India's assisted reproduction sector has expanded significantly in recent years, reflecting growing awareness of fertility challenges and improved access to treatment. A peer-reviewed analysis published in Reproduction and Fertility found that the number of ART centres in the country increased from around 500 in 2010 to approximately 1,500 by 2019. Alongside this growth has come a broader understanding of infertility as a shared concern, rather than one that affects women alone. Male factors are now estimated to contribute to 40-50% of infertility cases among couples seeking treatment, bringing male reproductive health into sharper focus as a critical, yet often under-addressed, aspect of India's evolving fertility landscape.
While this shift is encouraging, it also highlights an issue that has long remained under-recognised--male reproductive health.
One in every six people experience infertility in their lifetime, yet the attention seldom is upon men, who are also prone to reproductive issues. Due to the lack of awareness about male infertility, many men delay evaluation due to stigma, lack of awareness, or hesitation about seeking help. WHO notes that infertility affects both men and women and defines it as the inability to achieve pregnancy after 12 months or more of regular, unprotected sexual intercourse. Yet, social perceptions continue to place the burden of investigation primarily on women, even when male factors may be equally involved. This delay can result in couples spending more time, money and emotional energy before receiving the right diagnosis and treatment.
This is a growing public health concern in India according to a 2025 study based on Global Burden of Disease (GBD) data which states that the prevalence of male infertility in South Asia increased by nearly 47% between 1990 and 2021. India recorded the highest increase in the region, with prevalence rising by almost 59%, particularly among younger men in their late twenties.
{{/usCountry}}This is a growing public health concern in India according to a 2025 study based on Global Burden of Disease (GBD) data which states that the prevalence of male infertility in South Asia increased by nearly 47% between 1990 and 2021. India recorded the highest increase in the region, with prevalence rising by almost 59%, particularly among younger men in their late twenties.
{{/usCountry}}Male infertility can result from a variety of medical conditions, many of which are treatable if diagnosed early. One of the most common causes is varicocele, a condition in which veins within the scrotum become enlarged, affecting sperm production. Research has shown that men with varicocele are more than three times as likely to develop azoospermia, a condition in which no sperm are present in semen.
Another important cause is obstructive azoospermia, which accounts for roughly one in five cases of male infertility. It occurs when there is a blockage in the reproductive tract, preventing sperm from being released. Early diagnosis can help doctors offer targeted treatments, including surgical sperm retrieval procedures.
In some cases, infertility may be linked to genetic factors, such as chromosomal abnormalities or Y-chromosome microdeletions, which may require specialised testing and genetic counselling.
Everyday habits can also affect male fertility. Lifestyle factors such as smoking, obesity and excessive alcohol intake, as well as exposure to environmental pollutants, can also negatively affect reproductive health. Prolonged heat exposure from certain occupations, long hours of driving, or extended sitting periods are also known factors of sperm DNA damage.
In addition, chronic stress, poor diet, low physical activity levels and excessive alcohol consumption may further impact fertility. While lifestyle changes may not resolve every fertility issue, they remain a simple and important part of any fertility care plan.
Despite improvements in fertility care across India, many men continue to be tested much later than their partners, or in some cases, not at all. Experts say this delay is often driven by stigma, fear of diagnosis and concerns around cost rather than medical necessity. Recent changes under India's ART (Regulation) Act, 2021 have also influenced how fertility clinics operate, affecting donor programmes, treatment pathways and cost structures. These are important considerations that couples should discuss with their health care providers.
One of the simplest and most effective diagnostic tools for male infertility remains the semen analysis. It is quick, non-invasive, relatively affordable and can provide valuable insights that help guide treatment decisions.
For couples trying to conceive, fertility care is ultimately about finding answers. Those answers are often incomplete when only one partner is assessed. As fertility patterns continue to evolve in India, experts stress the importance of early, evidence-based and stigma-free evaluation of both partners.
(The views expressed are personal)
This article is authored by Dr Unnati Mamtora, chief fertility consultant, Aksigen IVF.