When the sperm are a bottleneck for pregnancy

Men with a low sperm count can't get their wives pregnant in the bedroom. This is called male factor infertility, and the technical term for this is oligoastenospermia. This means that its it's the low sperm count which is the bottleneck in the bedroom, and this is a common cause for infertility.
Interestingly, the problem gets flipped when we move from the bedroom to the lab, because in-vivo is not the same as in-vitro.
When we use IVF for treating these infertile couples, the bottleneck is no longer the sperm, because we do ICSI for them, where we inject a single sperm inside an egg. This means that no matter how low the sperm count is , we can pretty much guarantee fertilization in the IVF lab.
The irony is that many of these couples have waited years before they are willing to do IVF.
They try all kinds of remedies to improve the sperm count homeopathy, Ayurveda, unani you name it !
This means the wife has often become much older by the time they come for the IVF treatment, which means the bottleneck now becomes her poor egg quality, rather than his sperm.
This means they often end up having to use donor eggs, because they wasted their chance of getting pregnant with her own eggs, because they delayed their treatment and didn't do IVF with her own eggs when she was young !
You can learn more about IVF by reading the IVF comic book free at

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.