Male Infertility: Time to Make It Part of the Conversation

Male factor infertility contributes to nearly half of all cases — yet it remains significantly under-investigated. When a couple presents for fertility care, the first investigations are almost invariably directed at the woman. This is both clinically inefficient and unfair.

What we know about male infertility

Approximately 40–50% of infertility has a male contributing factor. Yet many couples spend months — sometimes years — investigating and treating the female partner before a semen analysis is even ordered. A semen analysis is a simple, non-invasive test. It should be one of the first investigations performed, not one of the last.

The range of male factor conditions

Male infertility is not a single diagnosis. Low sperm count (oligospermia), poor motility (asthenospermia), abnormal morphology, and azoospermia (no sperm in the ejaculate) are distinct conditions with different causes and different treatment pathways. Sperm DNA fragmentation — not detected on a standard semen analysis — is increasingly recognised as a significant cause of recurrent IVF failure and pregnancy loss.

What treatment looks like

For many male factor conditions, ICSI — intracytoplasmic sperm injection — combined with IVF provides a clear treatment path. For men with azoospermia, surgical retrieval techniques (TESA, PESA) can recover viable sperm even when none appear in the ejaculate. At Ahana, we investigate both partners from the first appointment. That is the only sensible place to start.