Male Infertility (Mardon Mein Be-Auladi): Causes, Tests, Myths
When a couple can’t conceive, relatives usually look at the wife first. They shouldn’t. Male infertility (mardon mein be-auladi) plays a part in roughly half of all couples who struggle, and the first test for the man is cheap, quick and painless: a semen analysis. This guide covers what causes it, which tests come in what order, the myths that waste years, and when a urologist or andrologist is the right door to knock on.
The short version
- When to get checked: no pregnancy after 12 months of regular sex without contraception, or 6 months if the wife is 35 or older.
- First test: a semen analysis, done alongside the wife’s tests, not after them.
- Common causes: varicocele, past infections, smoking and naswar, gym steroids, excess weight, diabetes, heat.
- Who to see: a urologist or andrologist, ideally working with the couple’s gynaecologist.
- Biggest trap: “herbal” strength or fertility products, some of which hide real drugs or heavy metals.
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Is male infertility really that common?
Yes. Doctors usually split it like this: in some couples the problem is mainly the man, in some mainly the woman, in some both, and in some nobody finds a reason. Add those up. The man is involved in roughly half.
That number matters in desi homes, where years can go by with the wife taking medicines, injections and taunts from relatives while the husband, often with nobody even suggesting it, never gives a single sample. A man can have strong erections, normal desire and a healthy look and still have a low sperm count. Performance isn’t fertility.
Fertility is a couple’s test, so both partners start testing in the same month.
What causes male infertility?
Sperm take about three months to grow, so anything that upsets the testicles, the hormones that drive them, or the tubes that carry sperm can show up in the count. The usual suspects:
- Varicocele: swollen veins above the testicle, usually on the left, which warm the testicle. It’s one of the most common fixable findings. Our varicocele guide covers when repair helps.
- Infections: mumps after puberty can damage the testicles; untreated sexually transmitted infections can scar the tubes.
- Smoking, naswar and gutka: tobacco in any form is linked with poorer sperm. Quitting is one of the few changes fully in a man’s hands; our naswar and cigarette quitting guide walks through withdrawal.
- Gym steroids and testosterone: outside testosterone tells the brain to stop signalling the testicles, and sperm production can fall to zero. Recovery after stopping can take many months and isn’t guaranteed.
- Weight, diabetes and alcohol: a big waist shifts hormones, and poorly controlled diabetes can affect both sperm and ejaculation.
- Heat: long hours in a hot driver’s seat, a laptop on the lap, hot tubs and furnace work. The effect is usually modest and reversible.
- Things present from birth: an undescended testicle in childhood, some genetic conditions, or a missing sperm tube.
Age counts too. Less than for women, though, as sperm quality only drifts down slowly after about 40.
Which tests come first, and in what order?
The usual path, cheapest first. Nothing painful. Mostly painless.
- Semen analysis: abstain for 2 to 5 days, then collect the whole sample into the lab’s sterile cup, ideally at the lab. If you collect at home, keep it near body warmth and get it there within about 60 minutes. Our semen report guide explains every number.
- Repeat if abnormal: one bad result isn’t a verdict, since even a fever two months ago can drag a count down, so most doctors repeat it after a few weeks.
- Examination: a urologist checks testicle size, feels for a varicocele and checks that the tubes are there.
- Blood hormones: FSH, LH and testosterone, sometimes prolactin.
- Scrotal ultrasound: to confirm a varicocele or look at the testicles.
- Genetic tests: mainly when the count is zero or very low.
A zero count (azoospermia) sounds like the end. Often it isn’t, because sometimes there’s simply a blockage in the tubes that a surgeon can bypass or work around, and sometimes sperm can be retrieved straight from the testicle for IVF with ICSI (one sperm injected into one egg).
What people say, what tradition says, and our honest take
What people say
The WhatsApp version: it’s almost always the woman, a man who “performs” is fertile, and a kushta or “power” capsule fixes everything in weeks.
Unani texts link male fertility to a strong hot-and-moist temperament and recommend rich foods such as dates, milk, nuts and eggs, along with compound preparations. Ayurveda groups these under vajikarana (herbs and foods for virility), with ashwagandha and shatavari among the best known. Both were written long before anyone could count a sperm.
Our honest take
Worth it A semen analysis for every man in a couple that has waited a year, quitting tobacco, cutting alcohol, losing weight if needed, and controlling diabetes.
Depends Fine as food. Some herbs have small early trials, nothing that replaces a diagnosis. Any herb used as medicine needs a qualified practitioner to set the amount, and your doctor should know about it.
Skip Kushta and unlabelled “strength” powders. Some kushtas are made from metals such as mercury, lead or arsenic, which can harm the kidneys, nerves and sperm themselves.
Myth: if he has no erection problem, he can’t be infertile
Erections depend on blood flow and nerves, while sperm come from the testicles, so a man can have one problem without the other.
The reverse matters too. Weak erections can be an early sign of heart disease or diabetes, sometimes years before chest pain or a high sugar reading. See a doctor. Not a website.
