Q: I am a 27 years old woman and my husband is 36 years old. We got married four years back and have no children as yet. Last year, we had sexual intercourse but there was no pregnancy. I have a problem in ovulation (ovary growth and wall thickness). My husband underwent semen analysis test, which showed sperm volume of 3 ml, pH - 8.0, colour - grey - opalescent, liquefaction - more than 1 hour, viscosity - partially liquified, sperm count - 6.4, sperm motility at 37 degree - rapid linear progressive - nil, sluggish linear progressive - nil, non progressive - nil, non motile - 100, Candida - absent, trichomonads - absent, agglutination of sperms - absent.

A:According to information provided, your husband may have decrease libido along with abnormal semen analysis specially oligoasthenospermia. He should see a urologist who has special interest in male infertility and andrology. A detailed history, examinations, blood and hormone (including testosterone) tests and ultrasound etc may be needed. Depending on the findings, the urologist will decide whether he needs testosterone replacement treatment.

Varicocoele is a common cause of oligoasthenospermia and this should be investigated by clinical examination and ultrasound of scrotum. It is an abnormal dilatation of veins above the testicles and may requires surgical or percutaneous interventions. Genetic testing may also be needed to rule out genetic anomalies. If no correctable abnormalities are detected or if treatments are unsuccessful then you may try ART (Assisted Reproductive Techniques) like ICSI (Intracytoplasmic Sperm Injection) for fertilization and pregnancy. ICSI is performed in a fertility lab in collaboration with urologist, gynaecologist, embryologist etc.