Not everyone shares the same path when it comes to having a baby. It is estimated that up to 15% of couples struggle with fertility issues. In about a third of those cases, male infertility is a factor. There a number of ways to test for infertility in both women and men, but not everyone is familiar with how to check fertility in men. When you understand more about the causes of male infertility, the tests used for diagnosis will make more sense.
Common Causes of Male Infertility
There are a number of factors that can affect a man’s fertility, and those factors can indicate how to test for male infertility. Each broader cause may have several possible more specific underlying causes.
- Issues with Sperm Count and Quality: In order to successfully conceive, a man’s semen needs to have a good number of healthy sperm. This means at least one of the testicles must be functioning properly and the body is producing healthy levels of reproductive hormones. Low sperm count and low sperm function are both common contributors to male infertility.
- Problems with Vessels Responsible for Transporting Sperm: Sometimes infertility can be the result of problems with the transportation of sperm. Sperm moves through several different tubes before ejaculation. These tubes include the epididymis, the vas deferens, ejaculatory ducts, and the urethra. Blockages or defects in these vessels can cause male infertility. The vessels can become blocked due to trauma from injury, surgeries, infection, or abnormal development.
- Difficulty with Sexual Intercourse: Issues with getting and keeping an erection firm enough for intercourse (erectile dysfunction) can be an issue that interferes with male fertility. Other problems including premature ejaculation, pain during intercourse, or physical abnormalities may contribute to difficulty conceiving via intercourse.
- Ejaculation Issues: If a man is not ejaculating properly, then the likelihood of fathering a child via intercourse is small. Some injuries to the spinal cord prevent the ejaculation of semen even if sperm is still being produced. Another ejaculation problem that can affect male fertility is retrograde ejaculation. In this condition, semen enters the bladder during ejaculation, rather than exiting through the penis. Retrograde ejaculation can be caused by a number of conditions, medications, injuries, and surgeries.
Testing Fertility in Men
If a couple is struggling to get pregnant after a year of regular unprotected intercourse, then both of them may get tested to see if there are fertility problems. To check fertility in men, there are several tests that can be done, starting with a physical exam and semen analysis.
- Physical Exam with Medical History:
Every diagnostic process will begin with a comprehensive physical exam. In the case of male factor infertility, the genitals will be checked carefully for abnormalities or injuries that may be the cause of infertility. Other vitals and health information will also be taken.
A medical history should also be taken during the initial exam. The doctor will ask about existing health problems (both chronic and acute), previous illnesses and injuries, genetic conditions that may have been passed on, and any past medical procedures that may have affected fertility. The doctor may also inquire about your sexual development and if you experienced any abnormalities during puberty as well as your current sexual habits.
- Semen Analysis
Semen analysis is a standard test that can be used to check fertility in men. A semen sample is obtained and then sent to a lab for testing. Depending on personal beliefs, specimens can be obtained via masturbation and ejaculation into a specimen cup or by using a special condom during regular intercourse.
At the lab, the sperm is studied to determine if there are abnormalities in its motility (movement) or morphology (shape), and the number of sperm present. The semen will also be tested for infections and other potential issues.
Semen analysis is often done several times when testing for male factor infertility. This is due to the fact that sperm counts may fluctuate between specimens, so taking several samples over a specified time period will yield more accurate results than a single test.
Results of semen analysis tests may provide answers, or they may prompt the doctor to recommend more specific testing.
- Further Testing: If the physical examination and semen analysis are inconclusive or indicate further testing is needed, more in-depth methods can be used to check for the cause of male infertility.
- Scrotal Ultrasound: The doctor may check for testicular abnormalities and other structural issues like varicocele with an ultrasound.
- Hormone Testing: Abnormal hormone levels can be the cause of issues with sperm production, affecting sperm count and quality. Blood tests can be done to check levels of testosterone and other hormones important to sexual function.
- Genetic Testing: A genetic problem may be at the root of male factor infertility if sperm count or concentration is very low. Genetic testing may be recommended to check for inherited syndromes or congenital disorders in these cases.
- Transrectal Ultrasound: An ultrasound to check the prostate and find any blockages in the ejaculatory ducts and seminal vesicles is performed by inserting a lubricated ultrasound wand into the rectum.
- More Specific Sperm Function Tests: There are several more specialized tests that can be performed on a sperm sample, although they are not commonly used. Tests can determine whether sperm attaches to the egg well, has problems with penetration, or how well it survives after ejaculation.
- Urinalysis after Ejaculation: Testing the urine for the presence of sperm after ejaculation can determine whether or not retrograde ejaculation is responsible for fertility issues.
- Testicular Biopsy: Samples of the testicle are removed with a needle to be tested for abnormalities in sperm production.
Make an Appointment
At Laurel Fertility, we know that dealing with infertility, no matter the cause, can be an emotional and frustrating process. Our success rates in helping patients in the Bay Area build their families are outstanding. Our model of care includes not only advanced medical treatments but also individualized support for each patient. If you have questions or concerns, including how to check fertility in men, call us at (415) 673-9199. You can also request an appointment online.