Types of Tests for Male Infertility
In the past, couples struggling to conceive (as well as their doctors!) often disregarded the possible contributing role of male factor infertility. Yet in fact, a couple's inability to get pregnant is just as likely the result of male infertility as female infertility.
The First Tests: Physical Exam, Medical History, and Semen Analysis
As part of a general physical exam, the genitals will be examined, and men will be asked questions regarding their sexual habits, sexual development, and past surgeries, injuries or medical conditions that could affect fertility.
Whenever infertility is suspected, men first undergo semen analysis. In this simple procedure, a sample of the man's semen is sent to a lab where the quality of the sperm is determined. This analysis reports on sperm count or concentration (number of sperm), sperm motility (movement), and sperm morphology (shape of the sperm), all of which are closely linked with fertility rates. To confirm accurate results, a semen analysis should be performed at least twice.
Compared to the invasive and expensive nature of some female infertility tests, semen analysis is easy and painless. Testing sperm early on can save a couple much stress, headache, heartache, and money.
While semen analysis is the first course of action and may be sufficient to determine male infertility, sometimes further and more specialized testing is necessary.
Blood Work: Blood work checks the level of hormones which stimulate the production of sperm (i.e. testosterone and follicle-stimulating hormone or FSH)
Genetic Karyotyping: This test helps to identify genetic disorders or abnormalities by analyzing the structure and number of chromosomes in a sample of cells.
Transrectal Ultrasound: An ultrasound uses sound waves to produce images (on a video screen) of the inner body. In this procedure a small wand is inserted into the rectum in order for a doctor to examine a man's prostate and to check for ejaculatory duct or seminal vesicles blockages.
Scrotal Ultrasound: Allows a doctor to look for evidence of a testicle obstruction or a varicocele
Post-Ejaculatory Urinalysis (Urine Test): A urine sample is collected after orgasm to check for the presence of sperm and to determine if sperm are entering the bladder instead of leaving the body through the penis. This condition is called retrograde ejaculation (reverse ejaculation) and is one cause of male infertility
Vasography: In this X-ray, a radioactive dye is injected into the male reproductive tract. Used when there is suspicion of an obstruction in the ejaculatory ducts or vas deferens (the tube that carries sperm from the testes to the urethra)
Testicular Biopsy: A small sample of testicular tissue is surgically removed to confirm an obstruction in the male reproductive tract. This test is risky and is thus used as a 'last resort' once other tests are inconclusive.
Sperm Function Tests: These tests examine how well sperm function after ejaculation. For example, how able sperm are to penetrate an egg, how straight they travel, how fast they travel, etc.
If male factor infertility is confirmed, and if the cause of the problem is pinpointed, it can either be treated directly or with fertility drugs or treatments. Fortunately, the number of infertility treatment options for men and women today is rising. In the worst-case-scenario, however, in which male fertility problems cannot be treated, couples might want to consider the use of a sperm donor or adoption.