Picture this: a couple has been trying for a baby for over a year. Appointments are made, tests are booked, and the questions mount. In most cases, and perhaps most tellingly, the first call is to a gynecologist. The husband waits at the corridor.
This scenario is not unusual. In fact, it reflects a deeply ingrained misconception: that infertility is primarily, or even exclusively, a woman’s condition.
Here at Thomson Fertility, we see the real picture every day, and it looks very different.
Male infertility is not rare. It is not a niche concern. It is, in fact, one of the most common and most underdiagnosed factors in a couple’s fertility journey. Understanding this is not just important, it could be the key that unlocks your path to parenthood.
The Numbers Tell A Clearer Story
Global data on infertility has grown significantly in recent years, and the findings are hard to ignore. A landmark 2025 review published in The Lancet Regional Health – Western Pacific identified the Western Pacific Region, which includes Southeast Asia, as having the highest infertility prevalence in the world, at 23.2 per cent, compared to a global average of 17.5 per cent.
Within those figures, defective sperm function was found to be the largest single, defined cause of human infertility.
Closer to home, Malaysia is facing a male fertility crisis that demands attention. A parliamentary statement in April 2023 revealed that 60 per cent of sperm analyses conducted between 2010 and 2019 at the National Population and Family Development Board facilities (LPPKN) showed abnormal results, a finding described by the Deputy Minister of Women, Family and Community Development as “alarming.”
Of those couples who struggle to conceive, research consistently shows that approximately half involve a male factor. “That means in every two couples sitting in a fertility clinic, one is likely dealing, at least in part, with a male fertility issue,” explained Dr Puvanesvaran Velupulai, Consultant Obstetrician and Gynaecologist and Fertility Specialist, Thomson Fertility Puchong.
Yet, men are often the last to be assessed.
Why The Misconception Persists
The assumption that fertility challenges belong to women is rooted in cultural norms, historical medical practice, and, frankly, a reluctance among many men to seek help.
“In many Asian societies, male infertility carries an added layer of stigma, linked, unfairly, to masculinity and strength,” Dr Uma Mariappen, Consultant Obstetrician and Gynaecologist and Fertility Specialist, Thomson Fertility Puchong added.
When Sperm Cannot Be Found In The Ejaculate
For some men, azoospermia (the complete absence of sperm in the ejaculate) is the diagnosis, caused either by a blockage such as a prior vasectomy or infection (obstructive azoospermia), or by impaired sperm production within the testicles (non-obstructive azoospermia). The good news is that fatherhood is still within reach.
Under our Fertility Solutions for Him, Thomson Fertility offers four surgical retrieval options tailored to each case: PESA (Percutaneous Epididymal Sperm Aspiration), a needle-based day procedure requiring no incision; MESA (Microsurgical Epididymal Sperm Aspiration), which retrieves higher-quality, mature sperm from the epididymis; TESE (Testicular Sperm Extraction), where small tissue samples are taken directly from the testicle when epididymal sperm is inaccessible; and Micro-TESE, the most advanced option, using a surgical microscope to pinpoint sperm-producing tissue with precision, particularly in severe non-obstructive cases. All are performed as outpatient procedures, and retrieved sperm is used with ICSI to fertilise an egg.
What Male Infertility Actually Looks Like
One of the reasons male infertility goes undetected for so long is that it rarely announces itself.
“Unlike some female fertility conditions, male infertility is largely silent, meaning a man can feel completely healthy and still have significant issues with sperm quality, count, or motility,” Dr Muhilan Parameswaran, Consultant Urologist, Thomson Fertility @Thomson Hospital Kota Damansara elaborated.
That said, there are signs worth paying attention to. Men should speak with a specialist, and in many cases, a urologist specifically, if they notice any of the following, particularly when a couple has been trying for a baby without success:
- Reduced sexual desire or changes in libido.
- Difficulty with erections or ejaculation.
- Pain, swelling, or a lump in the testicular area.
- Reduced facial or body hair, which may indicate hormonal imbalance.
- A history of previous infections, surgeries, or trauma in the groin or pelvic region.
- A known diagnosis of conditions such as varicocele, diabetes, or hormonal disorders.
A testicular lump or swelling deserves particular attention. While most cases are benign, this is also one of the presenting signs of testicular cancer, which is most common in men of reproductive age.
“A urologist examination during a fertility workup serves a dual purpose: it investigates the fertility concern, and it rules out, or catches early pathology that has nothing to do with conception but everything to do with long term health,” Dr Muhilan reiterated.
“Most Importantly, the absence of all these symptoms does not rule out a fertility concern. Many men with low sperm count or poor motility have no symptoms whatsoever. This is precisely why proactive screening matters so much,” Dr Puvanesvaran further emphasised.
What Affects Sperm Health, And What You Can Do About It
Male fertility is influenced by a surprisingly wide range of factors – some within your control, and some not.
Lifestyle and Environment: Smoking, excessive alcohol consumption, obesity, and chronic stress are all known to negatively impact sperm production and quality.
Environmental exposure is equally concerning – air pollution, radiation from everyday devices such as laptops and mobile phones, and heavy metals found in food, water, and cosmetics, including cadmium, lead, and arsenic – have been associated with declining sperm counts, impaired motility, and abnormal sperm morphology.
Heat is also a factor that is frequently underestimated. The testes are located outside the body for a reason; sperm production requires a temperature slightly lower than core body temperature.
Prolonged use of saunas, hot baths, or tight-fitting clothing may impair sperm production over time.
Medical and Biological Factors: Varicocele, an enlargement of the veins within the scrotum, is one of the most common and treatable causes of male infertility, affecting approximately 15 per cent of all men, often with no pain or obvious symptoms.
