A working couple, Asha and Anand, approached various fertility clinics after failing to conceive naturally. They were in their early 30s and married for 5 years. Standard medical investigations like hormonal profile and ultrasound showed no infertility related female factor in Asha. Semen analysis of the Anand showed 50% sperm motility and 60% of sperms with morphological defects. Couple underwent three unsuccessful Intra Uterine Insemination (IUI) procedures at two different centers. While the couple was contemplating going for further advanced treatment with ICSI, they were unsure if it should be done with self or donor sperm. Would ICSI fail because of the sperm issues revealed by the semen analysis? Should we directly go for a donor sperm instead? They approached a fertility expert based out of Mumbai who recommended GeneAndroTM for Anand to identify the root cause and to plan further course of treatment – basically, to take the guess work out of the picture. Genomic Fertility Analysis by GeneAndroTM identified CATSPER gene mutation which causes a condition called Spermatogenic failure Type 2. The mutation disrupts the functioning of sperm resulting in inability of the sperm to penetrate the egg wall (Zona Pellucida). Men with CATSPER gene mutations present variable semen parameters from normal to severely low sperm count, motility and poor morphology, along with inability to penetrate egg due to disruption of calcium dependent hyperactivity of sperm. Diagnosis of CATSPER mutation in Anand ruled out the possibility of normal conception for couple. But, on the brighter side, research has shown that men with CATSPER mutation have high success rate with advanced assisted reproductive technologies like ICSI. The couple therefore decided to go for an ICSI cycle with Anand’s sperm and they conceived in the first cycle itself!