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Can IVF Help Men With Severe Male Infertility?

The short answer is yes but the complete answer depends on what is causing the infertility and how comprehensively it has been investigated.

Male fertility in Chennai and across South India is increasingly being affected by a combination of lifestyle factors and underdiagnosed clinical conditions. Severe male infertility — defined as very low sperm count, poor motility, significantly abnormal morphology, or complete absence of sperm in the ejaculate was once considered one of the most difficult fertility challenges to treat. That is no longer the case.

What IVF With ICSI Makes Possible

Conventional IVF requires a sufficient number of motile sperm to allow natural fertilisation in a culture dish. For men with severe male infertility, this threshold may not be met making standard IVF inadequate as a standalone solution.

ICSI — Intracytoplasmic Sperm Injection changes this entirely. A single healthy sperm is selected under high magnification and injected directly into each retrieved egg. This means that even men with extremely low sperm counts can achieve fertilisation, provided at least some viable sperm are present in the sample.

For men with azoospermia where no sperm are present in the ejaculate, surgical sperm retrieval through TESA or PESA can obtain sperm directly from the testicular tissue. This retrieved sperm is then used immediately in ICSI within the IVF cycle.

What Determines Success

The outcome of IVF with ICSI for severe male infertility depends on several factors working together. Sperm DNA fragmentation significantly affects embryo quality even when ICSI achieves fertilisation which is why DNA fragmentation testing is a critical part of male fertility in Chennai evaluation at Dr. Aravind's IVF Fertility and Pregnancy Centre.

Female partner factors particularly egg quality and ovarian reserve are equally important to the overall cycle outcome. Advanced sperm selection techniques including PICSI and MACS further improve fertilisation quality for men with elevated DNA fragmentation.

The Right Evaluation Changes Everything

Severe male infertility is not a dead end. It is a clinical challenge that requires the right diagnosis, the right treatment protocol, and a laboratory equipped to handle complex cases with precision.

At Dr. Aravind's IVF Fertility and Pregnancy Centre, male fertility in Chennai is evaluated and treated at every level of severity — because every couple deserves a complete clinical picture before any door is closed.

If you have been through one or more IVF cycles without achieving a successful pregnancy, there is a good chance nobody has mentioned sequential embryo transfer to you yet. Most couples only discover it after searching extensively on their own or after moving to a more specialist centre.

This article explains what it is, who it is for, and why it may matter for your next cycle.

What Is Sequential Embryo Transfer?

In a standard IVF cycle, one embryo is transferred to the uterus on either Day 3 or Day 5 of development. The goal is to select the single best embryo and give it the optimal conditions for implantation.

Sequential embryo transfer takes a different approach. Two embryos are transferred in the same cycle but at different developmental stages, typically one on Day 3 and a second on Day 5. The rationale is that the Day 3 embryo may produce developmental signals that improve the uterine environment for the Day 5 blastocyst that follows.

This approach is not suitable for every couple. But for those with repeated implantation failure despite transferring good quality embryos, it represents a clinically reasoned alternative worth discussing.

Who Is It For?

Sequential embryo transfer is most commonly considered for couples who have experienced two or more failed transfers with chromosomally normal or high quality embryos, where no structural uterine cause has been identified and endometrial receptivity appears adequate on standard assessment.

It is also discussed in cases where embryo quality has been consistently good but implantation has not occurred, suggesting that the issue may relate to endometrial signalling rather than embryo quality alone.

According to ESHRE guidelines on recurrent implantation failure, exploring alternative transfer protocols is a recognised clinical pathway after repeated failure with standard approaches.

At the best fertility centre in Electronic City, Dr. Aravind's IVF Fertility and Pregnancy Centre evaluates each couple's transfer history thoroughly before recommending whether sequential transfer, standard blastocyst transfer, or a modified protocol is the most appropriate next step.

What It Is Not

Sequential embryo transfer is not a guaranteed solution. It is not appropriate for all patients, and it does involve transferring two embryos, which carries a small increased probability of multiple pregnancy. The decision to consider it should always follow a detailed clinical review.

What it represents is an option. One that deserves to be on the table when standard approaches have not produced the expected outcome.

For a broader overview of implantation failure and the investigations that precede protocol changes, visit the Dr. Aravind's IVF blog for detailed clinical guides.

The best fertility specialist in India will always tell you: if a protocol has failed more than once with good quality embryos, the question worth asking is not just what went wrong but what could be done differently.

Introduction — Misinformation Is Costing Couples Years

Here is a number that every couple in Chennai trying to conceive should know: nearly half of all infertility cases involve a male factor. And yet, the average man who walks into a fertility clinic has spent twelve to eighteen months sometimes longer believing at least one piece of misinformation that delayed his evaluation entirely.

Most men who walk into our clinic believed at least one of these myths and that belief delayed their parenthood by one to three years.

