Most infertile couples, usually have more than one cause of infertility. Therefore, they have not managed to conceive even after a year of trying. Men who have issues that may result in infertility, do not show any signs or symptoms and need to get tested. In some cases, the cause of infertility may not be identified.
Diagnosing male infertility involves:
- A clinical examination with a complete medical history physical examination- to rule out any physical cause for infertility or clinical signs of any hormonal dysfunction.
- Semen Analysis- This is the most common male fertility test. What is checked is:
- Sperm count
- Motility of the sperm-the ability to swim
- Velocity or forward progression of the sperm
- Morphology of the sperm-size and shape of the sperm
- Total semen volume
- The liquefaction of the semen- the change from the normal gel-like state at ejaculation to a liquid state
A sample of semen is collected by masturbating and ejaculating into a special container at the doctor’s office or by using a special condom to collect semen during intercourse. The semen should then be examined within a few hours, to achieve the most accurate results.
After your semen is collected, it is sent to the laboratory to measure the number of sperms present in it and to check for abnormalities in its shape. The laboratory will also check for signs of infections in your semen. Very often, the sperm counts fluctuate from one specimen to another. In many cases, semen analysis tests are done over a period to gain accurate results. If your sperm analysis is normal, your doctor might recommend you to do a thorough test of your partner, before he conducts any more male fertility tests on you.
Your doctor may also recommend a few additional tests to help identify the cause of infertility. They are:
- Hormone testing: Hormones that are produced by the pituitary gland, the hypothalamus and testicles, play a vital role in the sexual development and sperm production. Abnormalities present in other hormonal or organ systems might also cause infertility. However, a blood test measures the testosterone level and other hormones that can cause male infertility.
- Genetic Tests: If your sperm concentration is extremely low, there could be a possibility of a genetic cause. However, in such cases, a blood test can reveal if there are changes in the Y chromosome which can lead to male infertility. Genetic testing can also be ordered to diagnose numerous congenital or inherited syndromes.
- Ultrasonography: Performing an ultrasonography test on the man’s scrotum helps to find out if there is any obstruction in the testicles. It can also be used to check the presence of varicocele or other abnormalities with the supporting structures of the reproductive system.
- Analysis of the urine: Presence of some amount of sperm in the urine indicates that sperms are travelling into the bladder instead of coming out. This helps to determine whether the person is suffering from retrograde ejaculation or not.
- Testicular biopsy: This involves collecting samples from the testicles and conducting tests on it. It helps to identify problems with the sperm production processes. However, it is not commonly used to identify fertility problems.