Failure To Treat Male Infertility Leads To Unnecessary IVF Treatments, Says Fertility Expert

For years, infertility has been perceived as a predominantly female problem, a misconception that continues to influence how couples seek treatment. In reality, medical evidence shows that male-factor infertility plays an equally significant role in conception challenges. According to global estimates from the World Health Organization (WHO), male infertility contributes to roughly 50% of infertility cases worldwide, either alone or in combination with female factors. Yet, despite this data, men are often not fully evaluated before couples are advised to undergo assisted reproductive technologies (ART) such as in-vitro fertilisation (IVF) or Intracytoplasmic Sperm Injection (ICSI).

This leads to a growing concern among fertility specialists about the rising number of couples undergoing expensive, invasive IVF cycles when the root cause, in many cases, is a treatable male reproductive issue. As one fertility expert, Dr. Anindita Singh, Fertility Specialist at Nova IVF Fertility, Kolkata, notes, male factors such as low sperm count, poor motility, hormonal imbalance or simple anatomical issues like varicocele are often overlooked, pushing couples toward IVF prematurely.

Today, experts like Dr. Singh emphasise that a complete male fertility evaluation is not only medically prudent but ethically necessary. Early diagnosis can reduce unnecessary interventions, emotional distress and financial burden, helping couples achieve pregnancy naturally or with far less invasive treatment.

Male Infertility: A Major Yet Overlooked Contributor

Male-factor infertility is responsible for approximately 30% of infertility cases, and contributes alongside female factors in another 20-40%, meaning nearly half of infertility challenges stem from male reproductive health issues. Despite this, men are frequently the last to be investigated during fertility assessments, reinforcing long-standing gender biases.

The WHO and major reproductive health bodies like the American Society for Reproductive Medicine (ASRM) confirm that sperm-related issues, including low sperm count (oligospermia), absence of sperm (azoospermia), poor sperm motility, and morphology abnormalities, are among the most common causes of male infertility.

Simple, Treatable Issues Are Often Missed

Many causes of male infertility are completely treatable or manageable with targeted interventions. Yet couples are often pushed toward IVF without addressing the male partner's health first.

Dr. Singh highlights this clearly: "Sometimes male factors such as low sperm count, poor sperm motility, male hormone imbalance, or even an easily treatable anatomical abnormality like varicocele may be overlooked so that the couple goes directly to IVF or ICSI."

Research supports this:

• Varicocele, a common condition affecting up to 15% of men, can significantly impair sperm production. Surgical repair often improves semen parameters and natural conception rates.
• Hormonal disorders such as low testosterone, elevated prolactin and pituitary dysfunction can be corrected with medication.
• Lifestyle factors like obesity, smoking, alcohol, heat exposure, stress can reduce sperm quality. Studies show improvements with weight management, smoking cessation and regular exercise.

When these reversible factors are not evaluated, couples may undergo IVF unnecessarily, subjecting women to hormonal stimulation, painful procedures and substantial costs.

Why IVF Should Not Be the First Step

IVF is a breakthrough treatment, but it is not always the correct first-line approach. Dr. Singh notes: "In many cases, the real cause is one that can be treated by medicine, lifestyle alteration, or a small operation. Failure to recognize this may result in couples entering the cycle of assisted reproduction, which may not solve the problem."

Leading reproductive bodies agree. ASRM recommends a full male fertility assessment BEFORE initiating IVF, including semen analysis, physical examination and relevant hormonal tests. NICE (UK) advises thorough evaluation of both partners before considering IVF.

Why Early Male Fertility Evaluation Is Critical

Failing to diagnose male infertility leads to:

• Unnecessary IVF cycles that may not address the underlying cause.
• Higher emotional and financial burden on couples.
• More invasive interventions for women, despite the issue originating in male reproductive health.

As Dr. Singh emphasises, "Making sure that men have gone through the right assessment can be a big time saver, and works against the build-up of unnecessary procedures."

Male infertility is common, highly treatable and too often overlooked. With nearly half of conception problems linked to male factors, experts insist that diagnosing and treating the male partner first is essential, before recommending IVF. Proper evaluation not only increases the chances of natural conception but also prevents avoidable emotional, physical and financial strain for couples. Fertility specialists like Dr. Singh agree: The best fertility journey begins with a comprehensive, unbiased assessment of both partners, not with premature IVF.

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