Male Fertility
A male factor is involved in roughly half of all infertility. Evaluating the man early saves couples months of unnecessary treatment.
Understanding Male Fertility
Male infertility is the inability to achieve a pregnancy with a fertile partner after twelve months of regular unprotected intercourse. It is a common condition, and one that is still too often overlooked — in many couples the woman undergoes extensive investigation and treatment before the man has had even a basic semen analysis.
This matters because the male evaluation is quick, inexpensive and non-invasive. A clinical examination, an advanced semen analysis and a hormone profile can be completed within days, and frequently identify a correctable problem such as a varicocele, an infection, a hormonal deficiency or a medication effect.
Importantly, a fertility assessment is also a general health assessment. Impaired semen parameters have been associated with underlying hormonal, genetic and metabolic conditions, and occasionally with testicular tumours. A proper evaluation looks at the man's health as a whole, not just his sperm count.
Symptoms
- Inability to conceive after twelve months of regular unprotected intercourse
- Six months without conception where the female partner is over 35
- Reduced sexual desire or erectile difficulty
- Small, soft or asymmetrical testicles
- A swelling or 'bag of worms' sensation in the scrotum, suggesting varicocele
- Reduced facial or body hair, or other signs of hormone deficiency
- Previous testicular injury, undescended testis, mumps orchitis or hernia surgery
- Very low ejaculate volume, or absence of ejaculation
If you recognise several of these, an assessment is worthwhile. Early evaluation usually means simpler treatment.
Causes & Risk Factors
Varicocele
Enlarged veins draining the testicle raise scrotal temperature and impair sperm production. It is the single most common correctable cause of male infertility.
Obstruction
Blockage anywhere from the epididymis to the ejaculatory ducts — congenital, post-infective, or following hernia or vasectomy surgery — prevents sperm reaching the ejaculate despite normal production.
Hormonal disorders
Low testosterone, pituitary dysfunction, raised prolactin or thyroid disease can suppress sperm production. Notably, testosterone supplements taken for bodybuilding or 'energy' are a frequent and reversible cause of severe suppression.
Infection and inflammation
Epididymo-orchitis, prostatitis and sexually transmitted infections can damage sperm production or cause obstruction.
Genetic factors
Klinefelter syndrome, Y-chromosome microdeletions and cystic fibrosis gene mutations account for a proportion of severe cases and are identified through targeted testing.
Undescended testis
A testis that did not descend normally in childhood carries a lifelong reduction in sperm production, even after surgical correction.
Lifestyle and occupational exposure
Smoking, alcohol, heat exposure, obesity, anabolic steroids and certain chemical exposures all measurably reduce semen quality.
Ejaculatory dysfunction
Retrograde ejaculation — where semen passes backwards into the bladder — and anejaculation, often related to diabetes or spinal injury.
Diagnosis at RAMS
We diagnose before we treat. Each step below is chosen for what it will actually change about your management.
Clinical history and examination
Covering childhood testicular problems, infections, surgeries, occupational heat exposure, medication, supplement and steroid use, and sexual history. Testicular volume and consistency are assessed, and the cords examined for varicocele.
Advanced semen analysis
Performed to current WHO criteria, assessing concentration, motility, strict morphology, vitality, volume and leucocyte count. Because sperm counts fluctuate naturally, the test is usually repeated before conclusions are drawn.
Hormone profile
Morning testosterone, FSH, LH and prolactin. The FSH level in particular helps distinguish a production problem from an obstruction.
Scrotal Doppler ultrasound
Confirms varicocele, assesses testicular volume and structure, and excludes tumours or epididymal abnormality.
Sperm DNA fragmentation testing
Considered where semen parameters appear normal despite unexplained infertility, or after recurrent pregnancy loss.
Genetic and specialised testing
Karyotype and Y-microdeletion analysis in severe oligospermia or azoospermia, with post-ejaculatory urine examination where retrograde ejaculation is suspected.
Treatment Options
Treatment is matched to the cause and to your circumstances. Every option, including doing nothing for now, is explained before you decide.
Correction of reversible factors
Stopping anabolic steroids or testosterone supplements, treating infection, adjusting medication, weight reduction, and reducing heat and tobacco exposure. Semen parameters typically take three months to reflect any change, since a sperm production cycle lasts around 74 days.
Microsurgical varicocelectomy
Performed under an operating microscope, this ligates the abnormal veins while preserving the artery and lymphatics. Microsurgical technique substantially reduces recurrence and hydrocele formation compared with conventional open surgery.
Hormonal therapy
Targeted treatment for confirmed hormonal deficiencies, using agents that stimulate the body's own sperm production rather than suppressing it.
Surgical correction of obstruction
Reconstructive microsurgery to bypass or reverse blockage in appropriately selected men.
Sperm retrieval procedures
TESA and PESA retrieve sperm directly from the testis or epididymis in men with azoospermia, making biological fatherhood possible where the ejaculate contains no sperm.
Sexual dysfunction management
Where erectile or ejaculatory difficulty is preventing conception, treating it is often the whole solution.
Benefits of Treatment
- A definite answer, usually within days rather than months
- Identification of correctable causes before invasive treatment is considered
- Improved natural conception rates after varicocele correction
- Options for biological fatherhood even in azoospermia
- Detection of underlying hormonal or general health conditions
- Evaluation and counselling for both partners' understanding
Why Choose RAMS
A dedicated men's health centre in Hanamkonda — built so that sensitive concerns meet genuine specialist expertise.
20+ Years of Experience
Two decades of andrology and urology practice, including complex and revision cases.
Fellowship-Trained Andrologist
Formal sub-specialty training in andrology and men's health — uncommon in the region.
Everything Under One Roof
Consultation, diagnostics, day-care procedures and surgery at a single address.
Modern Surgical Equipment
Dedicated theatre with an operating microscope, endoscopy and uroflowmetry.
Complete Confidentiality
Private consulting rooms and access-controlled records, always.
Open 24 Hours
Urological emergencies attended round the clock, all seven days.
Dr. Rammohan Thatipamula
MBBS, MS, MCh Urology · Fellowship in Andrology & Men's Health
With more than 20 years in clinical practice, Dr. Rammohan is among the few specialists in the Warangal region with formal fellowship training in andrology alongside an MCh in urology. That combination means male sexual health, fertility and urological surgery are handled by one specialist, rather than split across departments.
Male Fertility FAQs
When should we see a specialist?
After twelve months of regular unprotected intercourse without conception — or after six months if your partner is over 35. If there is a known problem such as an undescended testis, previous testicular surgery or a varicocele, come earlier.
Does a low sperm count mean I cannot father a child?
No. Many men with low counts conceive naturally, and treatment frequently improves the count. Even when no sperm appear in the ejaculate, retrieval procedures often find sperm within the testis.
Is infertility usually the woman's problem?
No. A male factor is present in roughly half of all cases, either alone or alongside a female factor. Both partners should be assessed together from the outset.
Can testosterone supplements improve my fertility?
Quite the opposite — external testosterone suppresses the body's own sperm production and is a common cause of severe, sometimes prolonged, infertility. If you are taking any testosterone or steroid preparation, tell us at the first visit.
How long before I see improvement?
Sperm production takes approximately 74 days, so semen parameters are normally reassessed three months after starting treatment. Meaningful improvement earlier than this is unlikely, whatever is promised elsewhere.
Talk to a specialist about male fertility
Consultations are private, unhurried and completely confidential. We are open 24 hours, all seven days, in Hanamkonda.
Hospital Street, Hanamkonda, Telangana 506001 · Open 24 hours, all days