It is typically diagnosed and managed by a urologist, who can also assess for other structural or testicular abnormalities during the same visit.
Other medical causes include hormonal imbalances, blocked reproductive ducts, past infections (such as mumps or sexually transmitted infections), and genetic conditions.
Depending on the diagnosis, Thomson Fertility offers a range of targeted solutions for men: Surgical sperm retrieval methods include PESA, MESA, TESE, or Micro-TESA.
In the lab, if the sperm quality is poor, IVF with ICSI gives sperm the best chance of fertilizing an egg; and for genetic conditions, Preimplantation Genetic Testing (PGT-M and PGT-A) can be used alongside IVF to screen embryo before transfer. Seeking solutions at the early stage of planning is crucial.
Age, too, plays a role that is often overlooked in men. While the decline in male fertility with age is more gradual than in women, research published in Frontiers in Aging (2025) confirms that increasing paternal age is negatively associated with sperm quality and DNA integrity. Couples are increasingly delaying childbearing, and understanding the male biological clock is part of that conversation,” Dr Uma explained further.
Male Fertility Is A Window Into Overall Health
Here is something that may surprise you: male fertility is not just a reproductive matter. It is increasingly understood as a marker of overall wellbeing and a urological assessment as part of that fertility journey can flag issues well beyond sperm parameters, from hormonal disorders to, in rarer cases, testicular or prostate pathology that benefits enormously from early detection.
A growing body of research, including a major 2025 study published in Biomedicines (PMC/MDPI), indicates that men with poorer semen parameters have elevated all-cause mortality compared to fertile counterparts, with a dose-dependent relationship between the severity of sperm impairment and health risk.
“There is a growing expert consensus from 2023 to 2025 that the evaluation of male infertility should be leveraged to improve overall men’s health, not just reproductive outcomes,” added Dr Muhilan.
In short, a fertility assessment for a man is not merely about having a baby. It is an opportunity for a urologist or fertility specialist get a meaningful snapshot of his broader health, and to address issues, including ones unrelated to fertility, that might otherwise go unnoticed for years.
The First Step: A Simple, Accessible Screening
At Thomson Fertility, we believe that fertility is a shared journey, and so should be the initial screening process. Our HIS Fertility Screening Package was designed with exactly this in mind: to make it easy, affordable, and non-intimidating for men to take that first step.
Available from RM188, the HIS Package includes:
- A Doctor’s Consultation: A private, confidential discussion with one of our experienced fertility specialists.
- A Detailed Semen Analysis: Assessing sperm count, motility, and morphology to give a clear picture of sperm health and quality.
This package is also available alongside the HER Fertility Screening Package (RM388), making it easy for couples to screen together, in one visit, with one coordinated plan.
Should the results indicate that further investigation or treatment is needed, our team is equipped to guide you through every step, from advanced diagnostic tests to treatments including IUI, IVF, ICSI, or, for severe male factor infertility, surgical sperm retrieval procedures such as TESE and PESA.
Thomson Fertility has facilitated over 8,500 IVF births since 1994, achieving a pregnancy rate of 61 per cent in 2024, results that are comparable to or higher than leading fertility centres in the United Kingdom, the United States, and Australia.
We were also recognised by the Malaysia Book of Records as the IVF centre with the most babies from a single practice. This experience means that when results call for a more complex path, you are in experienced, trusted hands.
When Should You Come In?
The general clinical guideline is to seek a fertility assessment after 12 months of regular, unprotected intercourse without conception. However, we recommend coming in sooner, after 6 months, if:
- Either partner is 35 or older.
- There is a known medical history that may affect fertility.
- The male partner has any of the symptoms listed earlier in this article.
- There have been previous pregnancy losses.
And if you are simply curious about where you stand? Come in. Knowing is always better than not knowing.
A semen analysis is non-invasive, takes very little time, and gives you the kind of information that empowers informed decisions, whether you are planning a family now, in five years, or just want peace of mind regarding your reproductive health.
Your Fertility Journey Starts With Both Of You
At Thomson Fertility, we have always believed that the road to parenthood is walked together. A thorough, honest, and compassionate approach to both male and female fertility is not just best practice, it is the foundation of everything we do.
If you and your partner have been trying to conceive, or if you simply want to understand your reproductive health better, we encourage you not to wait. The conversation starts here, and it starts with both of you.
Book your HIS Fertility Screening Package (RM188) today:
- +6018 211 1930 (Kota Damansara).
- +6018 211 1088 (Puchong, Ipoh, Johor Bahru).
Sources and Further Reading
- The Lancet Regional Health – Western Pacific: “Determinants of male fertility in the Western Pacific Region: environmental, biological, and lifestyle influences” (December 2025)
- Awani International – Bernama: “Fertility Problems Among Men In Malaysia Alarming” (April 2023)
- Malay Mail: “Not Just A Women’s Issue: Men Behind Nearly Half of Fertility Problems, Malaysian Expert Says” (December 2025)
- Biomedicines / PMC–MDPI: “Male Infertility and Reduced Life Expectancy: Epidemiology, Mechanisms, and Clinical Implications” (June 2025)
- Frontiers in Aging: “Increasing age in men is negatively associated with sperm quality and DNA integrity but not pregnancy outcomes in ART” (May 2025)
- National Geographic / Cleveland Clinic: “Scientists don’t know what’s causing men’s fertility to decline. But there are clues.” (March 2026)
- University of Virginia / The Conversation: “Male Fertility Is Declining; Studies Show That Environmental Toxins Could Be a Reason” (November 2025)
- Bernama: “Thomson Fertility Surpasses 8,500 IVF Births, Showcasing Excellence In Reproductive Care” (January 2026)
- The Malaysian Reserve: “TMC Fertility’s innovations in fertility preservation” (July 2024)
