Male Infertility Test for Male Factor Infertility || Health Fettle ||

Male Infertility Test for Male Factor Infertility 

Infertility is a problem for 1 out of 5 couples presently trying to have children. If after a year of trying to conceive a couple is not successful, a basic infertility evaluation may be started. However, if the female partner in the couple is over age 30 or has a significant past medical history of irregular periods or previous pelvic infections, the infertility evaluation, and infertility tests may be started earlier.

The infertility workup itself follows a fairly specific sequence. A complete workup or evaluation of the woman usually takes three or four cycles to complete. This is because certain infertility tests have to be performed at specific times in the menstrual cycle.

Both husband and wife are being tested and scored. For the husband, male infertility testing is largely over if the semen analysis is normal since there is little additional male infertility testing usable beyond semen analysis.

Male Infertility Test for Male Factor Infertility || Health Fettle ||

Male Infertility Test

The following is an overview of the infertility tests involved. You may want to use it to understand what may be required medically or as a tool to double check that you have had all the infertility tests.

Initial Appointment for 'male factor infertility'

The doctor will take a very careful medical history from the male. The doctor will also want to know about the medical history of the immediate family. Attention will be paid to details concerning previous surgery, infections, chronic illnesses, and hospitalizations. Background information on smoking, alcohol intakes, medications, and exposure to environmental or occupational toxins will be requested. 

Of course, a reproductive history from both partners will be needed. Details about the types of birth control practiced will be obtained. In addition, any history of previous pregnancies should be discussed. Information about the frequency and nature of sexual intercourse and previous venereal disease is crucial in the evaluation.

Physical Examination for 'male factor infertility' 

A physical examination of the male is usually accomplished on the first visit. The physical exam will include an examination of the genital organs, with the doctor noting size, position, and condition of the penis and testes. A rectal exam is done to determine the size and consistency of the prostate gland and seminal vesicles. The doctor will also note the development of secondary sex characteristics. Again, routine blood and urine tests may be performed.

Male Infertility Test for Male Factor Infertility || Health Fettle ||

Medical Evaluation of the Male for 'male factor infertility'

Semen Analysis

This is the first and most informative male infertility test performed on the male. An analysis can be performed anytime because a man is not cyclic as women are. Abstinence from intercourse for 24 to 48 hours before the analysis is suggested. Abstinence for a longer period than 2 days is not necessary.

For the semen analysis, the doctor will ask the man to masturbate a specimen into a clean container. This can be done at home and kept at body temperature and delivered to the lab for evaluation if it can be delivered within 60 minutes of collection. 

The laboratory then will examine the specimen under a microscope looking for the number of sperm present, how fast the sperm are swimming (motility), and the shape of the sperm (morphology). The doctor also will check the total volume of the specimen and its viscosity (thickness).

Normal Sperm Count

A fertile semen specimen should have at least 20 million sperm, with at least 50% of the sperm motile and 50% to 60% with good morphology. Normal volume is 2 to 5 ccs. A semen analysis should be repeated at least once because all of these levels fluctuate. It is also a good idea to repeat semen analysis periodically if the infertility investigation of the couple is lengthy, as these levels can change over a long period of time.

If the semen analysis indicates that there may be a problem, other tests on the semen will be undertaken. The semen will be checked for the presence of fructose, a special kind of sugar produced in the epididymis. If it is absent, this may mean there is a blockage in the ductal system but that sperm production may be normal. 

In addition, the semen may be checked for unusual clumping or agglutination that could indicate an immunologic response or a so-called sperm antibody condition. Some physicians also order a new test called the "zona-free hamster egg test" to check that the sperm is (in fact) able to penetrate the outer layer of the hamster egg, which is very similar in structure to a human egg.

Evaluation for a varicocele

Several additional male infertility tests may be performed if the semen analysis is not normal. Evaluation for a varicocele is accomplished by palpating the scrotum while the man is bearing down or coughing. The link between the presence of a varicocele and infertility is not clearly understood. The most common theory is that the presence of a varicocele (varicose veins of the testicle) causes poor circulation that ultimately inhibits normal sperm production.

Evaluation for a blockage

In the event of a subfertile semen analysis, a small biopsy of one or both testicles may be suggested. This procedure is performed in a hospital under local or general anesthesia. The testicular tissue is examined in the laboratory. This test can tell the doctor if there is an absolute infertile state with no sperm-producing tissue present, or blockage in the vas deferens (the tube that conducts sperm from the testicle to the penis) indicated by the presence of normal testicular tissue yet little or no sperm in the ejaculate.

Finally, if a blockage in the vas deferens is suspected during a testicular biopsy, a vasography can be done to pinpoint the area of the blockage. This is an x-ray study in which dye is injected into the vas deferens and a series of x-rays are taken to determine if a blockage exists and, if it does, where the blockage may be.

Male Infertility Test for Male Factor Infertility || Health Fettle ||

Once an infertility workup is underway it is important that the couple get the results of each test as they are done. Couples should ask their doctor(s) for explanations of all test results. Once the problem diagnosed, take the proper treatment for that.