Patients who have difficulty conceiving tend to investigate only the woman, and the man is rarely considered at fault. However, whenever I am looking at a couple, I believe that 30% of causes of infertility are female related, 30% are male related, 30% where both the partners have an issue, and 10% couples have unexplained infertility where all the reports are normal and there's no reason why. Therefore, it is essential to investigate the male, as he plays a key role in treatment, not only biologically but also emotionally and behaviourally.
Male Factor Infertility: More Common Than We Think
Male factor infertility contributes to nearly 40–50% of infertility cases, either as a sole cause or in combination with female factors. Low sperm counts, reduced motility, abnormal morphology, DNA damage (DNA Fragmentation) & and hormonal imbalances can affect fertilisation rates, embryo quality, implantation and even pregnancy outcomes.
Sperm Quality Directly Impacts Embryo Health
While IVF and ICSI (Intracytoplasmic Sperm Injection) have enabled fertilisation even with low sperm count, we have to consider sperm quality as well. Poor sperm DNA integrity has been associated with lower fertilisation rates, poor quality embryos, failed implantation and increased miscarriages.
Advanced tests, such as sperm DNA fragmentation assays, help identify hidden sperm issues that routine semen analysis may miss. Addressing these concerns through medical treatment, antioxidants, or lifestyle modification can significantly improve IVF outcomes.
Lifestyle Choices Make a Big Difference
We often think the woman has to make lifestyle changes to improve pregnancy rates; however, it is equally important for a man to make these changes. Men underestimate how smoking, alcohol consumption, obesity, chronic stress, poor sleep, and exposure to environmental toxins negatively impact sperm production and function.
Simple yet effective changes—like quitting smoking, moderating alcohol intake, maintaining a healthy weight, exercising regularly, improving diet, and managing stress—can enhance sperm parameters within just a few months. Since sperm development takes approximately 74 days, timely lifestyle correction before IVF cycles can be extremely beneficial.
In addition to this, when we ask the woman to make lifestyle changes, it is important to have the support of the male partner in aiding these lifestyle changes for their partner. For example, in PCOS patients, when we advocate diet and exercise, I always ask the partner to support this by following a similar diet and exercise pattern so that the woman isn't in an obesogenic environment.
Hormonal Balance and Medical Conditions
Men suffering from diabetes, thyroid disorders, varicocele, infections, and hormonal imbalances can impair sperm quality. It's very important to identify and treat some of these conditions before the IVF procedure, as it can tremendously improve sperm health and reduce the interventions required. Sometimes, treating these conditions can even lead to a natural pregnancy.
The Emotional and Psychological Role of the Male Partner
Emotional support from the male partner definitely has an important role in the success rates of the IVF Process. IVF is not only a physical procedure, but it also affects the woman emotionally. Male partners who stay informed and remain present throughout the procedure help reduce their partners' stress levels. High stress levels can negatively affect the hormones and possibly affect treatment outcomes.
Compliance and Timely Participation Matter
IVF success also depends on precision and timing. The male partners should be available and compliant for semen collection, abstinence periods & follow-ups. In case of severe cases, we may have to even go for surgical sperm retrieval like TESA & micro-TESE
Genetic Contribution and Long-Term Outcomes
Sperm quality influences not just fertilisation but also the long-term health of the child. Emerging research suggests that poor sperm DNA integrity may affect epigenetic programming, potentially influencing pregnancy outcomes and offspring health.
This underscores the importance of optimising male fertility well before attempting conception—whether natural or assisted.
Breaking the Myth: IVF Is Not Just a Woman's Responsibility
One of the biggest barriers to successful IVF treatment is the persistent myth that fertility issues are primarily a woman's problem. This mindset delays male evaluation, increases emotional strain on women, and may reduce the overall chances of success.
A collaborative approach—where both partners take equal responsibility for diagnosis, treatment, and lifestyle changes—leads to better clinical outcomes and a healthier emotional journey.
So, remember: IVF is a team effort, and both partners are indispensable parts of that team. From sperm quality and lifestyle choices to emotional support and treatment compliance, men influence every stage of the IVF process. It's important to address male factors early and treat them so we can significantly increase the chances of parenthood for couples.
About Dr. Rohan Palshetkar
Dr. Rohan Palshetkar is a distinguished IVF specialist, endoscopic surgeon, obstetrician, and gynaecologist based in Mumbai, known for his gold-medal academic background in M.S. OBGY and advanced training in reproductive medicine and embryology. He currently serves as Head of Unit at Bloom IVF and has extensive experience in infertility treatment, minimally invasive surgery, and comprehensive women’s healthcare. Dr. Rohan Palshetkar has also held academic roles and delivered lectures at national and international forums, reflecting his commitment to advancing women’s health. His practice focuses on personalized, compassionate care to support families through their fertility and reproductive journeys.
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