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ARTICLE | 19th August 2020

Male Infertility by Dr Ramadas Rajagovallu

Male Infertility - by Dr Ramadas Rajagovallu (Consultant Obstetrician & Gynaecologist)

What is infertility? 

Infertility is defined as a failure to conceive after regular unprotected sexual intercourse for 1 year in the absence of known reproductive pathology. 

Male Infertility

  • 15% of all couples are infertile; male factor infertility contributes to over 50% of them
  • Many known causes, some have a medical option as first-line, some with a high success rate
  • Majority of causes is idiopathic, suggesting that treatment is empiric or directed towards optimization
  • Important to identify the cause to recognise where medical management is potentially useful

Evaluation - Male infertility

  • History and physical examination
    • Obesity
    • Hypothalamic or pituitary failure
    • Abnormalities of the testes, epididymis, prostate or penis 
    • Presence of vas deferens
    • Degree of varicocele
  • Semen analysis 
    • Endocrine and chromosomal assessment (Serum FSH, Prolactin) 
    • Anatomical evaluation (testicular biopsy) 
    • Psychological factors 

Obesity in Malaysia

Supplements for Male Infertility 

  • Include herbs, vitamins, and nutritional supplements, many of them rely on antioxidant properties
  • Primarily intended for the 30-40% of infertile men where no cause could be determined (idiopathic male infertility) 
  • According to EAU Guidelines on male infertility, little evidence for empiric treatment (medical therapy reserved only in hypogonadotropic hypogonadism)


Preconception counseling 

  • Doubt of infertility 
  • Regular sexual intercourse
  • No alcohol
  • No smoking
  • Ideal weight
  • Stress level
  • Diet

Invasive procedures- Sperm retrieval 

  • Percutaneous Sperm Aspiration (PESA)     



  • Testicular Sperm Extraction (TESE) 



   Assisted Reproductive Treatment (IUI, IVF, ICSI)

  1. Intrauterine Insemination (IUI) 



     2.  In-vitro Fertilisation (IVF) / Intracytoplasmic Sperm Injection (ICSI) 




  • Lifestyle Modifications
  • Regular Sexual Intercourse
  • Seek Medical Assistance 
  • Assessment and Treatment 
  • Donation Programme 
  • Adoption 



For an appointment, kindly contact our specialist clinic at +603-7982 6500 (ext: 2519/2520).

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Taman Desa Medical Centre
45, Jalan Desa, Taman Desa, Off Jalan Klang Lama, 58100 Kuala Lumpur Malaysia.


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