Male infertility affects 10-15 per cent of couples in India

Male infertility affects 10-15 per cent of couples in India

Male infertility is becoming a growing public health issue in India, particularly among working-age men in urban areas. According to the Indian Council of Medical Research, the prevalence of male infertility in India is around 10-15 per cent. This means that out of every 100 couples attempting to conceive, 10-15 face difficulties attributed to the male partner.

Despite these figures, medical professionals say the topic remains shrouded in secrecy and taboo. While the responsibility for conception is overwhelmingly viewed as a woman's burden, studies suggest that male factors contribute to nearly 40–50 per cent of infertility cases.

The Physical and Emotional Toll

For many men, the discovery of infertility is linked to a sense of shame and a perceived loss of virility. One man shared that the experience felt emasculating and heartbreaking, describing the emotional turmoil of failed IVF attempts and the jealousy felt toward friends with children.

Another individual, who discovered at age 15 that he would be unable to have biological children due to undescended testicles and delayed puberty, described the experience as massively isolating. Even after using a sperm donor to have twins, he reported struggling with anxiety over whether the children looked like him.

The psychological impact often extends to family dynamics. One man recounted that while he told his mother and sister about his azoospermia — a condition where there is zero sperm — it took much longer to tell his father. He noted that this felt more shameful because a father often serves as a model for manhood, creating a subconscious need for approval.

Causes and Risk Factors

Doctors attribute the rise in infertility to a combination of medical conditions and modern lifestyle choices. Dr. Bhavatej Enganti, Consultant Urologist and Andrologist at the Asian Institute Nephrology and Urology, noted that hormonal imbalances, diabetes, and cardiovascular diseases can contribute to infertility.

• Lifestyle and Habits: Excessive alcohol consumption reduces sperm count and quality, while smoking damages sperm DNA. Chronic stress from modern work culture can lower testosterone and disrupt sperm development.
• Environmental Factors: Exposure to heavy metals, pesticides, pollutants, and plastics in urban environments is linked to declining sperm quality.
• Nutritional Deficiencies: A lack of essential nutrients, specifically zinc, selenium, vitamin D, and antioxidants, can impair sperm production.
• Medical Conditions: Infections of the reproductive or urinary tract, such as epididymitis or prostatitis, can affect fertility. Chromosomal disorders like Klinefelter syndrome or conditions such as hypogonadism also play a role.

Identifying the Signs

Medical experts warn that male fertility problems often develop silently. However, certain symptoms should prompt immediate medical consultation. Dr. Enganti advises that pain, swelling, or lumps in the testicles should never be ignored, as they may indicate varicocele or other infections.

Other warning signs include changes in sexual function, such as reduced sexual desire, problems with ejaculation, or difficulty maintaining an erection. The most definitive sign, however, is the inability to conceive after one year of regular, unprotected intercourse.

Diagnosis and Treatment Paths

The primary step in diagnosis is a semen analysis to evaluate sperm count, motility, and morphology. Experts recommend this evaluation if a couple has been unsuccessful in conceiving for over a year, or after six months if the female partner is over 35.

Treatment approaches vary by medical philosophy. Some clinics focus on clinical urological interventions and hormone therapies. Others, such as Ayu Fertility founded by Dr. Prashant Jain, utilize an Ayurvedic approach that focuses on a balance of digestion, hormonal health, physical strength, and mental well-being to identify root causes.

Beyond clinical treatment, doctors emphasize lifestyle corrections. These include stress reduction techniques, improved work-life balance, and balanced nutrition to support natural hormone regulation.