Ways That Doctors Can Diagnose Male Infertility

When couples find that they are struggling with infertility, they begin the process on finding a diagnosis. Both men and women can contribute to the causes so both should seek out medical assistance to get a diagnosis for their infertility.

Here is what might be involved in diagnosing male infertility.

Your diagnosis will start with a complete medical exam and past medical history. Be prepared for the doctor to ask personal questions such as past and current sexual habits, sexual development during puberty and sexual history including any STDs.

Men will be asked to provide a semen sample either by masturbating and ejaculating into a special container at the doctor's office or collected at home by using a special condom during intercourse. The semen is then sent to a laboratory for a number of tests like measuring the number of sperm present and looking for abnormalities in the shape and/or movement of the sperm. Because sperm counts fluctuate significantly from one specimen to the next, several semen analysis tests are done over a period of time to ensure accurate results.

Other Tests That Can Be Ordered

  • A scrotal ultrasound uses high-frequency sound waves to produce images inside the body. A scrotal ultrasound can help your doctor see if there are problems in the testicles and supporting structures.

  • Hormone testing. Hormones produced by the pituitary gland, hypothalamus and testicles play a key role in sexual development and sperm production. Abnormalities in other hormonal or organ systems also might contribute to infertility. A blood test measures the level of testosterone and other hormones.

  • Post-ejaculation urinalysis. Sperm in your urine can indicate your sperm are traveling backward into the bladder instead of out your penis during ejaculation (retrograde ejaculation).

  • Genetic tests. When sperm concentration is extremely low, there could be a genetic cause. A blood test can reveal whether there are subtle changes in the Y chromosome — signs of a genetic abnormality. Genetic testing might be ordered to diagnose various congenital or inherited syndromes.

  • Testicular biopsy. This test involves removing samples from the testicle with a needle. If the results of the testicular biopsy show that sperm production is normal, your problem is likely caused by a blockage or another problem with sperm transport.

  • Specialized sperm function tests. A number of tests can be used to check how well your sperm survive after ejaculation, how well they can penetrate an egg and whether there's any problem attaching to the egg. Generally, these tests are rarely performed and often do not significantly change recommendations for treatment.

  • Transrectal ultrasound. A small, lubricated wand is inserted into your rectum. It allows your doctor to check your prostate and look for blockages of the tubes that carry semen (ejaculatory ducts and seminal vesicles).

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Michael Hickey