Myth: herbal fertility products are natural, so they’re safe
Drug regulators keep finding “herbal” men’s products laced with undeclared sildenafil or tadalafil, steroids or other medicines. Hidden sildenafil or tadalafil taken with nitrate heart medicine (the tablets or spray some men use for angina) can drop blood pressure dangerously and kill. Steroids in a “gainer” or “power” capsule can shut down sperm production, the exact opposite of what the buyer wanted. We’ve written about this in hidden steroids in herbal gainers.
Myth: tight underwear is the main cause
Heat matters a little, and loose cotton underwear is a harmless change. But switching to boxers won’t fix a varicocele, a blockage or a hormone problem. Get tested.
What can a man do while tests are running?
Today’s habits show up in a semen report about three months later. The useful changes are boring. And real:
- Stop tobacco in every form, including naswar, gutka and shisha.
- Bring the waist down if it’s over about 90 cm.
- Keep the laptop off the lap and take breaks from long hot drives.
- Stop any steroid or testosterone product, with a doctor’s help if you’ve used it for a long time.
- Have regular sex every 2 to 3 days through the month, instead of trying to time one perfect night.
Did you know?
A healthy man makes millions of new sperm every day. And the testicles sit outside the body for a reason: sperm grow best a couple of degrees cooler than the core.
Book an appointment after 12 months of trying (6 months if the wife is 35 or over), or sooner if you’ve had an undescended testicle, mumps after puberty, testicle surgery, chemotherapy, steroid use, a known varicocele, or erection or ejaculation problems. Go the same day for sudden testicle pain or swelling. See a doctor promptly for a new lump in the testicle. Don’t start, stop or change any prescribed medicine because of fertility worries without asking the doctor who prescribed it.
For more plain-language guides like this, browse our Desi Remedies section. The wife’s side of the story is in khwateen mein be-auladi.
Male infertility: questions couples ask
What is the main cause of male infertility?
There isn’t one main cause. Varicocele is among the most common fixable findings, followed by past infections, hormone problems, tobacco, steroid use and excess weight; in a fair share of men no single cause is found even after full testing, and couples can still be helped with IUI or IVF.
How do I know if I am infertile as a man?
You usually can’t tell from how you feel. Most infertile men have no symptoms at all; the only reliable way is a semen analysis, ideally after 12 months of trying, or 6 months if your wife is 35 or older.
Can male infertility be treated?
Often, yes. Repairing a varicocele, stopping steroids, treating an infection or a hormone problem can improve sperm; when that isn’t enough, IUI, IVF and ICSI can work with very few sperm, and sperm can sometimes be taken directly from the testicle.
What is a normal sperm count?
The current World Health Organization lower reference is about 16 million sperm per millilitre, with movement and shape also counting. A number below that isn’t a sentence of infertility, and a number above it isn’t a guarantee; Our semen report guide explains each line.
Kya kamzori se aulad nahi hoti?
General tiredness or “kamzori” doesn’t by itself cause infertility. Specific problems in the testicles, hormones or tubes do; feeling weak can point to anaemia, diabetes, thyroid problems or depression, which deserve a check in their own right.
Does masturbation cause male infertility?
No. Sperm are made every day, and ejaculation doesn’t use up a fixed supply; very frequent ejaculation lowers the count in the next sample for a day or two, which is why labs ask for 2 to 5 days of abstinence before the test.
Does smoking or naswar affect sperm?
Yes. Tobacco in any form is linked with lower counts, poorer movement and more DNA damage in sperm; because sperm take about three months to grow, the benefit of quitting shows up in a report a few months later.
Can gym supplements cause infertility?
Steroids and testosterone, including those hidden in some “mass gainers”, can stop sperm production completely. Plain protein from food doesn’t; if you’ve used steroids, tell the urologist; recovery is possible but can take a year or longer.
Do erection problems mean I am infertile?
Not necessarily. Erection problems and sperm problems are separate, though both can make conceiving harder; weak erections deserve a doctor’s visit because they can be an early sign of heart disease or diabetes.
Is it safe to take herbal medicine for sperm count?
Only with care. Some products sold as herbal contain hidden sildenafil, tadalafil or steroids, and kushtas can contain heavy metals; if you use any herb, choose a labelled product, let a qualified practitioner set the amount, and tell your doctor, especially if you take heart medicine.
Should the husband and wife be tested at the same time?
Yes. Testing both partners in the same month saves time and money; a semen analysis is far simpler than most female fertility tests, so leaving it until last makes little sense.
Does diabetes affect sperm?
Poorly controlled diabetes can affect sperm quality, erections and ejaculation, sometimes causing semen to flow backwards into the bladder. Good sugar control helps; fasting sugar of 126 mg/dL or more, or an HbA1c of 6.5% or more, is the diagnostic line.
What is azoospermia and is there hope?
Azoospermia means no sperm in the semen. It can come from a blockage or from the testicles making very few sperm; in many men a urologist can still retrieve sperm by a small procedure for IVF with ICSI, so get a specialist opinion before giving up.
Which doctor should I see for male infertility?
A urologist or an andrologist (a urologist with special training in male reproduction). Fertility clinics usually have one; your wife’s gynaecologist can order the first semen analysis and refer you.
Can mumps cause infertility in men?
Mumps after puberty can inflame one or both testicles, and in some men it damages sperm production. Mumps in young children rarely does; the MMR vaccine protects against it.