How Fertility Specialists Diagnose and Treat Male and Female Infertility

Infertility — the inability to conceive after one year of unprotected intercourse (or six months if the woman is above 35) — affects many couples globally. At Womb IVF, our mission is to guide couples compassionately through this complex journey, combining the latest science, personalised care, and rigorous diagnostics to maximise success. Below, we explore how fertility specialists diagnose and treat both male and female infertility, current trends, and what patients can expect on this path to parenthood.

1. The Diagnostic Phase: Understanding the Root Causes

Before recommending treatment, fertility specialists conduct detailed investigations to identify the causes of infertility in either or both partners. This systematic approach helps tailor the therapy.

A. Female Fertility Assessment

1. Detailed history & physical exam
   The specialist begins by reviewing menstrual history, previous pregnancies, surgeries, hormonal symptoms (e.g. irregular cycles, PCOS symptoms, thyroid issues), maternal age, lifestyle, and prior investigations.

2. Hormonal blood tests
   Key markers include FSH, LH, estradiol, AMH (anti-Müllerian hormone), TSH, prolactin, and sometimes androgens. These tests assess ovarian reserve, ovulatory function, and endocrine status.

3. Ultrasound (transvaginal / pelvic)
   To assess uterine shape, endometrial lining, ovarian follicles, ovulation signs, and look for fibroids, uterine polyps, ovarian cysts or features of polycystic ovary syndrome (PCOS).

4. Tubal patency evaluation
   Since fallopian tubes must be open for egg–sperm interaction, tests like HSG (hysterosalpingogram), sono-salpingogram (ultrasound + contrast), or even diagnostic laparoscopy may be used to check for blocked or damaged tubes.

5. Uterine cavity evaluation
   Hysteroscopy (camera into the uterus) or saline infusion sonography helps detect polyps, adhesions, septa, or congenital anomalies.

6. Other specialized tests (if needed)
   Laparoscopy for endometriosis, pelvic adhesions, or ovarian lesions; hysterosalpingography for structural issues; genetic / immunological screening when unexplained issues persist.

B. Male Fertility Assessment

1. Semen analysis
   This is fundamental. The semen is evaluated for volume, sperm concentration (count), motility (movement), morphology (shape), vitality, and presence of infections.

2. Hormonal profiling
   Measuring FSH, LH, testosterone, prolactin and sometimes inhibin B can help identify endocrine causes of poor sperm production.

3. Physical & ultrasound exam
   To look for varicocele (enlargement of veins in the scrotum), testicular size and structure, epididymal issues, or obstruction.

4. Genetic testing / chromosomal studies
   In severe cases (very low or no sperm), specialists may test for Y-chromosome microdeletions, karyotyping, or CFTR gene in case of congenital absence of vas deferens.

5. Advanced sperm function tests
   DNA fragmentation assays, oxidative stress markers, sperm chromatin integrity, and other functional assays may be done when conventional semen analysis fails to explain infertility.

6. Sperm retrieval for obstructive / non-obstructive azoospermia
   If no sperm are seen, procedures like PESA (Percutaneous Epididymal Sperm Aspiration), TESA (Testicular Sperm Aspiration), or TESE (Testicular Sperm Extraction) can be attempted to extract sperm directly from testicular or epididymal tissue. Womb IVF offers surgical sperm retrieval for severe male factor cases. 

2. Integrating Diagnoses & Designing a Treatment Plan

Once test results from both partners arrive, fertility specialists at Womb IVF formulate a comprehensive, customized plan. Key principles include:

• Treat the least invasive but effective option first.

• Address treatable causes (e.g. hormonal imbalances, tubal blockages, varicocele).

• Combine interventions when needed (e.g. IUI + mild stimulation) before going to full IVF.

• Use advanced reproductive technology (ART) only after proper evaluation.

Let’s walk through how men and women may be treated, alone or in combination.

3. Treatment Options for Female Infertility

A. Ovulation Induction & Intrauterine Insemination (IUI)

• If ovulation is irregular (e.g. due to PCOS, mild hormonal issues), doctors may prescribe oral or injectable ovulation induction agents (clomiphene citrate, letrozole, gonadotropins).

• When sperm parameters are reasonable and tubes are open, IUI (placing washed sperm into the uterus at the time of ovulation) may be attempted. Womb IVF includes IUI among its core offerings.

• IUI is lower cost, minimally invasive, and often one of the first steps in mild or unexplained infertility.

B. Fertility-Enhancing Surgery & Endoscopy

• Laparoscopic or hysteroscopic procedures may correct structural problems: remove fibroids/polyps, open blocked tubes, resect adhesions, treat endometriosis, or correct uterine septa.

• These interventions can restore normal anatomy and improve natural conception or success of ART.

C. In Vitro Fertilization (IVF) & ICSI

• If simpler treatment fails or underlying issues are severe (e.g. tubal disease, diminished ovarian reserve, male factor), IVF is the preferred route. Womb IVF offers In-Vitro Fertilization (IVF) and ICSI (intracytoplasmic sperm injection) for optimized fertilization.

• In IVF, eggs are retrieved, fertilized in the lab, cultured, and embryos transferred back into the uterus.

• With ICSI, a single sperm is injected into egg cytoplasm—especially useful when male factor or previous fertilization failure is present.

