Traditionally infertility has been considered as a woman’s problem, but it is found that one out of every three cases of infertility is associated with man. A diagnosis of male infertility can be one of the toughest situations a man can have.Not being able to father a child can make a man feel like he is the culprit of his partner to not able to bear a child.
A man’s fertility generally associated with the quantity and quality of his sperm.If the number of sperms a man ejaculates is of a poor quality or low, it will very be difficult and sometimes impossible for him to become a dad. A male infertility diagnosis includes a medical history, physical, general hormone tests, more semen analyses and some other more laboratory tests.
Questions related to Medical History may include:
- A discussion of related to your past medical history, any chronic health problems, any inherited conditions and injuries or surgeries that could affect fertility. Your doctor might also discuss things related to your sexual development during puberty and your sexual habits.
- Your doctor may ask questions about your family history of infertility or birth defects.
- A discussion that may involve information regarding social history and occupational hazards to find out any potential exposure to dangerous substances that could have a bad impact on your fertility.
Questions related to physical examinationmay include:
- This includes physical examining your genitals and the evaluation of the pelvic organs like, testes, penis, scrotum and prostate.
Laboratory Tests may include:
- Semen Evaluation: A doctor may ask for the sample of semen for further evaluation. Semen samples can be collected in different way.You can be asked to provide the sample by masturbating and ejaculating into a special container at the clinic itself. But due to some cultural or religious beliefs, some prefer other alternative method way for the sample. In this case the semen can be collected in to a special condom during intercourse. The semen is then sent to a laboratory for the evaluation of sperm motility or movement, maturity and shape of the sperm, the volume of the ejaculate and the actual sperm count and the liquidity of the ejaculate. The lab will also perform the tests for the signs of problems such as infections related to your semen. If your sperm analysis found to be normal, your doctor will likely go for the testing of your female partner before conducting any further male infertility tests.
- Hormone testing: Hormones produced by the pituitary gland, hypothalamus and testicles may be evaluated to check levels of testosterone and FSH (follicle-stimulating hormone) to determine the overall balance of the hormonal system and specific state of sperm production in your body. Abnormalities in other hormonal or organ systems also might increase the chance of infertility. Serum LH and prolactin are other hormonal tests that may be evaluated if initial testing indicates the need for them.
- Hormone testing: There could be a genetic cause, if concentration of your sperm is extremely low. A blood test can check whether there are significant changes in the Y chromosome(signs of a genetic abnormality). Genetic testing might be considered to diagnose various inherited, congenital syndromes or chromosome abnormalities, that may cause the lack of sperm or lead to developmental problems of infertility.
- Anti-Sperm Antibodies: Some male can produce abnormal antibodies that obstruct the sperm on the way to the egg, which prevent your partner from getting pregnant. For such male, making sperm isn’t the real issue. It is getting the sperm where they need to go. Male with these problems have normal sperm in their testicles, but the sperm in semen are either abnormal, missing or in low numbers.There are several other reasons exist the male might have low sperm in their semen even if his body makes enough of it. A medical examination can also be performed to check these problems and to identify the presence of antibodies that may contribute to infertility.
- Scrotal ultrasound: An ultrasound of the man’s scrotum performed to detect varicoceles (varicose veins) or duct obstructions in the prostate, seminal vesicles, scrotum and ejaculatory ducts. A transrectal ultrasound also closely looks at the vesicles and ejaculatory ducts that transfer semen.
- Post ejaculatory urinalysis: This test performed to check for the presence of sperm in a man’s urine indicating retrograde ejaculation.
- Hypo-osmotic swelling: This a laboratory test that uses a special sugar and salt solution to evaluate the ability of the sperm to penetrate the egg and the sperm’s tail. The tails of healthy sperm supposed to swell in the solution as compared with dead or abnormal sperm where the tails do not swell.
- Acrosome reaction: A laboratory test that helps to find out if sperm heads are able to go through the chemical changes which is very important to dissolve an egg’s tough outer shell.
- Sperm agglutination: A laboratory test involving the examination of sperm under a microscope to evaluate if the sperm are bundling together. Bundling prevents sperm from swimming through the cervical mucus.
- Sperm penetration assay: A laboratory test uses hamster eggs to evaluate a sperm’s capability of penetrating the egg. Although this test is rarely used.
- Acrosome reaction: A laboratory performed to check and determine if sperm heads are able to go through the chemical changes requisite to dissolve an egg’s tough outer shell.
- Vasography: This is an x-ray exam which is used to determine if there is blockage or leakage of sperm in the vas deferens.
- Hemizona assay: It is a laboratory test in which a non-usable human egg is cut in half. The main purpose of this test is to check if the sperm are able to penetrate the outermost protective layer of the egg.
- Kruger and World Health Organization (WHO) Morphology: This is performed to evaluate sperm shape and features more closely.
- Seminal Fructose Test: This test is performed to identify if fructose is being added properly to the semen by the seminal vesicles. Infertility diagnosed in Female