Male infertility training for gynaecologists: what the laboratory actually shows

Cell Mate co-founder Rajnish Sehgal recently led a full-day andrology workshop in Delhi for gynaecologists who had travelled in from across the country. The subject was male factor infertility, and specifically the laboratory work that sits behind it.

The session ran at the microscope, with the field projected onto a screen for the room, because the point was not to recite reference values. It was to show clinicians what those values actually look like in a sample.

Why male infertility is still under-investigated in India

Infertility affects roughly 1 in 6 couples worldwide (WHO), and about half of those cases involve a male factor. In practice, the male partner is often the last person tested. A couple can spend a year in investigation on the female side before anyone asks for a semen analysis.

This is rarely a matter of clinical indifference. It is a training gap. Andrology gets very little dedicated time in most postgraduate pathways, and the laboratory side gets almost none. A clinician who has never watched a semen analysis being performed is understandably cautious about interpreting one, and far less likely to order the second-line tests that matter.

Reading a semen analysis properly

The first hour went to the report itself. Concentration, total count, motility grading, and how each parameter should be read against WHO reference values rather than treated as a pass or fail line.

A recurring theme: a single semen analysis is a snapshot, not a verdict. Counts fluctuate with illness, fever, abstinence period, stress and collection technique. Reference values describe a population, not an individual’s fertility. A result slightly below range is information, not a diagnosis, and a result inside range does not close the file.

Sperm processing across multiple techniques

Processing was demonstrated live, with more than one method shown side by side. The teaching point was the reasoning, not the protocol: which technique suits which sample, what each one does to yield and to the quality of what you recover, and where the trade-offs sit.

For clinicians who refer out for processing rather than performing it, this matters. Knowing what happens to a sample after it leaves the room changes how you counsel on results.

Sperm vitality

Vitality separates two findings that look identical on a motility count. Sperm can be immotile and alive, or immotile and dead, and the distinction changes the clinical direction entirely. The session covered how the test is performed and when it should be requested, particularly in cases of severe asthenozoospermia.

Sperm morphology under strict criteria

Morphology is one of the most inconsistently reported parameters in Indian labs. The workshop covered assessment under strict criteria, what the common defects look like at the scope, and why two labs can return meaningfully different morphology percentages on the same sample.

Sperm DNA fragmentation testing

This is where the room stayed longest.

Sperm DNA fragmentation measures damage to the genetic material inside the sperm, which a conventional semen analysis cannot detect. Count, motility and morphology can all sit comfortably in range while a significant proportion of sperm carry fragmented DNA.

It is associated with unexplained infertility, recurrent pregnancy loss and failed IVF or ICSI cycles. It is also still rarely ordered in India, largely because it is rarely taught. Contributing factors discussed included oxidative stress, varicocele, infection, heat exposure, smoking and advancing paternal age.

Training as infrastructure, not marketing

Cell Mate’s clinical side rests on 35+ years of andrology and cryopreservation practice, and teaching has been part of that work throughout. Sessions like this one are not a lead channel. They are how the standard of male fertility evaluation moves in a country where most of it happens outside specialist centres.

Every gynaecologist who leaves a session able to read a semen report with confidence changes the pathway for the couples in front of them, whether or not those couples ever encounter Cell Mate.

More from our training programme

Frequently asked questions

Keep reading