Patients who have difficulty in conceiving tend to only investigate the woman, but the man is rarely considered at fault. However, whenever I am looking at a couple, I believe that 30% of causes of infertility are female related, 30% are male related, 30% where both the partners have an issue and 10% couples have unexplained infertility where all the reports are normal and there’s no reason why. Therefore, it is very important to investigate the male as he plays a very important role in the treatment not only biologically but also emotionally and behaviourally as well.
Male factor infertility: More common than we think
Male factor infertility contributes to nearly 40–50% of infertility cases, either as a sole cause or in combination with female factors.Low sperm counts, reduced motility, abnormal morphology, DNA damage (DNA Fragmentation) & hormonal imbalances can affect fertilisation rates, embryo quality and implantation and even pregnancy outcomes.
Sperm quality directly impacts embryo health
While IVF and ICSI (Intracytoplasmic Sperm Injection) have enabled fertilisation even with low sperm count, we have to consider sperm quality as well. Poor sperm DNA integrity has been associated with lower fertilisation rates, poor quality embryos, failed implantation and increased miscarriages.
Advanced tests such as sperm DNA fragmentation assays help identify hidden sperm issues that routine semen analysis may miss. Addressing these concerns through medical treatment, antioxidants, or lifestyle modification can significantly improve IVF outcomes.
Lifestyle choices make a big difference
We always think the woman has to make changes in her lifestyle to improve pregnancy rates, however it is equally important for a man to make these changes as well. Men underestimate how smoking, alcohol consumption, obesity, chronic stress, poor sleep, and exposure to environmental toxins negatively impact sperm production and function.
Simple yet effective changes—like quitting smoking, moderating alcohol intake, maintaining a healthy weight, exercising regularly, improving diet, and managing stress—can enhance sperm parameters within just a few months. Since sperm development takes approximately 74 days, timely lifestyle correction before IVF cycles can be extremely beneficial.In addition to this, when we ask the woman to make lifestyle changes, it is important to have the support of the male partner in aiding these lifestyle changes for their partner. For example, in PCOS patients, when we advocate diet and exercise, I always ask the partner to support this by following a similar diet and exercise pattern so that the woman isn’t around an obesogenic environment.
Hormonal balance and medical conditions
Men suffering from diabetes, thyroid disorders, varicocele, infections, and hormonal imbalances can impair sperm quality. It’s very important to identify and treat some of these conditions before the IVF procedure as it can tremendously improve sperm health and reduced the interventions required.Sometimes, treating these conditions can even lead to a natural pregnancy.
The emotional and psychological role of the male partner
Emotional support from the male partner definitely has an important role in the success rates of the IVF Process. IVF is not only a physical procedure but it also affects the woman emotionally. Male partners who stay informed and are present during the entire procedure, help reduce the stress levels in their partners. High stress levels can negatively affect the hormones and possibly affect treatment outcomes.
Compliance and timely participation matter
IVF success also depends on precision and timing.The male partners should be available and compliant for semen collection, abstinence periods & follow ups. In case of severe cases, we may have to even go for surgical sperm retrieval like TESA & micro-TESE
Genetic contribution and long-term outcomes
Sperm quality influences not just fertilization but also the long-term health of the child. Emerging research suggests that poor sperm DNA integrity may affect epigenetic programming, potentially influencing pregnancy outcomes and offspring health.This underscores the importance of optimizing male fertility well before attempting conception, whether natural or assisted.Breaking the myth: IVF is not just a woman’s responsibility
One of the biggest barriers to successful IVF treatment is the persistent myth that fertility issues are primarily a woman’s problem.This mind-set delays male evaluation, increases emotional strain on women, and may reduce the overall chances of success.
A collaborative approach, where both partners take equal responsibility for diagnosis, treatment, and lifestyle changes, leads to better clinical outcomes and a healthier emotional journey.
So remember, IVF is a team effort and both the partners are an indispensable part of that team. It is important to address the male factors early and treat them so that we can significantly increase the chances of parenthood for the couples.
Dr. Rohan Palshetkar, Consultant IVF Specialist, Bloom IVF, Palshetkar Patil Nursing Home, Opera House
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