the male side with the same depth as the female side. Semen analysis is the starting point, not the conclusion. Sperm DNA fragmentation, hormonal evaluation, and where appropriate, surgical sperm retrieval are part of the integrated pathway. The aim is not to identify a single factor and assign blame — it is to optimise both partners’ contribution to the cycle.
Our approach to male-factor infertility
Male evaluation begins with a WHO-2021-criteria semen analysis. Abnormal findings trigger a second sample to rule out lab or sampling variability. Where abnormalities persist, deeper testing — DNA fragmentation, hormonal panel, scrotal ultrasound, urology referral — is added selectively. The clinical decision is informed by the female workup in parallel; the cycle plan calibrates ICSI vs IVF and additional techniques (IMSI, PICSI, MACS) based on the combined picture.
Sperm DNA fragmentation
Standard semen analysis measures concentration, motility, and morphology — but two samples with identical parameters can have very different DNA integrity. DNA fragmentation testing is added where there is recurrent miscarriage, prior unexplained IVF failure, advanced paternal age, or known lifestyle risk factors. High fragmentation may direct toward antioxidant therapy, varicocoele evaluation, or surgical sperm retrieval.
Surgical sperm retrieval — TESA / PESA
For azoospermia (absence of sperm in ejaculate), TESA (testicular sperm aspiration) or PESA (percutaneous epididymal sperm aspiration) retrieve viable sperm for ICSI. The technique selection depends on whether the cause is obstructive or non-obstructive. Where indicated, urology collaboration is integrated.
Male-factor topics
Male Infertility Treatment in Ahmedabad | Balaji Horizon
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Sperm DNA Fragmentation — The Hidden Male Factor
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TESA / PESA Sperm Retrieval in Ahmedabad | Balaji Horizon
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Guidelines we follow
- WHO Laboratory Manual for the Examination of Human Semen (2021)
- ESHRE Andrology Guidelines
- EAU Guidelines on Male Infertility
- AUA-ASRM joint guidelines on male infertility
Dr Patel leads fertility care at Balaji Horizon, integrating reproductive surgery and IVF into a single plan — ethical, evidence-based and individualised, with realistic expectations and no overpromising of success.
Male factor — tests and options
| Finding | Option |
|---|---|
| Low count or motility | ICSI |
| High sperm DNA fragmentation | Lifestyle, antioxidants, surgical sperm |
| No sperm in ejaculate | TESA / PESA with ICSI |
Frequently asked questions
Can IVF work with a low sperm count?
Often yes. ICSI, where a single sperm is injected into each egg, allows fertilisation even with very low counts or motility. The right technique depends on the semen analysis and, sometimes, further tests.
What is sperm DNA fragmentation?
It measures damage to the genetic material in sperm, which can affect fertilisation, embryo quality and miscarriage risk. It is tested in selected cases and can guide treatment, including lifestyle changes or surgical sperm retrieval.
What if there is no sperm in the ejaculate?
Surgical sperm retrieval (TESA or PESA) can recover sperm directly from the testis or epididymis for use with ICSI, allowing many men with azoospermia to have a biological child.
Individualised IVF and fertility planning with honest, evidence-based counselling — and realistic expectations from the very first consultation.
Where this fits
Male evaluation runs in parallel with female evaluation and informs cycle planning. For laboratory techniques designed for male factor, see lab techniques.
For a specialist IVF consultation, contact Balaji Horizon Women’s Hospital.
WhatsApp the hospital · +91 97234 31544 · Science City Road, Ahmedabad 380060
Dr. Priyadatt Patel
Senior Gynecologist · Advanced Laparoscopic Surgeon · IVF and Endometriosis Programme Lead
MS OBGyn · Pregnancy Care · Advanced Gynaecological Ultrasound · Fertility Preservation
ESHRE / ESGE / AAGL / ASRM guideline-aligned practice. 3D Karl Storz precision technique. Fertility-preservation-first philosophy. Evidence-based decisions, honest counselling, long-term outcomes orientation.
Science City Road, Ahmedabad 380060
Mon–Sat 11:00–20:00 · +91 97234 31544
Naranpura, Ahmedabad
Mon–Sat 08:30–10:30 · +91 70460 02566