As the best IVF centre in Chennai, we believe the most powerful fertility tool available to any couple is not a medication, not a procedure, and not a laboratory. Myths about male fertility are not harmless. They cause real delays. And every month of delay has a clinical cost particularly for the female partner, whose ovarian reserve does not pause while misinformation runs its course.

Here are the seven myths we encounter most often — and the clinical truth behind each one.

Myth 1 — "If I Can Get an Erection, My Sperm Count Is Fine"

MYTH. And one of the most deeply held ones.

Sexual performance and sperm production are biologically independent systems. An erection is a vascular event it depends on blood flow, nerve signalling, and psychological arousal. Sperm production is a hormonal and testicular function; it depends on FSH, LH, testosterone, and the health of the seminiferous tubules inside the testes.

These two systems share no direct link. A man can have completely normal erectile function while producing severely reduced sperm counts or no sperm at all. Conversely, some men with hormonal imbalances affecting sperm production may also experience changes in libido — but this is a secondary effect, not a reliable diagnostic indicator.

The ability to get an erection tells you nothing whatsoever about sperm count. Only a semen analysis does.

Myth 2 — "You Can Tell by Looking at Semen"

MYTH. This one persists because it seems logical — but biology does not support it.

Sperm cells constitute less than five percent of total semen volume. The rest is seminal fluid — produced by the prostate and seminal vesicles which has no direct relationship to sperm count. Semen appearance, volume, colour, and consistency can all appear completely normal in a man with severe oligospermia or azoospermia.

According to WHO Laboratory Manual for Examination and Processing of Human Semen, reference values for semen analysis require laboratory microscopy — there is no visual or physical characteristic of semen that indicates sperm count to a clinician or to the patient.

At the best IVF centre in Chennai, semen analysis is conducted under strict laboratory quality control — the only reliable way to know what is actually happening.

Myth 3 — "Low Sperm Count Only Affects Older Men"

MYTH. And an increasingly dangerous one as lifestyle patterns shift.

Men in their 20s and early 30s are being diagnosed with low sperm count at rates that were not seen a generation ago. Environmental factors — endocrine-disrupting chemicals in food packaging, air pollution, and water contamination — combined with lifestyle factors including sedentary work, poor sleep, chronic stress, and heat exposure from devices, are accelerating sperm quality decline in younger men globally.

A 2017 meta-analysis published in Human Reproduction Update found a 52 percent decline in sperm concentration among men in Western countries over a 38-year period — a trend that affects all age groups, not just those above 40.

Male fertility evaluation is as relevant at 27 as it is at 45. Age does not confer protection.

Myth 4 — "It Will Fix Itself With Time"

MYTH. And one of the most clinically costly ones.

Some causes of low sperm count — varicocele in particular — worsen progressively without treatment. Varicocele is an enlargement of the veins within the scrotum that raises local temperature and damages sperm production. Left untreated, it does not stabilize. It continues to impair sperm quality over time.

Hormonal imbalances require clinical correction — they do not self-resolve. Genetic causes cannot be reversed through waiting. And obstructive azoospermia — where sperm is present in the testes but cannot exit due to a structural blockage — requires surgical intervention that becomes no easier with delay.

More critically — every month of waiting is a month of continued decline in the female partner's ovarian reserve. The fertility clock affects both partners simultaneously. Waiting for a male fertility problem to resolve on its own is rarely a neutral decision. It is almost always a costly one.

Myth 5 — "Normal Testosterone Means Normal Sperm Count"

MYTH. This misunderstanding stems from a reasonable but incorrect assumption — that because testosterone drives male reproductive function, normal testosterone must mean everything is working correctly.

It does not.

Testosterone is one variable in a complex hormonal system. FSH — Follicle-Stimulating Hormone directly stimulates sperm production inside the testes. LH drives testosterone production but does not alone confirm adequate sperm generation. Prolactin, when elevated, suppresses the entire reproductive hormonal axis. Thyroid dysfunction affects sperm motility and morphology independently of testosterone.

A man can have testosterone within normal range while having significantly impaired FSH signalling, elevated prolactin from a pituitary adenoma, or subclinical thyroid dysfunction — all of which independently suppress sperm production. A complete hormonal panel not testosterone alone is required for accurate male fertility assessment.

For couples who have experienced recurrent implantation failure or poor embryo quality despite adequate sperm count, our blog on male infertility investigation and treatment explains how advanced testing identifies what standard panels miss.

Myth 6 — "Only the Woman Needs Fertility Testing"

MYTH. The most persistent and most damaging myth in this entire list.

Male factor infertility contributes to approximately 40 to 50 percent of all infertility cases globally — a statistic supported by decades of reproductive medicine research. Yet in clinical practice, male evaluation still frequently lags months behind female investigation — costing couples time, money, and emotional energy that a simultaneous evaluation would have saved.

