Male Infertility Service

Male Infertility Treatment -

Abstaining from alcohol, tobacco and illicit drugs can improve male fertility. A healthy diet, sufficient (not excessive) exercise, proper amounts of vitamin B12, vitamin C and zinc also improve fertility.

Addressing impotence or premature ejaculation can improve fertility. Treatment for these problems often is primarily with medication or behavioural approaches, though mechanical and surgical treatments are sometimes effective. Artificial insemination with an ejaculate could be deployed to overcome infertility.

Hormonal treatment is needed usually in 5% of the men. Other treatments include surgical treatment of varicocele, ejaculatory duct incisions and sperm concentration methods through electroejaculation.

Microsurgical bypass operations, micro-epididymal sperm aspiration (MESA) and bilateral testicular biopsies are the treatment procedures that are commonly deployed.

This treatment is carried out in cases of irreversible azoospermia, severe oligospermia, poor motility and abnormal morphology of sperm. Other cases include reproductive option after radiation or chemotherapy, severely Rh-sensitized and Rh-negative women with an Rh-positive partner.

At Manipal Fertility, we provide individual care to all our patients and ensure that appropriate treatment, medication and advice is available throughout the treatment lifecycle.

Surgical sperm retrieval is indicated when there is no sperm in the ejaculate (azoospermia). This can result from an obstruction in the reproductive tract (obstructive azoospermia) or due to lack of sperm production (non-obstructive azoospermia). Obstructive azoospermia may be due to a blockage of the tubes transporting the sperm (due to infection or due to surgical blockage of the vas following the male sterilization). Surgical sperm retrieval techniques enable the urologist to recover sperm directly from the epididymis or even the testes of men with obstructive azoospermia so that the sperm can then be used to fertilize eggs by ICSI. The extra sperm and testicular tissue can be frozen for future attempts.

Reproductive Surgery (Micro Surgery) – Surgical sperm retrieval can be achieved by:


Percutaneous Epididymal Sperm Aspiration (PESA)


Microsurgical epididymal sperm aspiration is performed as an open operation under the operating microscope. Individual tubules of the epididymis are isolated and micropuncture aspiration is taken. This approach has the advantages of reliable retrieval of large numbers of epididymal spermatozoa that can be readily frozen and thawed for subsequent attempts at fertility. Since MESA involves direct retrieval of spermatozoa from the epididymal tubule, it minimizes the contamination of the epididymal fluid by blood cells which may affect spermatozoa fertilizing capacity during the IVF.

Testicular fine-needle aspiration of the testis is done for the recovery of spermatozoa. Percutaneous puncture and aspiration of the testis can be performed using a 21-23-gauge needle connected to a 20cc syringe.

Under local or general anesthesia, sperm retrieval is effected using an open testicular biopsy technique.

“The video explains in detail about the Testosterone Replacement Therapy in an informative animated form. The doctor may recommend a Testosterone Replacement Therapy, if the level of testosterone in the blood stream is significantly lower than normal.”

“This video is an informative animated presentation that explains in detail about Testicular Cancer. Testicular Cancer is a disease of abnormal cell growth in one or both of your testicles.”

“This video is an informative animated presentation that explains in detail about sperm retrieval procedures. If a man has trouble in getting a woman pregnant, he may have a condition known as infertility. His doctor may recommend a procedure to collect his sperm, so it can be used to help him father a child.”

“This video is an informative animated presentation that explains in detail about semen analysis. A semen analysis is a test done on men to measure the amount and quality of their reproductive fluid called the semen and their reproductive cell called sperm. For semen analysis, men need to provide semen sample after not ejaculating for two to five days.”