How to test male fertility


Many people assume that fertility is a women’s issue. In fact, just as often, it’s a man’s issue. In about 40% of infertility cases, the man is the source or co-source of the difficulty. It is crucial that when couple decides they are having trouble conceiving, the man be tested for infertility.

Discovering male fertility problems early can lead to earlier treatment and better chances of conception. Testing the man first is a good idea since testing the woman can be uncomfortable and expensive.

Where to start?

First stop, the urologist. A urologist will do a basic exam and interview which includes: a full medical and reproductive history along with any surgeries in the past, lifestyle questions about exercise, smoking and drug use, a physical exam, and a frank discussion about sex life include any trouble with sexual performance and sexually transmitted disease. Typically, any exam for infertility will require a sample of semen for analysis. It is important that the analysis take place simultaneously with the physical exam and interview.

Sperm and semen analysis

The count, shape and movement of the sperm will be analyzed. One could expect that fertility would be high with a large quantity of healthy sperm, but there are exceptions. About 15% of infertile men have normal semen and plenty of normal sperm. If the sperm is normal, a second test may be taken to confirm those results. If two normal tests are taken, the man is usually eliminated from consideration as the source of the infertility.

Physical exam findings

A simple physical exam may uncover varicoceles which is an abnormal formation of veins above the testicle which can be fixed with surgery. Testicular size may give a clue about hormone levels. However, hormones are not usually an issue for men.

Other factors

Some men make abnormal antibodies against their own sperm. The antibodies attack the sperm on the way to the egg. Sometimes the sperm simply aren’t able to get where they need to go. Retrograde ejaculation is a condition where sperm ejaculate backwards, into the bladder. Or, a man may have a missing vas deferens which is the path out for sperm. Sometimes there may be an obstruction blocking sperm. Most of these conditions can be fixed, and fertility restored, with surgery.

Source: WebMD


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