Diagnosing male infertility is generally achieved by physical examination, blood tests, semen analysis and a survey of the man’s medical history. Diagnosis is best made by urologists specializing in male infertility.
A physical examination is vital for a physician to identify some issues related to male infertility. A man should expect this will include an exam of both the scrotum and of the peritesticular area.
A semen analysis is often critical in determining a man’s fertility, and is often recommended to rule out male infertility before the woman undergoes any invasive procedure. The analysis looks at eight factors, including:
- Semen volume:
- Normal volume is 1.0-6.5 milliliters (mL) per ejaculate. In very rare cases, there is an absence of semen, termed aspermia.
- Sperm count:
- Normal sperm count is defined by the World Health Organization as having over 20 million sperm per mL. A count of under 20 million/mL is termed oligospermia while the absence of sperm altogether is termed azoospermia (see expanded entries for both below).
- Sperm motility:
- Forward motion capacity. Normal motility is about 8 million sperm per mL showing good motility.
- Sperm morphology:
- Measuring how many sperm are shaped normally, in which 70% indicates good morphology. Abnormally shaped sperm appear variously at the head (two heads, tiny heads, round heads) and tail (two tails, short tails). These shapes tend to affect their motility as well.
- Other factors may include:
- Liquefaction time, pH levels, and fructose levels. An off-average number in any factor can signify infertility.