At the best IVF centre in Chennai, simultaneous bilateral evaluation — both partners assessed within the same appointment window — is the clinical standard, not an optional extra. It is the only approach that gives the complete picture from which accurate treatment recommendations can be made.

If your current fertility clinic is investigating only the female partner without concurrently evaluating the male, that is a gap worth addressing directly.

Myth 7 — "IVF Is Only for Women's Problems"

MYTH. In fact, one of the most transformative developments in assisted reproductive technology was specifically developed for male factor infertility.

ICSI — Intracytoplasmic Sperm Injection is a procedure in which a single healthy sperm is selected and injected directly into an egg. It was developed precisely because conventional IVF where sperm and egg are placed together and fertilisation is allowed to occur naturally is not effective when sperm count or motility is severely impaired.

ICSI requires only one viable sperm per egg retrieved. For men with severe oligospermia, non-obstructive azoospermia where sperm is surgically retrieved from the testes, or elevated DNA fragmentation affecting fertilisation, ICSI within an IVF cycle is the most effective clinical pathway available and outcomes are genuinely encouraging when the right protocol is applied.

IVF with ICSI is as much a male fertility treatment as it is a female one.

What You Should Actually Do If You Suspect Low Sperm Count

Stop assuming. Start with a semen analysis.

A semen analysis is a straightforward, non-invasive investigation that takes one appointment and provides results the same day at a quality-controlled laboratory. It covers sperm count, motility, morphology, volume, and pH the foundational parameters for male fertility assessment.

If results are abnormal, additional investigations hormonal panel, scrotal ultrasound, sperm DNA fragmentation testing, and genetic screening where indicated build the complete clinical picture from which an accurate treatment recommendation can be made.

Both partners should be tested within the same appointment window. This is not about blame or comparison, it is about efficiency. A complete picture from day one saves months of misdirected investigation.

According to ESHRE guidelines on male infertility, simultaneous bilateral evaluation is the evidence-based standard for couples presenting with conception difficulty regardless of which partner is suspected to be the contributing factor.

Dr. Aravind's IVF Fertility and Pregnancy Centre the best IVF centre in Chennai offers fast, private, same-day semen analysis reporting alongside comprehensive female fertility evaluation in a single coordinated appointment. Visit our Chennai fertility centre page for consultation and appointment details.

FAQ Section

Q: Does semen volume indicate sperm count? No — a high semen volume can contain very few sperm, and a low volume can contain adequate numbers. Only laboratory microscopy of the sample provides an actual sperm count.

Q: Can stress alone cause low sperm count? Chronic stress can lower testosterone and suppress the hormonal signals driving sperm production — but it is rarely the sole cause. A full evaluation is still needed to identify all contributing factors.

Q: Is low sperm count genetic and will it pass to my son? Some causes — particularly Y-chromosome microdeletions — are genetic and can be transmitted to male offspring. Your fertility specialist will advise genetic counselling and testing if this is clinically suspected based on your evaluation results.

Q: Can I take supplements without a doctor's advice to improve sperm count? Basic antioxidants — Vitamin C, Vitamin E, zinc, selenium, and CoQ10 — are generally safe and have evidence supporting their role in sperm health. However, targeted hormonal or medical treatment must always follow a proper diagnosis rather than precede one.

Q: Is a second semen analysis necessary after the first one? Yes — most reproductive specialists recommend repeating semen analysis after two to three weeks to confirm initial findings, as sperm count fluctuates naturally based on abstinence period, recent illness, heat exposure, and other variables.

Conclusion

Myths do not make babies. Accurate diagnosis does.

Every myth on this list has a clinical cost measured in months of delay, misdirected investigation, and narrowing fertility windows for both partners. The good news is that every one of these myths is disprovable with a single, straightforward semen analysis appointment.

Stop guessing. Start knowing.

Book your semen analysis at Dr. Aravind's IVF Fertility and Pregnancy Centre — the best IVF centre in Chennai.

He Said IVF Won't Work. This Thanjavur Specialist Proved Him Wrong

When One Doctor Says No — Another Says Let's Try Differently

Priya had been told by two doctors that IVF would not work for her.

Low ovarian reserve. Poor egg quality. The words felt like a door closing forever.

But her husband refused to give up.

They made one last appointment — Dr Aravind IVF Fertility Center.

The Specialist Who Looked Closer

The fertility specialist reviewed everything previous reports, hormonal levels, treatment history and saw something others had missed.

A different protocol. A personalized approach. A genuine plan.

Nine Months Later

Priya held her son for the first time.

The doctor who said IVF would not work was wrong.

The best fertility specialist in Thanjavur proved that with the right expertise, the right lab, and the right care possibilities exist where others see dead ends.