Male Infertility Tests
Fertility testing for men or women is generally not necessary until couples have consciously tried to become pregnant for at least 12 months. That is the timeframe medical professionals have agreed on as a definition for infertility. Once that time has elapsed, both partners should visit a doctor who can identify factors that could be preventing conception.
Although men may be uncomfortable seeking help and may assume it’s not their problem, there are good reasons to be tested:
- From 20% to 50% of infertility cases involve male factors, so it is important to know if there is a problem
- Your partner (and her doctor) will strongly urge you to be tested and they will eventually win the argument
- You will feel good to know you are OK
- If you are not OK, you can begin taking medication or treatment to fix the problem
A urologist is the right specialist for evaluating male fertility. The initial examination will include:
- medical history – same as any GP or internist
- medication list – all prescriptions and over the counter drugs used on a regular basis
- lifestyle questions – exercise, alcohol and drug use, and sexual history including any STDs
- physical examination – looking for anatomical abnormalities in the scrotum, penis and testicles; also looking for any physical signs of hormone irregularities
- lab tests – a semen sample will be collected for lab analysis; blood may also be analyzed
Test Results and Male Infertility Causes
Beyond the common physical and lifestyle issues leading to advice you expect – stop smoking, lose weight, reduce alcohol intake, etc. – the urologist will deal with more technical male anatomical and medical causes of male infertility:
- Varicocele – affecting about 40% of men with fertility problems – is vein enlargement in the scrotum that can reduce sperm count and sperm quality. It is most often discovered during the physical exam. Treatment involves micro surgery, done on an outpatient basis. Resulting improvement in sperm production can be measured three months after surgery because it takes that long for your body to produce new sperm.
- Sperm count and quality – involved in about 25% of infertility cases – is found in lab analysis of the semen. The lab looks at these factors:
– quantity – number of sperm – expecting 20 million sperm per milliliter of sperm (and minimum 2 milliliters per ejaculation)
– motility – measurement of percentage of sperm swimming forward – 25% minimum expected
– morphology – evaluates sperm shape, specifically percentage of normally shaped sperm – minimum 14% expected
– pH levels – acidity or alkalinity of semen – pH more than 7.2
– white blood cell count – high number (over 1 million per milliliter) could indicate infection
Semen analysis is the only lab test needed to evaluate fertility in most men, simply because semen is the man’s only physical contribution to conception. For men with a low sperm count, there is no need to do any other tests, because more information is not particularly useful. But many doctors also do blood tests for hormones, including prolactin, FSH, LH and testosterone. Finding a high FSH level in the blood can help evaluate testicular function. The testosterone level indicates whether or not the testes are able to produce adequate amounts of the male hormone, testosterone. Low testosterone level causes a decreased libido, treatable with medication, testosterone gel packs or injections.
Bottom line – male infertility testing is quick and easy in most cases, far simpler and more convenient than testing for females. And most male-related problems can be more easily treated.
