Fertility Testing In Men

What is male infertility?

Infertility, otherwise known as the inability to successfully reproduce, is a problem that affects people of all genders, including men. Some studies claim that of all couples who struggle with infertility, between 30-50% of those cases are due in some part to male infertility. The list of possible factors and causes is long, and patients may require multiple tests and consultations before a diagnosis can be determined. In some cases, infertility may be unable to be explained by doctors.

Testing procedures

Causes of male infertility are ultimately related to the sperm, including problems such as low sperm production, abnormal sperm function, or physical blockages that prevent sperm from traveling the necessary path to an egg. Potential male infertility can be assessed through a variety of medical tests. These include:

• Semen analysis. This is the most common procedure when determining the fertility of the male partner. Sperm is collected and then examined to evaluate the count, shape, appearance, and mobility of the sperm cells. The sample will also be examined for sperm concentration.
• Blood test. Lab work may be used to check hormone levels (such as testosterone) and to rule out any infections that may be interfering with normal sexual function.
• Urinalysis. This test can be used to rule out infections and can show any presence of sperm in the urine. Sperm in urine is a possible indicator of a condition known as retrograde ejaculation, where sperm enters the bladder instead of exiting through the penis during orgasm.
• A physical examination of the penis, scrotum, and prostate is also routine when determining if there are problems with male fertility.

If the above tests yield normal results, doctors will often focus attention on the female partner to determine any issues with her fertility. However, there are a number of additional tests that may be recommended for male partners. These include:

• Acrosome reaction. This test examines if sperm heads are able to dissolve an egg’s tough outer shell in order to penetrate.
• Assay. These tests determine if the sperm cells can penetrate an egg.
• Hypo-osmotic swelling. This test can determine if the sperm cells have healthy tails.
• Sperm agglutination. This test determines if sperm is clumping together, which would prevent individual sperm cells from swimming through the cervical mucus.
• Testicular biopsy. This test requires a small sample of tissue from the tubes inside the testes in order to determine how well sperm are being produced.
• Ultrasonography. This test can locate blockages or damage to the male reproductive tract.
• Vasography. This x-ray test can show if there is blockage or leakage of sperm in the ducts that carry it to the urethra.

Treatment and prevention

While not all causes of male infertility can be treated or reversed, some treatment options include medications that support sperm production, antibiotics that eliminate infection, and hormones to improve hormone production and balance. Prevention measures such as avoiding prolonged heat from long showers and wearing looser fitting underwear can help with sperm health and production.

In cases of male infertility where treatment and improvement are more difficult, artificial insemination, in vitro fertilization (IVF), or the use of donor sperm may be options for a couple to consider in producing a child.

Diagnosis

If after a year of regular, unprotected intercourse you have been unable to conceive a child and notice problems with sexual function and/or pain or lumps in the testicles, it is recommended that you see a doctor. Individuals who have a history of such problems or have had groin, testicle, penis, or scrotum surgery should also consult a medical professional.