Infertility Tests for men

These mainly include semen analysis, surgical examination of the testes and a hormone test.

Semen analysis involves the man producing a small sample of semen which is then sent to a laboratory. The man is asked to abstain from ejaculation for 2 to 3 days prior to this to ensure an accurate reading.

Many clinics and hospitals ask for two samples for testing, especially if there is a problem with the first one. It takes around 3 days to produce sperm so there is likely to be a period of time between the first sample and the second sample.

The exceptions to this are if the man has consumed excessive amounts of alcohol or has suffered from an illness or viral infection.

The laboratory will be assessing the following:

• Volume
• Concentration
• Motility (movement)
• Shape
• White blood cells

A normal volume is 2 to 5mls.

Concentration refers to the amount of sperm present. A normal reading is more than 20 million per ml.

Motility is a term used to describe the movement of the sperm. Some sperms are better swimmers than others and swim in a straight line whereas others are erratic. And it’s these better swimmers which are likely to fertilise an egg.

A normal level of motility is where 50% or more of the sperm show good movement.

The shape of a sperm affects its ability to move and so enable fertilisation. Ideally, 30% or more of sperm should have a normal shape.

With white blood cells, you are looking at a normal reading of fewer than one million per ml.

There is another semen analysis test called the ‘anti-sperm antibody test’ which analyses the levels of antibodies attached to sperm. You may be familiar with the term antibodies but if not here’s a quick explanation…

Antibodies are part of our body’s immune system and are there to attack any foreign invaders such as germs or viruses. They are proteins which can diffuse the threat from an invader by stopping it from binding to areas within the body. It can also trigger other cells to target a germ or virus.

Basically, antibodies inform the immune system of a threat and activate cells to destroy this threat. They exist to fight disease and infection.

So how does this apply to sperm?

The antibodies treat sperm as an invader and bind themselves to them. This reduces their mobility which interferes with fertilisation of the egg. The only treatment available for this is intracytoplasmic sperm injection (ICSI).

If no obvious reason can be found then the doctor will perform a surgical exploration of the testes. There are only a few cases which require this form of surgery which include testicular cancer, trauma and torsion.

Testicular cancer is the most common form of cancer in men and particularly affects men aged between 20 and 35. Treatment involves diagnostic imaging (MRI scan) and a biopsy as well. The biopsy is sent to the laboratory to check for signs of cancerous growth.

Trauma can occur as a result of an accident or injury. The danger here is that of a rupture of the testicles which results in leaking fluid and a build up of pressure in the scrotal sac which is extremely painful. Surgery is needed to repair this damage.

Testicular torsion is a painful condition in which the testes become entangled by the cord in which they hang. This strangulates them thereby restricting blood flow which can lead to permanent damage if left untreated. Surgery is needed to unwind these testes.

Other surgical procedures include a vasovasostomy to bypass any blockages in the vas deferens or a vasoepididymostomy to remove any blockages in the junction between the epididymis and the vas deferens.

Semen analysis is the first test you will undergo as part of a male fertility assessment. However, there are a couple of conditions which require further investigation. These are oligospermia (low sperm count) and Azospermia (no sperm are produced).

Both of these conditions are caused by a blockage in the male reproductive system or defective sperm production.

Investigation of these will include an ultrasound and/or Vasography. Ultrasound is used to detect problems via sound wave patterns in internal structures of the body. Any break or interruption to these patterns indicates a potential obstruction.

Vasography is the name given to an x-ray study of the vas deferens. It involves the insertion of a small probe against the scrotum which acts as a conduit for coloured dye. An x-ray is taken as the dye passes through the vas deferens. This enables the doctor to see if there are any blockages or damage in the vas deferens.

Another factor is that of faulty hormones: a blood test is one way of checking hormone levels to see if there are any problems within your endocrine system. Your endocrine system is a complex system which controls many functions in the body which include reproduction.

One very important part of the endocrine system is the adrenal glands which produce the male sex hormones testosterone, luteinising hormone (LH) and follicle stimulating hormone (FSH).

And these hormones control sperm production. Any problems with these will affect male fertility.

Test results

Once you receive the results of your tests then your specialist will be able to decide upon a course of treatment. You will both undergo a series of basic tests to start with, which are carried out on every couple. These include an ultrasound scan for women and a sperm analysis for men.

Related Articles

• Infertility Tests for women
• Infertility Tests for men