Infertility is often assumed to be a female issue — but male factors contribute to roughly 40–50% of all infertility cases. Understanding the causes and treatment options is an important first step for any couple trying to conceive.
This article covers the most common causes of male infertility, how it’s diagnosed, and what treatment options are available at GFC.
Common Causes of Male Infertility
1. Sperm Quality and Quantity Issues
The most frequently encountered category, with several distinct presentations:
- Oligospermia — Low sperm count (below 15 million/mL)
- Asthenospermia — Poor sperm motility (progressive motility below 32%)
- Teratospermia — Abnormal sperm morphology (normal forms below 4%)
- Azoospermia — No sperm present in the ejaculate
2. Anatomical Factors
- Blocked or absent vas deferens
- Varicocele (enlarged veins in the scrotum) — common and treatable
- Undescended testicle history
3. Hormonal Imbalances
Low levels of FSH, LH, or testosterone can impair sperm production. Hormonal causes are identified through blood testing.
4. Lifestyle Factors
- Smoking — directly damages sperm DNA
- Excessive alcohol consumption
- Chronic stress
- Obesity
- Frequent heat exposure (hot tubs, saunas, tight clothing)
5. Medical History
- Mumps orchitis (testicular inflammation from mumps infection)
- Urogenital infections
- Chronic conditions such as diabetes
Signs to Watch For
Male infertility usually has no obvious symptoms. The most common indicator is simply not achieving pregnancy after:
- 12 months of regular unprotected intercourse (general guideline)
- 6 months if the female partner is 35 or older
Other possible signs include pain or swelling around the testicles, reduced libido, or a history of urogenital infections or surgery.
Semen Analysis: The First Step
A semen analysis is the standard starting point for male fertility assessment. It evaluates multiple parameters simultaneously.
| Parameter | Normal Range (WHO) |
|---|---|
| Semen volume | ≥ 1.5 mL |
| Sperm concentration | ≥ 15 million/mL |
| Progressive motility | ≥ 32% |
| Normal morphology | ≥ 4% |
Results help the doctor identify the specific issue and design an appropriate treatment plan.
Treatment Options
For Low Count or Poor Quality Sperm
- IUI — Suitable for mild to moderate sperm issues. Prepared sperm are placed directly into the uterus at ovulation.
- ICSI — The preferred option for severe sperm issues. A single sperm is injected directly into each egg, requiring far fewer sperm than conventional IVF.
Sperm Enhancement Services at GFC
- Sperm Advance (MSS + PICSI) — 12,500 THB. Selects the highest-quality sperm before IUI or ICSI.
- Sperm Premium (MSS + MACS + PICSI) — 34,500 THB. Advanced sperm selection for severe male factor cases.
For Azoospermia (No Sperm in Ejaculate)
In some cases, sperm can be retrieved directly from the testicle (TESE/PESA) and used with ICSI. Your doctor will assess feasibility during consultation.
Lifestyle Modifications
Not a replacement for medical treatment, but meaningful improvements in sperm quality have been associated with:
- Stopping smoking
- Reducing alcohol
- Reaching a healthy weight
- Avoiding testicular heat exposure
- Adequate sleep
When to See a Doctor
- After 12 months of trying without success
- After 6 months if the female partner is 35 or older
- If you have a known history of varicocele, undescended testicle, or urogenital surgery
- If you’ve had a previous abnormal semen analysis
FAQ
What tests will the male partner need?
A semen analysis is the starting point, followed by a hormone blood panel if indicated. Your doctor will order based on initial findings.
Can ICSI be done with very low sperm count?
Yes. ICSI is specifically designed for severe male factor infertility — it requires only one viable sperm per egg. Your doctor will assess and advise based on your specific results
Should varicocele be treated before starting ICSI?
It depends on severity and the couple’s overall treatment plan. Your doctor will recommend the most appropriate approach for your situation.
Does the male partner need to be present throughout treatment?
Both partners should attend the first consultation. The male partner needs to be present on the day of semen collection during treatment.
Can diet or supplements improve sperm quality?
Antioxidant-rich foods may have a modest positive effect, but they’re not a substitute for medical evaluation and treatment. Discuss specific supplementation with your doctor.
Where can I book a semen analysis at GFC?
Contact GFC via Line @gfcclinic or call 097-484-5335. Available at all 3 branches — Rama 9, Rama 3, and Ubon Ratchathani.
Summary
Male infertility is common and, in many cases, treatable. A semen analysis is the essential first step — giving your doctor the data needed to recommend the right approach, whether that’s lifestyle changes, IUI, ICSI, or sperm enhancement services.
GFC’s team of 7 specialist doctors is experienced in treating both male and female factor infertility, managing over 2,000 cases per year.
→ Learn about ICSI for male factor infertility → ICSI at GFC → Learn
