Male-factor infertility can have several causes, and the appropriate assessment depends on the individual history and semen analysis. ICSI is one technique used in fertility treatment, but it does not address every cause or guarantee pregnancy. This guide introduces the main questions to discuss with a specialist.

Common causes

  • Low sperm count, poor motility or abnormal shape
  • Varicocele (enlarged veins in the scrotum)
  • Hormonal problems
  • Infections or blocked ducts, including after vasectomy
  • Genetic causes (e.g. Y-chromosome microdeletions, Klinefelter syndrome)
  • Lifestyle: smoking, heavy alcohol, heat exposure, obesity, anabolic steroids

Which tests may be considered?

  1. Semen analysis — count, motility, morphology (ideally repeated)
  2. Hormones — FSH, LH, testosterone, prolactin
  3. Ultrasound of the scrotum if needed
  4. DNA fragmentation testing in selected cases, if your doctor considers it useful
  5. Genetic tests for very low or zero sperm counts

How ICSI works

In ICSI (intracytoplasmic sperm injection), an embryologist selects a single sperm and injects it directly into each egg. ICSI is a fertilization method: it can help when sperm numbers are very low, but it does not guarantee embryo development, pregnancy or a live birth.

No sperm in the ejaculate?

This is called azoospermia. In some men, sperm can be retrieved directly from the testis or epididymis (TESA, micro-TESE) and used for ICSI; this is not possible in every case. Your doctor will explain which procedure fits your case.

Improving sperm quality

Sperm take about three months to develop, so changes made now show up in about 90 days: stop smoking, reduce alcohol, avoid saunas and hot laptops on the lap, reach a healthy weight. Evidence for supplements is limited, so discuss them with your doctor rather than treating them as standard therapy.

Frozen sperm and travel

If you cannot be in Yerevan on the day of egg retrieval, sperm can be frozen in advance and shipped. Single fathers using surrogacy often do this. See surrogacy for single fathers.

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Sources and Last Update

Sources: Law of the Republic of Armenia on Human Reproductive Health and Reproductive Rights (arlis.am).

Last updated: 14 October 2026. This article is general information, not medical or legal advice; your doctor assesses your individual situation.

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