Male infertility

A structured path through male infertility.

In roughly half of infertile couples, a male factor is contributing. A careful workup — semen analysis, hormones, imaging — usually reveals a treatable cause.

PMDC Registered

Neurospinal and Cancer Care Institute (NCCI)

Consultation

Mon – Sat, Evenings

Introduction

Why the male workup matters

Focusing only on the female partner is a common — and costly — mistake. A simple semen analysis and hormonal panel can save couples years of unsuccessful attempts and needless IVF cycles.

Semen analysis is the essential first test
Hormonal profile (FSH, LH, testosterone, prolactin)
Scrotal ultrasound to look for varicocele
Genetic and karyotype testing when indicated

Causes

Common causes of male infertility

Male infertility rarely has just one cause. A methodical review usually finds one or more contributing factors — most of them treatable.

Cause 01

Varicocele

Enlarged scrotal veins — the single most common correctable cause.

Cause 02

Hormonal imbalance

Low testosterone, high prolactin or thyroid disorders can suppress sperm production.

Cause 03

Infections

Past mumps orchitis, tuberculosis or untreated STIs may damage the testes.

Cause 04

Genetic factors

Klinefelter syndrome or Y-chromosome microdeletions affect sperm counts.

Cause 05

Obstruction

Blocked ducts from prior hernia surgery, infection or congenital absence of the vas.

Cause 06

Lifestyle

Smoking, heat exposure, obesity, steroids and certain medications all impair sperm.

Symptoms to watch

When to see a urologist

Any one of the following symptoms is worth a consultation — especially if it has been ongoing for more than a few weeks.

!No pregnancy after 12 months of trying

!Very low semen volume or thin ejaculate

!Testicular pain, swelling or heaviness

!History of undescended testis or hernia surgery

!Low libido or erectile difficulties

Diagnosis

How the diagnosis is made

The evaluation is quick, respectful and evidence-based. Most couples have a clear diagnosis after a single visit and two tests.

1
Couple-focused history
Duration of trying, prior pregnancies, medical and surgical background of both partners.
2
Physical examination
Checks for varicocele, testicular volume and abnormalities of the vas deferens.
3
Semen analysis ×2
Two samples 2–3 weeks apart — the cornerstone of the workup.
4
Hormone panel
FSH, LH, testosterone, prolactin and thyroid function tests.
5
Scrotal ultrasound
Confirms varicocele, testicular tumours and duct anomalies.

Why patients choose us

A modern approach, delivered with warmth

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Lifestyle & medical

Weight, smoking, heat exposure, medications — often correctable.

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Hormonal therapy

For hypogonadotropic hypogonadism and select hormonal patterns.

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Varicocelectomy

Micro-surgical repair for varicocele — the commonest correctable cause.

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Micro-TESE

Sperm retrieval for non-obstructive azoospermia, coordinated with IVF.

Prevention & lifestyle

What you can do every day

Sperm are exquisitely sensitive to heat, toxins and lifestyle. Small changes over 3 months can transform a semen analysis.

✓Stop smoking and recreational drugs entirely

✓Avoid saunas, hot tubs and laptops on the lap

✓Limit alcohol to occasional, moderate use

✓Achieve a healthy BMI — obesity lowers testosterone

✓Never use anabolic steroids — they shut down sperm production

✓Have a semen analysis before starting any long-term medication known to affect fertility

Inside the practice

A day at the clinic

Real moments from consultations, imaging, surgery and follow-up — the standard of care patients can expect.

Frequently asked

Questions patients often ask

One year of regular unprotected intercourse is the classic cutoff, or 6 months if the female partner is over 35. Come sooner if there are risk factors on either side.

No — the sample is repeated 2–3 weeks later before drawing conclusions. Recent illness, medications and abstinence period all affect the result.

In selected patients with an abnormal semen analysis and a clinical varicocele, micro-surgical repair improves semen parameters in around two-thirds of cases.

Book a consultation

Ready to talk it through?

A single consultation usually clarifies the diagnosis and the treatment path. Book yours today, or contact the doctor for a quick question.

Dr. Shahid H. Baloch

Consultant Urologist & Sexologist in Karachi — providing modern, evidence-based urological care with a focus on kidney stones, prostate disease, male infertility and men’s sexual health.

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