Male infertility in India: How toxic lifestyles, pollution are sabotaging men’s reproductive health

Male infertility now accounts for 30-40% of conception challenges in India, emerging as a major yet under-discussed public health issue. Driven by modern lifestyle factors, environmental exposures and genetic conditions, the problem affects an estimated 27.5 million people nationwide.

Medical experts warn that addressing this challenge requires a three-pronged approach: improved diagnostic tools, timely medical interventions and concerted efforts to reduce the social stigma surrounding male reproductive health.

Firstpost talked to leading specialists to analyse the causes behind this trend, evaluate current treatment options and discuss pathways to better awareness and care.

India’s infertility crisis: 27.5 million affected

Dr. Archana Dhawan Bajaj, Gynecologist, Obstetrician and IVF Expert, Nurture IVF Clinic (New Delhi):

Male infertility has become a major issue impacting a large segment of the global population, leading to conception difficulties for millions of couples around the world.

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With infertility rates rising in India, the issue has become a major personal and social health concern. Infertility has repercussions that extend beyond emotional turmoil, impacting the social and economic spheres of the couples involved. India is home to an estimated 27.5 million infertile individuals, comprising both men and women.

A semen test is among the key examinations utilised to assist in diagnosing male infertility. A semen sample is subjected to this laboratory examination that assesses the quality and volume of your sperm.

Additional tests that a provider might recommend to assist in determining the cause of male infertility may consist of imaging tests like ultrasound or magnetic resonance imaging (MRI), as well as invasive tests such as a venogram.

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Hormone levels can be assessed through blood tests, which can also check for genetic or chromosomal irregularities. Urinalysis (test of urine) can assist in diagnosing STIs and diabetes. A testicular biopsy involves removing a small sample of testicular tissue to assess the sperm production level of your testicles.

How advanced diagnostics can improve fertility outcomes

Dr. Sanjay Gohil, Consultant Haematopathologist, HOD Haematology & Transplant Immunology, Immunogenetics (HLA), Metropolis Healthcare Ltd:

Diagnostics play a critical role in the early detection of male infertility. Through semen analysis, hormonal tests, genetic testing, imaging, and other procedures, clinicians can identify the root causes of infertility. Early detection enables better treatment options, improves chances of conception, and helps individuals and couples take proactive steps toward resolving infertility.

Semen Analysis is the primary and most critical test for assessing male fertility. This comprehensive analysis evaluates key factors like sperm count, motility (movement), morphology (shape), and semen volume. These parameters are essential for determining sperm quality and fertility potential.

The Sperm DNA Fragmentation Test measures the integrity of sperm DNA. High levels of DNA fragmentation can significantly impact fertility and may be linked to poor reproductive outcomes.

Hormonal imbalances are another key factor in male infertility. Testosterone, Follicle-Stimulating Hormone (FSH), and Luteinizing Hormone (LH) play essential roles in regulating sperm production. Blood tests to measure these hormone levels can reveal any imbalances that may hinder fertility.

Genetic testing is also critical in diagnosing male infertility. Testing for Y-chromosome Microdeletions and karyotype abnormalities and screening for Cystic Fibrosis Mutations help identify genetic abnormalities that may affect sperm production or function.

In cases of Azoospermia (absence of sperm in semen), a Testicular Biopsy may be performed to determine if sperm production is occurring within the testes. This test can also provide sperm for assisted reproductive technologies if needed.

Lastly, Varicocele—a condition involving enlarged veins in the scrotum—is a common anatomical cause of male infertility. Other structural abnormalities can also contribute to infertility and can be detected using imaging techniques such as Scrotal Ultrasound.

Early diagnosis using these advanced tools is vital for determining the right course of action, improving fertility outcomes, and offering couples a better chance of conception.

Unhealthy lifestyles and pollution drive male infertility in India

Dr Amit Mutha, Senior Consultant, Sexual Medicine and Andrology, S. L. Raheja Hospital-A Fortis Associate, Mahim, Mumbai:

Recent scientific studies have shown that Male Infertility contributes to 30-40 percent of infertility cases in India. Globally, Male Infertility is a growing lifestyle disorder. This figure has steadily grown over the last decade, particularly among young men.

Factors like low sperm count, poor motility, hormonal imbalances, genetic conditions, plastic - microplastics endocrine disruptor, along with sexually transmitted infections like Gonorrhea, Trachoma, Herpes, etc., are contributing to increased incidence of male infertility.

Unhealthy lifestyles like a sedentary lifestyle, lack of exercise and sleep, chronic stress, and substance abuse like smoking, consumption of alcohol and drugs are significantly contributing to the rising numbers of male infertility cases.

Increased incidence of Sexually Transmitted Infections due to polygamous and polyandrous sexual indulgence, along with rising levels of air pollution across metro cities and rampant plastic pollution, is another factor causing the issues. Additionally, men who are exposed to high temperatures and radiation at their workplace and are within a proximity to blast furnaces have reported a serious decline in their sperm quality and quantity over time. Surgical conditions like Varicocele also contribute to the growing concern.

Male infertility continues to be a taboo and is rarely discussed in common parlance. However, most of the infertility cases are treatable with correct diagnosis, treatment and assisted reproductive techniques like Intrauterine Insemination (IUI), In Vitro Fertilisation (IVF) and Intracytoplasmic Sperm Injection (ICSI).