Month: July 2026

In India, fertility investigation is almost always started with the woman. Blood tests, scans, hormone panels — the woman goes through test after test while the man waits. This is one of the most common and costly mistakes in fertility care. The reality is that male factor infertility contributes to approximately 40 to 50 percent of all infertility cases — and a semen analysis costs a fraction of what a single IVF cycle costs.

Dr. Durga Vytla, a fertility specialist in Gachibowli, Hyderabad, makes semen analysis a mandatory first step in every couple's fertility workup — without exception. This guide explains what a semen analysis measures, what the results mean, and what options are available when the numbers are not normal.

What Is a Semen Analysis?

A semen analysis — also called a seminogram or sperm test — is a laboratory examination of a sperm sample. The sample is produced by masturbation after 2 to 5 days of sexual abstinence and is analysed within 1 hour of collection. The test evaluates multiple parameters of sperm health simultaneously.

It is non-invasive, relatively affordable (typically somewhere around Rs. 400 to Rs. 1,800 in Hyderabad), and provides an enormous amount of diagnostic information in a single test. There is no medical reason to delay doing a semen analysis — yet it is routinely deprioritised in fertility workups across India.

What Does a Semen Analysis Measure? — The 4 Key Parameters

1. Sperm Count (Concentration)

The normal threshold per WHO 2021 reference values is 16 million sperm per millilitre of semen. A count below this is called oligospermia (low sperm count). A count of zero sperm is called azoospermia — which requires further investigation to determine whether the cause is a production failure (non-obstructive) or a blockage preventing sperm from being released (obstructive).

2. Sperm Motility

Motility refers to the ability of sperm to move. WHO guidelines specify that at least 42 percent of all sperm should show some form of movement, and at least 30 percent should show progressive motility — meaning they are moving in a reasonably straight, forward direction toward the egg. Sperm that are not moving, or that move in circles or erratically, cannot fertilise an egg.

3. Sperm Morphology

Morphology refers to the shape and structure of individual sperm. This is assessed under high magnification using Kruger Strict Criteria. The threshold that causes concern is when fewer than 4 percent of sperm are normally shaped. At first glance, 4 percent sounds extremely low — but this is the established clinical standard. Abnormal shapes include large or small heads, double heads, coiled tails, or midpiece defects. Abnormal morphology reduces the sperm's ability to penetrate the egg.

4. Semen Volume

The total volume of the ejaculate should ideally be between 1.4 and 1.7 millilitres or more. A very low volume (less than 1.0 mL) may suggest retrograde ejaculation (where semen goes backward into the bladder), blockage of the ejaculatory ducts, or hormonal issues. A very high volume can dilute sperm concentration.

Other Important Parameters

•       Liquefaction time: Semen should liquefy within 60 minutes of ejaculation. Failure to liquefy can trap sperm and reduce motility.
•       pH: Normal semen is slightly alkaline (pH 7.2 to 8.0). Acidic semen can indicate blockage or infection.
•       White blood cells: Elevated WBCs in semen suggest infection or inflammation, which can impair sperm function.
•       Sperm vitality: The percentage of live sperm, regardless of motility. Even immotile sperm may be alive — relevant for ICSI.

What Causes Abnormal Semen Parameters?

Male infertility can arise from a wide range of causes — hormonal, structural, lifestyle-related, or genetic:

•       Varicocele: Varicose veins in the testes that raise temperature and impair sperm production — the most common treatable cause of male infertility
•       Hormonal imbalance: Low testosterone, high FSH, or elevated prolactin affecting sperm production
•       Obstruction: Blocked vas deferens or ejaculatory ducts preventing sperm from being released
•       Genetic factors: Y chromosome microdeletions or Klinefelter syndrome affecting sperm production
•       Infection: Sexually transmitted infections or prostatitis affecting sperm quality
•       Lifestyle: Smoking, alcohol, anabolic steroids, heat exposure (laptops on lap, hot baths), obesity
•       Medications and toxins: Certain medications and environmental exposures that impair sperm production

When Is ICSI Recommended for Male Infertility?

When semen parameters are significantly below normal, IVF with ICSI (Intracytoplasmic Sperm Injection) becomes the most effective assisted conception option. In ICSI, a single sperm is selected under high magnification and injected directly into a mature egg — bypassing the need for the sperm to penetrate the egg independently.

ICSI is recommended by Dr. Durga Vytla in Gachibowli for:

•       Severe oligospermia (very low count)
•       Severe asthenospermia (very poor motility)
•       Severe teratospermia (very poor morphology)
•       Surgically retrieved sperm (from TESA or PESA procedures for obstructive azoospermia)
•       Previously failed fertilisation with conventional IVF
•       Sperm DNA fragmentation above the clinical threshold

What Is Sperm DNA Fragmentation?

Beyond the standard semen analysis, Sperm DNA Fragmentation (DFI) testing is increasingly recommended in cases of recurrent IVF failure, repeated miscarriage, or unexplained infertility despite normal basic semen parameters. DNA fragmentation measures the percentage of sperm with damaged genetic material in their DNA strand.

High DNA fragmentation — typically above 25 to 30 percent — can impair fertilisation rates, embryo development, and implantation success even when standard semen parameters look normal. If standard tests are normal but fertility treatment is not working, DNA fragmentation testing is an important next step.

Can Semen Parameters Be Improved?

