UROLOGY · CONDITIONS
Male Infertility
Abnormal sperm production, function, or delivery accounting for 50% of infertile couples , with identifiable and treatable causes found in the majority of men.
ABOUT THIS CONDITION
What is Male Infertility?
Male factor infertility contributes to approximately 50% of all infertile partnerships. Causes include varicocele (most common correctable cause), ejaculatory dysfunction, hormonal disorders, obstruction, and testicular failure. A systematic evaluation , semen analysis, hormones, genetics, and scrotal imaging , identifies a treatable cause in the majority of men. Dr. Vipin provides comprehensive male infertility evaluation and surgical treatment , from microsurgical varicocelectomy and vasectomy reversal to micro-TESE for non-obstructive azoospermia , coordinated with fertility specialists for optimal IVF/ICSI outcomes.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Varicocele , most common correctable cause (40% of infertile men)
- Obstructive azoospermia , epididymal or vasal block
- Non-obstructive azoospermia , primary testicular failure
- Hormonal deficiency , hypogonadotropic hypogonadism
- Ejaculatory dysfunction , retrograde or absent ejaculation
- Genetic causes , Klinefelter, Y chromosome microdeletion
CLINICAL DETAILS
KeyFacts
Two semen analyses (2–4 weeks apart) are the foundation of male infertility investigation.
Microsurgical varicocelectomy improves sperm in 60–70% , the most impactful male infertility surgery.
Distinguish obstructive (FSH normal) from non-obstructive (FSH elevated) , critical for planning.
Microsurgical testicular sperm extraction , highest retrieval rate in non-obstructive azoospermia.
Vasovasostomy success rate >90% if <10 years from vasectomy. Microsurgical technique essential.
Klinefelter, Y microdeletion testing before TESE , genetic counselling offered to all couples.
HOW WE TREAT IT
Treatment Approach
Microsurgical Varicocelectomy
All dilated testicular veins are ligated through a small subinguinal incision under the operating microscope , the most effective surgical intervention for male infertility, improving semen parameters in 60–70% of men.
- 1
Semen Analysis & Hormones
Two semen analyses, FSH, LH, testosterone, prolactin, and thyroid function establish the diagnosis and guide the treatment pathway.
- 2
Scrotal Imaging
Scrotal Doppler ultrasound identifies varicocele grade, testicular volume, and any epididymal obstruction or testicular pathology.
- 3
Surgical Treatment
Microsurgical varicocelectomy, vasovasostomy, vasoepididymostomy, TESA, TESE, or micro-TESE planned based on the identified cause of azoospermia.
- 4
ART Coordination
Surgical sperm retrieval coordinated with the fertility unit for same-day ICSI. Semen analysis repeated at 3 and 6 months post-varicocelectomy.
AVAILABLE TREATMENTS
Treatment Options
Microsurgical Varicocelectomy
Gold standard varicocele repair , all veins ligated under the operating microscope with preserved artery, lymphatics, and vas.
TESA (Testicular Sperm Aspiration)
Fine-needle aspiration of testicular tissue to retrieve sperm for ICSI , minimally invasive, suitable for obstructive azoospermia.
TESE (Testicular Sperm Extraction)
Open testicular biopsy to extract sperm from seminiferous tubules for ICSI , performed for both obstructive and non-obstructive azoospermia.
Micro-TESE (Microsurgical TESE)
Operating microscope used to select and biopsy the most sperm-rich seminiferous tubules , highest retrieval rate in non-obstructive azoospermia.
Vasovasostomy
Microsurgical re-anastomosis of the vas deferens after vasectomy , success rate >90% within 10 years of vasectomy.
Vasoepididymostomy
Microsurgical connection of the vas directly to the epididymal tubule , bypasses epididymal obstruction from infection or surgery.
COMMON QUESTIONS
Frequently Asked
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