Basics of Male Fertility Tests
Statistically, male infertility is the cause of difficulty in conception in 20 percent (sometimes as much as 50 percent) of cases. For this reason it's as important for men to get tested for fertility as it is for women. Often male fertility tests are less invasive and less expensive than women's infertility testing.
The Medical Evaluation
A couple is considered infertile by most doctors if they haven't conceived after 12 months of frequent sex with no family planning or birth control. Technically not conceiving within 12 months doesn't mean a couple is infertile, but they could have impaired fertility and can get pregnant within a year or two after the initial 12 months. A successful pregnancy may require basic infertility treatments.
Diagnosing or ruling out male infertility begins with a visit to an urologist. The visit involves a basic physical exam and interview. During the interview the doctor will ask about your lifestyle and whether you smoke, exercise or use recreational drugs. You'll be asked if you've had any surgeries and which surgeries you've had. Any medications you're taking will be discussed. Your doctor will also likely discuss your sexual life and if you have any problems with sex. You will be asked if you have ever had or currently have any sexually transmitted diseases.
If a semen analysis is required, the man will need to provide a semen sample. Usually it's done nearby or right in the doctor's office so that an analysis can be done quickly.
The semen will be examined under a microscope. Sperm shape, movement and count will be assessed by a trained expert. In most cases, if there are a high number of normal-shaped sperm, the male fertility is higher. But even men with abnormal sperm or low sperm counts are fertile.
If nothing suspicious shows up in the first test, the doctor may order an additional test to confirm the results. Two normal semen analyses usually mean that the man doesn't have infertility problems. If the analyses show anything irregular, more tests may be needed to figure out the problem.
No semen or sperm (azoospermia) is actually less of a concern than abnormal sperm since no sperm can simply mean a blockage that can be relatively easily fixed with surgery.
Some men have atypical antibodies in their sperm that attack the sperm before it reaches the egg so that conception can't occur. Other times there is nothing wrong with a man's sperm, but the sperm can't get where it needs to go. Sometimes the sperm ejaculates backwards into the bladder in what's medically called retrograde ejaculation. Sometimes there are abnormal veins above the testicles that affect the ability of sperm to properly leave the body. This is usually discovered during a physical exam and is correctable with surgery.