A 36-year-old city banker remarried because his wife could not bear children and when the second wife also failed to conceive, he finally underwent a semen test, only to discover he had no sperm at all.

This is not an isolated instance of the male partner being responsible for a couple’s failure to produce offspring. “It affects one in 25 men in our country, but still is a topic under wraps and men don’t find it comfortable to discuss it in the open,” laments Rupin Shah, India’s leading andrologist.

With urban stress levels rising and environmental toxins reaching alarming proportions, almost 45-48 per cent of infertility cases in Calcutta are being attributed to the male factor, stresses Baidyanath Chakravarty of the Institute of Reproductive Medicine (IRM) in Salt Lake. The global “pure male infertility” count is 35 per cent.

Whenever a couple can’t conceive, it’s always the wife who is blamed and ridiculed. It is she who has to undergo all the tests and receive treatment, coupled with the family and social tensions, simply because male infertility is still a major blow to a man’s ego.

Experts insist it should be just the reverse. When testing a couple for infertility, the man must always be tested first. “Tests for the woman are far more complicated, invasive and expensive. It’s much simpler to find out if the man has a problem,” points out Mumbai-based Shah, who has entered into an association with Genomee, the fertility clinic at Bhagirathi Neotia Woman & Child Care Centre to address male infertility as a speciality.

Chakravarty at IRM agrees the male factor is sharply on the rise. “While about 65 per cent of the problem cases are organic defects, the rest 35 per cent suffer from some form of sexual dysfunction. The latter segment is growing alarmingly, primarily due to a breakneck lifestyle and wrong food habits weakening the body’s scavenging system, allowing free radicals to seriously affect the quality of sperms,” he observes.

Declining sperm quality is also being attributed to environmental toxins like pesticides entering the food chain, and plastics in our daily use, which are “endocrine disrupters’ and can affect hormone levels and fertility. Certain lifestyle factors associated with sedentary habits, like smoking, use of cocaine and use of anabolic steroids, are linked to poor quality of semen.

“While there has been significant advancement in assisted reproductive techniques, male evaluation and work-up is still largely ignored in Calcutta, since andrology as a speciality is yet to penetrate a critical mass. So, most of our referrals are from gynaecologists,” observes Arnab Deb, co-ordinating the Genomee male infertility clinic with Shah.

Factors like late marriage, decision to postpone child-bearing, work pressure, bad diet, unhealthy sex life, lack of exercise and sleep are also contributing to the growing incidence of male infertility in the city, doctors concur.

The treatment of male infertility ranges from administration of drugs to improve seminal quality to minor surgical interventions. Semen analysis can show both motility and morphology of sperms. Often, in case of male infertility, the semen analysis is abnormal. The count could be low (oligospermia) or sometimes the sperms are totally immobile or dead (azoospermia).

The management of male infertility, however, has come a long way and city hospitals are on catch-up mode. “Reproductive urology and andrology are among our focus areas and from counselling to penile implant, we offer the entire gamut,” declares Rupali Basu, general manager, Wockhardt Hospitals. The group’s Wockhardt Hospital and Kidney Institute on Rashbehari Avenue runs a male infertility clinic under the aegis of andrologist Avishek Mukherjee.