Male Infertility in India

MALE INFERTILITY IN INDIA

What it is, how common it is and how it affects the sufferer?

Inability of a man (or male partner in a couple) to cause pregnancy after 12 months of regular, unprotected sexual intercourse is defined as male infertility. Infertility can be caused by female, male, or both. In clinical practice, the male factor is often present either alone or together with female factors.^1,2

How common is it in India?

3.9% to 16.8% across different populations report infertility ²

The male factor contributes to about 40%–50% (as sole or contributing cause worldwide and in India). In other words, almost one in every two couples experiencing infertility has a male factor component ^1,2

Global and regional studies also show that the absolute number of men affected by infertility has been rising in recent decades, with the global burden increasing substantially between 1990 and 2019^3,4

The prevalence of infertility in India is rising steadily, with male-factor playing a major role in it.^2,4

Main cause of male infertility

Several factors have been linked with male infertility.

Abnormal semen parameters

Low sperm count — oligozoospermia
Poor motility — asthenozoospermia
Abnormal morphology — teratozoospermia
Absence of sperm — azoospermia^2,5

Hormonal or genetic causes

Defects such as GnRH deficiency, Kallmann or Klinefelter syndrome and Y-chromosome microdeletions can lead to male infertility¹

Lifestyle & environmental contributors

Smoking, alcohol consumption, heat exposure, certain drugs, pollutants are responsible for lowering semen quality¹

How male infertility impacts the sufferer?

Psychological distress

Men with infertility often experience anxiety, depression, lowered self-esteem, a sense of loss, and relationship strain. Studies and clinical reviews from India highlight that male infertility is often under-recognised and under-treated, which worsens psychological outcomes.⁶

Social stigma and family pressure

In many Indian communities, infertility is heavily stigmatised and frequently (and incorrectly) attributed to woman. Men may feel shame, conceal their condition, or be subjected to community/family pressure thereby affecting marital stability and social standing. Clinical guidance from national bodies highlights that delayed male evaluation is common due to such stigma.^7,4

Economic burden

Diagnosis (semen analysis, hormonal and genetic tests) and treatments (surgery, assisted reproductive technologies) can be expensive and often require repeated cycles — placing a significant financial burden on families. Limited insurance coverage for fertility care in India increases out-of-pocket expense.^6,8

Delayed care and worse outcomes

Because men are often evaluated after their female partners or after prolonged delays, opportunities for simpler or curative treatments may be missed and couples may move more quickly to high-cost assisted reproduction. National guidance recommends early, simultaneous evaluation of both partners.^1,7

What should individuals and couples know or do?

Couples should consult a doctor before starting any steps or new treatment. Semen analysis is the primary diagnostic tool in the laboratory evaluation of male infertility.¹

Many causes of male infertility are treatable or manageable with medical, surgical or assisted reproductive techniques. Lifestyle changes (smoking cessation, weight management and reducing heat exposure) may improve outcomes^1,2

Psychological support and counselling are important. Reducing stigma, offering couple-based counselling, and educating families can improve help-seeking and mental-health outcomes⁷

Male infertility is a common and growing public-health and clinical issue in India. Earlier and paired evaluation of couples, expanded access to affordable diagnostic services, and social support are key to reducing the health, social and economic impacts experienced by sufferers and their families. Males, the silent sufferers, need comprehensive support and care to overcome male infertility.

References:

1. Leslie SW, Hussain MA, Nelson L. Male Infertility. Available from: Male Infertility - StatPearls - NCBI Bookshelf. Accessed on: 12 Aug 2025.

2. Kumar N, Singh AK. Trends of male factor infertility, an important cause of infertility: a review of literature. J Hum Reprod Sci. 2015;8(4):191–6.

3. Agiwal V, Madhuri RS, Chaudhuri S. Infertility burden across Indian states: insights from a nationally representative survey conducted during 2019–21. Journal of Reproduction & Infertility. 2023;24(4):287.

4. Huang B, Wang Z, Kong Y, Jin M, Ma L. Global, regional and national burden of male infertility in 204 countries and territories between 1990 and 2019: an analysis of global burden of disease study. BMC Public Health. 2023;23(1):2195.

5. Standard Treatment Workflows of India. Available from: 1726568410_infertility_all.pdf. Accessed on: 12 Aug 2025.

6. Tholeti P, Uppangala S, Kalthur G, Adiga SK. The landscape of assisted reproductive technology access in India. Reprod Fertil. 2024;5(4):e240079.

7. Kaushal R, Gurnani N, Kumar M, Dada R, Kumar R. Male infertility in India: Demographics, aetiology and outcomes of standard clinical practice. National Medical Journal of India. 2020;33(6).

8. Agarwal A, Srivastava A, Fathima F, Lodhi B. Insight into epidemiology of male infertility in central India. IJRCOG. 2022;12(1):215.