D. Advanced Techniques & Enhancements

• Blastocyst transfer: extending embryo culture to day 5 helps choose viable embryos. Laser hatching: helps embryo hatch and implant by thinning the zona pellucida. 
• PGD / PGS (Preimplantation Genetic Diagnosis / Screening): biopsy of embryos to detect genetic abnormalities, ensuring only healthy embryos are transferred. 
• Cryopreservation: freezing eggs, sperm, or embryos for future use, important in fertility preservation (e.g. before cancer therapy or delaying childbearing).
• Single Embryo Transfer (SET): to minimize twin/multiple risk, especially in older women or those with medical conditions

4. Treatment Options for Male Infertility

A. Medical Management

• Hormonal therapy may be used if endocrine abnormalities are present (e.g. low testosterone, hypogonadism).

• Antioxidants, vitamins, lifestyle changes (reduce smoking, treat obesity, control heat exposure) are supportive strategies.

B. Surgical Correction

• Varicocelectomy: surgery to correct varicocele can improve sperm parameters.

• Correction of obstructions in vas deferens or epididymis may restore sperm delivery.

C. Sperm Retrieval + ART Integration

• If ejaculated sperm are absent, PESA, TESA, TESE methods may recover sperm directly from testicular tissue.

• Retrieved sperm, even in small numbers, can be used with IVF + ICSI for fertilization. Womb IVF includes these surgical sperm retrieval techniques. 
• In severe cases, donor sperm (if acceptable) can be considered as a fallback.

5. Latest Trends in Infertility Diagnosis & Treatment

• Genetic screening and noninvasive assays: improved PGD / PGS, embryo DNA sequencing, and noninvasive prenatal testing to reduce risks.

• Time-lapse embryo monitoring and AI-based embryo selection: capturing continuous images of embryo development to choose the highest potential ones.

• Minimal stimulation IVF / mild protocols: using lower doses of stimulation to reduce risk and cost, especially in “poor responders.”

• Endometrial receptivity assays: tests to determine the best window for embryo transfer (implantation window).

• Adjunct therapies: platelet-rich plasma (PRP) in the endometrium, intrauterine growth factors, immune-modulation therapies for unexplained infertility.

• Fertility preservation: egg and sperm freezing are increasingly common as more people delay parenthood or face medical treatments.

6. What Makes Womb IVF Special?

At Womb IVF, our approach combines evidence-based protocols with individualized care. Some highlights:

• Our full suite of treatments — from fertility treatments in Mumbai to advanced ART and male fertility services — ensures continuity of care under one roof.
• Under the leadership of Dr. Milind Wankhede, a seasoned fertility specialist and gynecologist, we deliver personalized, empathetic fertility solutions tailored to each couple’s needs.

• We integrate advanced techniques like laser hatching, blastocyst transfer, PGD/PGS, and surgical sperm retrieval to handle complex infertility cases. 
• Our clinic is committed to transparency, quality, and ongoing monitoring to maximize success and patient comfort from diagnosis through treatment and follow-up.

7. Patient Journey: A Snapshot

1. Initial consultation & baseline tests – medical history, baseline labs, imaging

2. Detailed fertility workup for both partners

3. Discussion of diagnosis & options

4. First-line treatments (ovulation induction + IUI, surgical correction, lifestyle changes)

5. If needed, proceed to IVF/ICSI + adjunctive methods

6. Embryo transfer & luteal support

7. Pregnancy testing, monitoring, follow-up

8. Cryopreservation & future planning if needed

8. Key Takeaways for Patients

• Infertility is often multi-factorial — treating both partners together yields better outcomes.

• Diagnosis is the cornerstone: the more precisely the cause is identified, the better the treatment choice.

• Start with less invasive options where possible; escalate to ART when needed.

• Modern fertility care integrates genetic screening, embryo monitoring, and personalised protocols to boost safety and success.

• Emotional support, realistic expectations, and patience are vital in this journey.

At Womb IVF, we believe in walking this journey with you — diagnosing, guiding, treating, and supporting you until you hold your baby in your arms.

Frequently Asked Questions (FAQs)

1. Q: How long does the diagnostic phase usually take at Womb IVF?
   A: The initial diagnostic phase typically spans 4–6 weeks, depending on coordination of blood tests, hormonal assays, imaging (ultrasound, HSG), and sometimes laparoscopy or genetic tests. Once results are compiled, your fertility specialist makes a plan.

2. Q: Can male infertility alone be overcome without IVF?
   A: It depends on severity. In mild-to-moderate cases, lifestyle changes, hormonal treatments, varicocele repair, or antioxidant therapy may help. But in severe cases (low or no sperm), IVF + ICSI combined with surgical sperm retrieval (PESA/TESA/TESE) may be necessary — a service we provide at Womb IVF.

3. Q: What is the difference between IVF and ICSI, and when is each used?
   A: In IVF, eggs and sperm mix in a petri dish and fertilization occurs naturally in vitro. In ICSI, a single sperm is directly injected into the egg. IVF is preferred when sperm parameters are good; ICSI is indicated when there’s male factor infertility or previous fertilization failure.

4. Q: Can I preserve my fertility (eggs or sperm) at Womb IVF, and when is it recommended?
   A: Yes — at Womb IVF we offer cryopreservation of eggs, sperm, and embryos using advanced vitrification techniques. This is especially useful for those undergoing cancer therapy, planning delayed parenthood, or wanting backup embryos for future transfer.