In many cases, yes — particularly when the cause is lifestyle-related or hormonal. Sperm takes approximately 90 days to fully mature (spermatogenesis), which means that changes made today will take about 3 months to reflect in a new semen analysis. Improvements that have evidence behind them include:

•       Stopping smoking: Smoking is directly linked to reduced count, motility, and increased DNA fragmentation
•       Reducing alcohol: Heavy alcohol consumption suppresses testosterone and impairs sperm production
•       Maintaining healthy weight: Obesity increases oestrogen levels and reduces testosterone
•       Reducing heat exposure: Avoiding hot baths, saunas, and keeping laptops off the lap
•       Antioxidant supplementation: Vitamin C, Vitamin E, zinc, selenium, and CoQ10 have evidence for improving sperm quality in men with oxidative stress-related infertility
•       Treating the underlying cause: Varicocele repair, antibiotic treatment for infection, or hormonal correction can produce significant improvements

Book a Consultation

If you and your partner are trying to conceive, do not wait to test only the woman. Book a couple's fertility evaluation with Dr. Durga Vytla in Gachibowli, Hyderabad — where both partners are investigated together from the very first visit.

If you have visited a fertility specialist recently and been told you need an AMH test, you may have wondered what that number actually means — and whether a low result means you cannot have children. Dr. Durga Vytla, a fertility and IVF specialist based in Gachibowli, Hyderabad, explains ovarian reserve in plain language so you can make informed decisions about your fertility journey.

What Is Ovarian Reserve?

Ovarian reserve refers to the quantity and quality of eggs remaining in your ovaries at any given time. Every woman is born with a fixed number of eggs — somewhere between one and two million — and that number declines throughout life. By puberty, this falls to approximately 300,000 to 500,000. By the time a woman reaches her late 30s, the number has fallen significantly further, and the rate of decline accelerates.

Unlike men, who continuously produce new sperm, women cannot generate new eggs. The eggs you have at any point in your life are the ones you were born with — and each month, a cohort of eggs is recruited, one matures and is released at ovulation, and the rest are lost. This is why time matters in fertility, and why ovarian reserve testing is such a valuable tool.

How Is Ovarian Reserve Measured?

1. AMH — Anti-Mullerian Hormone

AMH is produced by the small follicles in the ovaries, and its level in the blood gives a direct reflection of the number of remaining follicles — and therefore the approximate egg count. The key advantages of AMH as a test are:

•       It can be done on any day of the menstrual cycle — no need to wait for a specific cycle day
•       It is a blood test — quick, simple, and minimally invasive
•       It does not fluctuate significantly from cycle to cycle, making it a reliable snapshot

AMH levels decline with age, but they also vary between women of the same age. This is why two women who are both 32 years old may have very different fertility outlooks — one with an AMH of 3.5 ng/mL and another with an AMH of 0.8 ng/mL are in very different clinical situations.

2. Antral Follicle Count (AFC)

The Antral Follicle Count is performed via transvaginal ultrasound, typically on Day 2 or 3 of the menstrual cycle. The sonographer counts the number of small, resting follicles visible in both ovaries. These small follicles represent the pool from which eggs will be recruited for IVF stimulation.

A combined interpretation of AMH and AFC gives the most accurate picture of ovarian reserve. AMH tells us about the hormone signal; AFC tells us about the actual visible follicle pool.

3. Day 2 or 3 FSH

Follicle Stimulating Hormone (FSH) measured early in the menstrual cycle is an older but still useful marker. When ovarian reserve is low, the pituitary gland works harder — producing more FSH to stimulate the ovaries. An elevated FSH on Day 2 or 3 (typically above 10 to 12 IU/L) may suggest diminished reserve, and is interpreted alongside AMH and AFC for the full picture.

What Do AMH Levels Mean?

Does Low Ovarian Reserve Mean You Cannot Get Pregnant?

No — and this is the most important message. Low ovarian reserve does not mean zero fertility. It means that your egg supply is more limited than average for your age, and that time and strategy become more important.

Many women with low AMH conceive naturally or through IVF — but they benefit from acting sooner rather than later, and from working with a fertility specialist who can tailor their treatment protocol appropriately. A blanket protocol designed for a 28-year-old with normal reserve will not give the same results for a 36-year-old with low reserve — and that is exactly where individualised care makes the difference.

What Affects Ovarian Reserve?

Beyond age — which is the strongest predictor — several other factors can accelerate the decline of ovarian reserve:

•       Genetics: A family history of early menopause or premature ovarian insufficiency
•       Previous ovarian surgery: Removal of ovarian cysts or endometriomas can reduce the surrounding follicular tissue
•       Endometriosis: Particularly when it involves the ovaries, it can damage the follicle pool
•       Autoimmune conditions: Some autoimmune diseases can target ovarian tissue
•       Chemotherapy or radiation: Cancer treatment can significantly and sometimes permanently deplete ovarian reserve
•       Smoking: Shown to accelerate follicle loss and bring forward the age of menopause

Ovarian Reserve and IVF in Hyderabad — What to Expect

In IVF, ovarian reserve directly determines how many eggs are likely to be retrieved in a stimulation cycle. Women with higher reserve produce more eggs, giving the laboratory more embryos to select from. Women with low reserve may produce fewer eggs, meaning each egg is precious — and the stimulation protocol must be optimised carefully.

Dr. Durga Vytla tailors every IVF protocol in Hyderabad to the individual patient's ovarian reserve profile. For low responders, a modified stimulation approach and careful timing strategies are used to maximise the number and quality of eggs retrieved.

Who Should Get an Ovarian Reserve Test?

•       Any woman above 30 who is planning to start trying for a baby in the next 1 to 2 years
•       Any woman who is considering egg freezing for fertility preservation
•       Women with irregular periods, PCOS, or a history of ovarian surgery
•       Women with a family history of early menopause
•       Couples who have been trying to conceive for 6 to 12 months without success
•       Women about to undergo chemotherapy or radiation who wish to preserve fertility

Book a Consultation

Find out your ovarian reserve today. Book an AMH and fertility evaluation with Dr. Durga Vytla in Gachibowli, Hyderabad. One blood test can change how you plan your fertility journey.