Why the male side matters
A normal sex life and a healthy feeling body do not mean sperm is healthy. Most men with low sperm count have no symptoms at all. Dr. Prachi asks for a semen analysis at the very start of every assessment, because it is quick, painless and saves months of treatment aimed at the wrong partner. Her short video on the topic makes a simple point: male fertility deserves the same care and attention as female fertility.
Understanding the semen analysis
The sample is collected after two to five days without ejaculation. The lab looks at:
One abnormal report is not a final answer. Sperm counts vary, so a repeat test after a few weeks is common before decisions are made.
Common causes
- Varicocele: swollen veins around the testis that can raise its temperature.
- Hormone problems, including low testosterone or thyroid issues.
- Past infections, mumps after puberty, or groin and testicular surgery.
- Smoking, alcohol, heavy heat exposure, obesity and some medicines, including testosterone and steroid supplements.
- Genetic causes, especially when the count is very low or zero.
- Problems with erection or ejaculation.
Treatment options
- Fix what can be fixedStopping smoking, cutting alcohol, weight control, avoiding hot baths and laptops on the lap, and reviewing medicines. Results show in about three months.
- Treat medical causesInfections, hormone imbalance or a significant varicocele may be treated, often with the help of a urologist or andrologist.
- IUIFor mild problems, washing and concentrating the sperm for IUI can help.
- IVF with ICSIFor moderate to severe problems, a single sperm is injected into each egg. See the ICSI page.
- Surgical sperm retrievalWhen there is no sperm in the semen (azoospermia), sperm may sometimes be found in the testis using TESA or micro-TESE and used for ICSI.
Antioxidant supplements are widely sold for sperm health. Evidence is mixed, so it is better to discuss them with your doctor than to start several products at once.
Questions couples ask
How is a semen sample collected?
Usually by masturbation into a sterile container at the clinic, after two to five days of abstinence. A private room is provided.
Can a man with zero sperm count become a father?
Sometimes. Depending on the cause, sperm may be retrieved from the testis for ICSI. Tests help predict whether this is possible.
How long before lifestyle changes help?
New sperm take about 72 to 90 days to develop, so a repeat test is usually done after three months.
Does age affect male fertility?
Yes, though more slowly than in women. Sperm quality tends to decline after the mid 40s.
This page gives general information only. Dr. Prachi will advise on what suits you after reviewing your history and reports.
Medically reviewed by Dr. Prachi Benara, MS, DNB, MRCOG (London). Last updated October 2026.