Fertility Tests for Men
Although many people still think of fertility as a “woman’s problem” up to half of all cases of infertility involve problems with the man. In fact, about 20% to 30% of the time, a man’s low fertility is the main obstacle to conception.
So it’s crucial that men get tested for fertility as well as women. Yes, it can be embarrassing, but discovering male fertility problems early can mean earlier treatment and a successful pregnancy. Male infertility testing can also spare women unnecessary discomfort and expense.
Initial Male Infertility Evaluation
Doctors arbitrarily diagnose infertility when a couple hasn’t conceived a child after 12 months of unprotected and frequent sex. Impaired fertility may be a better description; many couples who keep trying will get pregnant in the second year or later.
A visit to a urologist should start the evaluation for male infertility. The urologist will likely begin with a basic interview and exam:
* A full medical and reproductive history, along with any surgeries you’ve had and medications you’re taking.
* Lifestyle questions, including exercise, smoking, and drug use.
* Physical exam.
* Frank discussion about your sexual life, including any problems with sex or previous sexually transmitted diseases.
In any evaluation for male infertility, the man will need to provide a sample of semen for analysis. The doctor will want the man to give the sample there, or at least someplace nearby, since it’s important that the analysis take place quickly.
Male Infertility Tests
Cutoff values for “normal” vary somewhat, depending on the lab and the interpreter, but the World Health Organization defines these as normal values:
| Semen Analysis Parameter | |
| Volume | |
| pH | |
| Sperm concentration | |
| Motility | |
| Rapid forward progressive motility | |
| Morphology | more normal forms (WHO criteria) 11% or more normal forms (Strict criteria) |
| Vitality | |
| White blood cells |
Identifying the cause of a man’s infertility is as much art as science. Male infertility specialists differ in their approach, but here are some of the tests a man can expect:
- Sperm and Semen Analysis
- Physical Exam
- Hormone Evaluation
- Genetic Testing
- Anti-Sperm Antibodies
- The blood testosterone, FSH, LH and prolactin levels
- Sperm agglutination
- Sperm penetration assay
- Hemizona assay
- Acrosome reaction
- Hypo-osmotic swelling
- Testicular biopsy
- Vasography
- Ultrasonography
- Sperm function tests
- Sperm antibody testing
