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Male infertility treatment in Goa
A male factor is involved in roughly half of couples who cannot conceive, and one simple semen test finds it. Many causes can be treated — with medicines, a small operation, IUI or ICSI. Even when no sperm are seen in the semen (azoospermia), micro-TESE under an operating microscope may still find sperm. Heartbeats IVF does this in Goa, in its own theatre at Vasco.
Usually, every test so far has been hers. Her scans, her blood tests, her questions from relatives. Nobody has asked him anything — and he has not offered, because somewhere inside he is afraid of what the report will say about him.
That is the wrong way round, and it costs couples years. A male factor is present in about half of couples — sometimes on its own, often alongside a female factor. So the semen test belongs at the beginning of the work-up, not the end: it is quick, it is inexpensive, and it spares a woman months of treatment aimed at the wrong problem. We test both partners together.
If you are the one reading this tonight, and not your husband — that is common, and you do not have to persuade him of anything by yourself. Showing him this page is often easier than finding the words out loud. Most men agree to the test once someone else has raised it first.
What a semen analysis measures
The sample is given in a private room and examined under a microscope:
- Count — how many sperm, in how much fluid.
- Motility — how many are moving, and how many swim forward.
- Morphology — how many are normally shaped; shape affects a sperm's ability to fertilise an egg.
- Whether sperm are there at all — if none are seen, the sample is spun down and rechecked before azoospermia is diagnosed.
One poor report is not a verdict. Sperm take about three months to be made, so an illness months ago can pull a report down. We usually repeat the test.
Causes that can often be corrected
- Varicocele — enlarged veins that keep the testis too warm; in selected men a small operation can improve the report.
- Hormone problems — weak signals from the brain to the testis; hormone treatment helps some men.
- Infection — treated with an appropriate course of antibiotics.
- Blockage — sperm are made but cannot get out; they can be collected directly.
- Everyday causes — smoking and tobacco, heavy alcohol, long hours of heat, excess weight, uncontrolled diabetes or thyroid disease.
ICSI — when sperm are few or weak
Often no clear cause is found. ICSI can still be attempted as part of an IVF cycle, with the sperm a man has: intracytoplasmic sperm injection, where the embryologist injects a single healthy-looking sperm directly into an egg. A count too low for natural conception or IUI may still be enough to try. Our laboratory does ICSI in-house.
Micro-TESE — when the report says no sperm at all
Azoospermia means no sperm are seen in the semen. It does not automatically mean you cannot be a biological father. In some men the testis is still making sperm in small pockets — too few to reach the semen, but possibly enough to fertilise an egg.
Micro-TESE (microdissection testicular sperm extraction) is how those pockets are looked for. Under anaesthesia the testis is opened and examined through a high-powered operating microscope. The magnification lets the surgeon see individual tubules — the tiny tubes inside the testis where sperm are made — and choose the fuller, healthier-looking ones instead of taking tissue blindly. What is found goes to the embryologist in the same session for ICSI, or is frozen.
It removes far less tissue than an ordinary needle or open biopsy. It needs that microscope, a trained surgeon and an embryology laboratory alongside — which is why many centres cannot offer it, and why we do it here in Goa. Sperm are not found in every man, and we say so before you decide.
Before advising the operation we check hormone levels and, where indicated, genetic tests — for two reasons. First, certain genetic patterns tell us in advance that a search inside the testis is very unlikely to succeed, which spares you an operation that would not have helped. Second, and this matters more: where a genetic cause is found, ICSI works around it; it does not repair it. The same cause can be passed on to a son, who could face this difficulty one day himself. If that applies to you we explain it fully, in your own language, and arrange genetic counselling — an unhurried sitting with a specialist in genetics — before you decide. The decision stays yours; it should just never be made without knowing this.
If you feel ashamed, read this part
Men put this test off for years because of what they fear it says about them. So, clearly: sperm production and sexual function are largely separate systems. Normal erections and a normal sex life are entirely possible in a man with no sperm in the semen. Largely, not entirely: testosterone drives both, so one hormone problem can weaken erections and the sperm report together — and that problem is itself often treatable. One more reason to be tested rather than to lie awake wondering. A couple's difficulty is never one person's fault.
Where we see you
The semen analysis, the consultation and the blood tests are done at whichever Heartbeats clinic is nearest you — Panjim, Margao, Mapusa or Vasco. That is the whole of it for most men.
Micro-TESE is different: it needs an operating microscope, an anaesthetist and an embryology laboratory in the next room, all in the same session, so it is done at Pai Hospital, Vaddem, Vasco-da-Gama. So is a varicocele operation. On a hospital day we send a car for you, free of cost, from your clinic and home again afterwards.
Dr. Mayur Pai (MBBS, MS) has practised fifteen years and does the procedures himself; three doctors are on the team, and we use single-use disposables throughout. Call or WhatsApp 095185 02773.
Questions men ask us
Is infertility the woman's problem or the man's?
Either, or both — a male factor is involved in about half of couples. Until the husband has had a semen test, the couple is only half investigated.
My sperm count is low. Can I still have my own child?
Often, yes. A low count can improve once the cause is treated, and ICSI needs only a few usable sperm — one is injected into each egg.
My report says azoospermia — no sperm. Is there any treatment in India?
Yes. If sperm are made but blocked, they can be collected directly. If production is very low, micro-TESE searches the testis under an operating microscope for pockets still making sperm.
If the cause turns out to be genetic, can it pass to my son?
It can. ICSI works around a genetic cause rather than repairing it, so a son may inherit the same difficulty. That is why we test for it before advising micro-TESE, and arrange genetic counselling if it is found, so the choice is yours and fully informed.
Do I have to travel out of Goa for micro-TESE?
No. It is done in our own theatre at Pai Hospital, Vasco, with our own embryology laboratory in the next room and in the same session, so any sperm found goes straight to ICSI or is frozen.
Where can I get male infertility treatment in Goa?
Heartbeats IVF. Semen analysis, the consultation and treatment of correctable causes at the clinic nearest you: Panjim, Margao, Mapusa or Vasco. ICSI and micro-TESE at our hospital in Vasco, with a car sent for you free on the day. Call or WhatsApp 095185 02773.
Your visit is confidential — nothing about you appears on this website or on social media.
This page is for general education and is not personal medical advice. Fertility treatment depends on your individual assessment. Please consult a doctor about your own situation. We do not carry out or offer sex determination of any kind, which is prohibited by law in India under the PCPNDT Act.