تويت
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 examination:
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 examination.
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
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
A trained expert assesses the man's sperm count, their shape, movement, and other variables. Generally, a higher number of normal-shaped sperm means higher fertility. But exceptions are common. Many men with low sperm counts or abnormal semen are still fertile. And about 15% of infertile men have normal semen and plenty of normal sperm.
If the first semen analysis is normal, the doctor may order a second test to confirm the results. Two normal tests usually means that the man doesn't have any significant infertility problems. If something in the results looks irregular, the doctor might order further tests to pinpoint the problem.
Surprisingly, if no semen or sperm at all are present (azoospermia), this can be a good thing. It might suggest a blockage in the "plumbing" that can be corrected with surgery.
Physical Examination
A good physical exam can detect varicocoeles and give clues to hormone problems. Testicular size can be measured. The physical examination should ideally be performed by a urologist.
Hormone Evaluation
Testosterone, and multiple hormones made in the brain, control sperm production. However, hormones are not the main problem in 97% of infertile men. Experts disagree as to how big a search should be done for hormonal causes of infertility.
Genetic Testing
Genetic tests can identify specific obstacles to fertility, and problems with sperm. Experts differ as to when genetic tests should be done.
Anti-Sperm Antibodies
Some men make abnormal antibodies against their own sperm. The antibodies attack the sperm on the way to the egg, preventing fertilization.
In other men, making sperm isn't the problem; it's getting the sperm where they need to go. Men with these conditions have normal sperm in their testicles. The sperm in semen, though, are missing, very low, or abnormal. There are several reasons for low sperm in semen when a man is making enough sperm:
Retrograde ejaculation. In this condition, sperm ejaculate backwards, into the bladder. Usually retrograde ejaculation is caused by a previous surgery.
Absence of the main sperm pipeline (the vas deferens). A genetic problem, some men are born without a main pipeline for sperm.
Obstruction anywhere in the "plumbing" between the testicles and the penis.
Anti-sperm antibodies, abnormally attacking a man's own sperm on their way to the egg.
Varicocoeles are the most common cause of correctable male infertility -- up to 38% of cases. These abnormal formations of veins above the testicle can be fixed with surgery.
Up to 25% of infertile men have abnormal or low sperm counts causing their infertility, for no identifiable reason. This is called idiopathic infertility.
Through thorough testing of both the man and the woman, 85% of couples can discover the cause of their infertility. Many couples will become pregnant after the first year, with continued attempts and treatment.
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 examination:
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 examination.
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
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
A trained expert assesses the man's sperm count, their shape, movement, and other variables. Generally, a higher number of normal-shaped sperm means higher fertility. But exceptions are common. Many men with low sperm counts or abnormal semen are still fertile. And about 15% of infertile men have normal semen and plenty of normal sperm.
If the first semen analysis is normal, the doctor may order a second test to confirm the results. Two normal tests usually means that the man doesn't have any significant infertility problems. If something in the results looks irregular, the doctor might order further tests to pinpoint the problem.
Surprisingly, if no semen or sperm at all are present (azoospermia), this can be a good thing. It might suggest a blockage in the "plumbing" that can be corrected with surgery.
Physical Examination
A good physical exam can detect varicocoeles and give clues to hormone problems. Testicular size can be measured. The physical examination should ideally be performed by a urologist.
Hormone Evaluation
Testosterone, and multiple hormones made in the brain, control sperm production. However, hormones are not the main problem in 97% of infertile men. Experts disagree as to how big a search should be done for hormonal causes of infertility.
Genetic Testing
Genetic tests can identify specific obstacles to fertility, and problems with sperm. Experts differ as to when genetic tests should be done.
Anti-Sperm Antibodies
Some men make abnormal antibodies against their own sperm. The antibodies attack the sperm on the way to the egg, preventing fertilization.
In other men, making sperm isn't the problem; it's getting the sperm where they need to go. Men with these conditions have normal sperm in their testicles. The sperm in semen, though, are missing, very low, or abnormal. There are several reasons for low sperm in semen when a man is making enough sperm:
Retrograde ejaculation. In this condition, sperm ejaculate backwards, into the bladder. Usually retrograde ejaculation is caused by a previous surgery.
Absence of the main sperm pipeline (the vas deferens). A genetic problem, some men are born without a main pipeline for sperm.
Obstruction anywhere in the "plumbing" between the testicles and the penis.
Anti-sperm antibodies, abnormally attacking a man's own sperm on their way to the egg.
Varicocoeles are the most common cause of correctable male infertility -- up to 38% of cases. These abnormal formations of veins above the testicle can be fixed with surgery.
Up to 25% of infertile men have abnormal or low sperm counts causing their infertility, for no identifiable reason. This is called idiopathic infertility.
Through thorough testing of both the man and the woman, 85% of couples can discover the cause of their infertility. Many couples will become pregnant after the first year, with continued attempts and treatment.
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